Index

INDEX
Note: Disorder names and key terms are in bold face. Page numbers in
bold face indicate main discussions. Page numbers followed by f, t, or b
indicate figures, tables, and boxed material, respectively.
A
A blood type, 629630, 630t
A1C, in diabetes mellitus, 1192, 1193
A1C test, in diabetes mellitus, 1193
AB blood type, 629630, 630t
Abarelix (Plenaxis), for prostate cancer, 1359t
Abatacept (Orencia), for rheumatoid arthritis, 1605t1607t, 16131614
Abciximab (ReoPro), for angina/acute coronary syndrome, 752t
ABCs
of burn management, 456
of emergency nursing, 1719
ABCDEs, of melanoma, 427, 429f
ABCDEFs, of angina treatment, 750t
Abdomen
assessment of, 884889
examination of, 886
auscultation in, 887
inspection in, 886-887
palpation in, 888, 888f
percussion in, 887
imaging studies of, 632t, 891892, 891t894t
quadrants of, 886, 887f
regions of, 886, 887f
Abdominal aortic aneurysms, 844845, 845f, 847f. See also Aortic aneurysms.
Abdominal breathing, 597
relaxation, 94, 94t
Abdominal bruits, 890t, 1084
Abdominal compartment syndrome, 994995, 1679
Abdominal distention, 890t
in irritable bowel syndrome, 994
postoperative, 345347, 356, 1127
Abdominal fat, vs. visceral fat, 921, 923f, 923t
Abdominal gas, 355356
Abdominal girth, measurement of, 10541056
Abdominal pain. See also Pain.
acute, 990991, 991t, 996f
chronic, 992993
emergency management of, 992t
rebound, 890t
Abdominal paradox, 484t485t
Abdominal surgery, 992993
postoperative care in, 993
preoperative care in, 993
Abdominal trauma, 994995, 995t
Abducens nerve, 1378f, 1378t
examination of, 1382
Abduction, 1538t
Abortion, 1316
induced, 13161317, 1317t, 1318b
spontaneous, 1316
Abrasion, corneal, 371t
Abscess
anorectal, 1028, 1028f
brain, 1418t, 1416
lung, 533534
pancreatic, 1062
peritonsillar, 503
tubo-ovarian, 13271328, 1327f
Absence seizures, 1456

Absolute neutrophil count, 664
Absolute refractory period, 691692, 799800, 800f
Absorption atelectasis, 596
Abuse, elder, 6364, 64t
Acanthamoeba keratitis, 388
Acanthosis nigricans, in diabetes mellitus, 1222
Acapella device, 599, 602f
Acarbose (Precose), for diabetes mellitus, 1200t, 1201
Accelerated idioventricular rhythm, 808
Access to care
health disparities and, 2122. See also Health disparities.
Accessory nerve, 1378f, 1378t
Accolate (zafirlukast)
for allergic rhinitis, 496t497t
for asthma, 571575, 573t574t
Accommodation, visual, 366
Acculturation, 22, 2728
AccuNeb. See Albuterol.
Accupril (quinapril), for hypertension, 724t727t
Accutane (isotretinoin), for acne, 435b
ACE inhibitors. See Angiotensin-converting enzyme (ACE) inhibitors.
Acebutolol (Sectral), for hypertension, 724t727t
Aceon (perindopril), for hypertension, 724t727t
Acetaminophen (Tylenol), 122, 123t
for inflammation, 173, 174t
for osteoarthritis, 16041608
hepatotoxicity of, 1043b
overdose of, 1731t
Acetazolamide (Diamox), for glaucoma, 399t400t
Acetohydroxamic acid, for urinary calculi, 1110
Acetylcholine, 1374t
Achalasia, 954, 957, 957f
Achilles tendon reflex, assessment of, 1385
Achilles tendonitis, 1539t
Acid ingestion, 1731t
Acid-base balance, 300304
buffers in, 301
pH and, 300, 301f
regulation of, 300301, 10781079
renal system in, 301, 1077
respiratory system in, 301
terminology of, 300t
Acid-base imbalances, 300304
assessment in, 304306, 305t
blood gas values in, 304, 304t
clinical manifestations of, 304, 303t, 305t
diagnosis of, 303, 304
in chronic kidney disease, 1143
metabolic acidosis, 302t303t, 303. See also Metabolic acidosis.
metabolic alkalosis, 302t303t, 303. See also Metabolic alkalosis.
mixed, 323
respiratory acidosis, 302, 302t303t, 565566. See also Respiratory
acidosis.
respiratory alkalosis, 302303, 302t303t, 565566. See also
Respiratory alkalosis.
ROME mnemonic for, 304t
Acid-fast bacilli test, in tuberculosis, 530
1
th
LewissMedicalSurgicalNursing,8 ed,Philippineedition
Acidosis, 300. See also Acid-base imbalances.

Aciphex. See Rabeprazole (Aciphex).
Acne vulgaris, 421t, 436f, 436t437t
Acoustic nerve, examination of, 1383
Acoustic neuromas, 406, 1412t
Acova (argatroban), for venous thromboembolism, 863t, 864
Acquired immunodeficiency syndrome (AIDS), 226. See also Human
immunodeficiency virus infection.
Acrochordons, 436t437t
Acromegaly, 12261228, 1227f
Acromioplasty, 1549
Acropachy, 1236, 1236f
Actemra (tocilizumab), for rheumatoid arthritis, 1605t1607t, 1614
ACTH, 1172t, 1175
deficiency of, 1229
in Addisons disease, 12511252
in Cushing syndrome, 1249
measurement of, 1186t1187t
ACTH stimulation test, 1252
Actigall (ursodiol), for primary biliary cirrhosis, 1044
Actigraphy, 102
Actinic keratosis, 427, 428t
fluorouracil for, 439
Actinomycosis, 533, 533t
Action potentials, 1373
cardiac, 690, 796f
Actiq. See Fentanyl.
Activase. See Alteplase (Activase).
Activated charcoal, for poisoning, 1731
Activated clotting time, 630t, 864t
Activated partial thromboplastin time, 630t, 864t
Active acquired immunity, 194, 194t
Active listening, 47
Active transport, 284285
Activities of daily living, in chronic illness, 59
Activity and exercise. See also under Exercise.
body weight and, 927, 929
FITT formula for, 744745, 769t
immobilization and, 15601561
in cardiac rehabilitation, 766, 768t
in COPD, 603604
in coronary artery disease, 741, 742743
in cystic fibrosis, 609
in diabetes mellitus, 1204, 1204t
in hypertension, 721
in multiple sclerosis, 1467
in older adults, 6768, 68b
in osteoarthritis, 1604, 1609
in osteoporosis prevention, 1596
in pain management, 131
in peripheral arterial disease, 854
in rheumatoid arthritis, 1618
isotonic, 768
measurement of, 767, 768t
metabolic equivalents for, 767, 768t
postoperative, 352
static, 768
Activity-exercise pattern, 37t, 38
Actonel (risedronate)
for osteoporosis, 1596
for Pagets disease, 15971598
Actoplus Met (metformin/pioglitazone), 1200t
Actos (pioglitazone), for diabetes mellitus, 1201
Acupressure, 83
Acupuncture, 83, 131, 1591b
for headaches, 1452b
Acute abdominal pain, 990991, 991t, 996f
Acute alcohol toxicity, 159

Acute arterial ischemia, 857858
Acute bronchitis, 520
Acute chest syndrome, 648650
Acute coronary syndrome, 754
acute intervention in, 764
ambulatory and home care for, 766
assessment in, 762t
collaborative care for, 751f, 750t, 758761
diagnosis of, 751f, 757758
ECG in, 814815, 814t
nursing care plan for, 763b764b
nursing diagnoses for, 762
nursing management of, 762770
patient teaching for, 767, 767t, 769t
planning in, 762
rehabilitation in, 765t, 767
Acute illness, 57, 58t
Acute kidney injury, 11351140
clinical manifestations of, 11361138
collaborative care in, 11391140, 1139t
continuous renal replacement therapy for, 11591160
contrast-associated nephropathy and, 1140
diagnosis of, 1138, 1139t
diuretic phase of, 1138
etiology of, 1136, 1137t
in multiple organ dysfunction syndrome, 1694
in older adults, 1141
in systemic inflammatory response syndrome, 1694
intrarenal, 1136
nutritional therapy for, 1140
oliguric phase of, 1136
pathophysiology of, 1136
postrenal, 1136
prerenal, 1136
recovery phase of, 1138
staging of, 1136, 1137t
vs. chronic kidney disease, 1136t
Acute liver failure, 1058
Acute lung injury, 1711, 1714t. See also Acute respiratory distress
syndrome (ARDS).
Acute lymphocytic leukemia, 670, 669t, 672t. See also Leukemia.
Acute myelogenous leukemia, 670, 670f, 669t. See also Leukemia.
Acute necrotizing ulcerative gingivitis, 945t
Acute pancreatitis, 1061, 1062f, 1063t1064t
Acute pericarditis, 823825. See also Pericarditis.
Acute pharyngitis, 502
Acute poststreptococcal glomerulonephritis, 1104, 1104t
Acute pyelonephritis, 10991100
Acute radiation syndrome, 1734, 1736t
Acute respiratory distress syndrome (ARDS), 552t, 17111715
case study of, 1717b
chronic (late) phase of, 1713
clinical progression of, 1713
collaborative care for, 17151717, 1715t
complications of, 17131714, 1714t
etiology of, 17111712
fibrotic phase of, 1712
fluid therapy for, 1716
injury (exudative) stage of, 17121714
mechanical ventilation in, 17151716
2
th
complications of, 17131714

medical supportive therapy for, 1716
pathophysiology of, 17111713, 1712f
positioning in, 17151716
reparative (proliferative) phase of, 1713
Acute respiratory failure. See Respiratory failure.
Acute tubular necrosis, 1136, 1137f
burns and, 448, 455
electrical injury and, 448
posttransplant, 1165
Acute viral rhinitis, 495497
Acyclovir (Zovirax)
for encephalitis, 1421
for genital herpes, 1307, 1308t
for postherpetic neuralgia prevention, 432b
Adalat CC (nifedipine), for hypertension, 724t727t
Adalimumab (Humira)
for inflammatory bowel disease, 10021003, 1022t
for rheumatoid arthritis, 16051607, 16131614
Adaptive grief, 143
Adaptive support ventilation, 1663
Addiction, 153t. See also Substance abuse.
definition of, 133, 153t
to opioids, 133
withdrawal in, 154t, 162
Addictive behaviors, 152, 153t
Addisonian crisis, 1252
Addisons disease, 1248t, 12511252, 1252t
preoperative management of, 320
Adduction, 1538t
Adefovir (Hepsera), for hepatitis, 10381039, 1038b
A-delta fibers, 115116
Adenohypophysis, 1175. See also Pituitary gland.
Adenomas, pituitary, 1412t
Adenosine (Adenocard)
for dysrhythmias, 809t
for paroxysmal supraventricular tachycardia, 803, 803b
Adenosine triphosphate, in muscle contraction, 1534
Adherence, ethical aspects of, 834b
Adhesions, 179t
Adipex-P (phentermine), abuse of, 154t, 160
Adipokines, 1192
Adjustable gastric banding, 931t, 932, 932f
Admission, same-day, 315
Admission observation, and discharge (AOD) area, 331
Adrenal androgens, 1177. See also Androgen(s).
Adrenal cortex, 1177
disorders of, 1247
hypofunction of, 12511252
Adrenal glands, 1177
disorders of
cortical, 1247
medullary, 1255
in fluid balance, 286288, 287f
in older adults, 1178t
structures and functions of, 1200f, 1174, 1177f
Adrenal hormones, 1172t, 1177
measurement of, 1184t1187t, 1187
Adrenal medulla, 1177
disorders of, 1255
Adrenalectomy
for Cushing syndrome, 12501251
for hyperaldosteronism, 1255
for pheochromocytoma, 1255
Adrenalin. See also Epinephrine (Adrenalin).
Adrenaline, endogenous, 1172t, 1177, 1374t

Adrenocortical insufficiency, 12511252
Adrenocorticotropic hormone. See ACTH.
Adult day care programs, 65
Adult inclusion conjunctivitis, 387

Adult T-cell leukemia, 669. See also Leukemia.
Advair. See Fluticasone/salmeterol (Advair).
Advance directives, 144, 145t
ethical aspects of, 605b
Advanced practice nurse, 34
Adventitious breath sounds, 484, 484t485t
in respiratory failure, 1705
Advil. See Ibuprofen.
Adynamic (paralytic) ileus, 1007
in spinal cord injury, 15121513
postoperative, 847
Afinitor (everolimus), for cancer, 269t270t
African Americans. See also Race/ethnicity.
cancer in, 241, 242b
culture-bound syndromes of, 29t
drug therapy in, 29t
heart failure in, 775b, 785
keloids in, 179f, 179t
multiple sclerosis in, 1464
prostate cancer in, 1360
sickle cell disease in, 641t, 647649
skin assessment in, 185t, 419t, 420421
skin disorders in, 420422, 422f
stroke in, 1426b, 1425
Afterload, 693, 1642, 1643t
Ageism, 21, 60
Age-related macular degeneration, 396397
Amsler grid test for, 374t
Aggrastat (tirofiban), for angina/acute coronary syndrome, 749t
Aggression, in Alzheimers disease, 14911494
Aging. See also Older adults.
biologic, 61
gender differences in, 6162, 62b
Agitation
delirium and, 14961497
in respiratory failure, 17081710s
Agnosia
after stroke, 1430
in Alzheimers disease, 1489
AIDS, 226. See also Human immunodeficiency virus infection.
Air embolism
in pulmonary artery catheterization, 1651, 1651b
pulmonary embolism and, 553
Air pollution
asthma and, 563
COPD and, 585
Airborne infection isolation, 532
Airborne precautions, 222
Airway burns, 446448, 451, 452t, 455, 455t
management of, 455457
Airway clearance techniques. See also Suctioning.
for bronchiectasis, 611
for COPD, 598599
for cystic fibrosis, 608609
for respiratory failure, 17061708
Airway management
emergency, 17191722
for facial fractures, 1570
for intermaxillary fixation, 1571
in anesthesia, 338339
in burn injury, 453, 455457
3
th
in head and neck cancer, 514516

in stroke, 1438
tracheostomy in, 503504. See also Tracheostomy.
Airway obstruction, 503
postoperative, 346, 348t, 349f
tracheostomy for, 503504. See also Tracheostomy.
Airway pressure release ventilation, 16621663, 1663t
Airway stents, for lung cancer, 540
Airways, artificial, 16541656. See also Endotracheal intubation.
Akarpine (pilocarpine), for glaucoma, 399t400t
AK-Homatropine (homatropine hydrobromide), for pupillary dilation,
392t
AK-Pentolate (cyclopentolate), for pupillary dilation, 392t
Alair Bronchial Thermoplasty system, 571
Alanine aminotransferase, 896t
Albumin, 307
transfusion of, 681t
Albuterol
for asthma, 570572, 573t574t, 575
for COPD, 591592
Alcohol Use Disorders Identification Test (AUDIT), 164, 163t, 167
Alcohol use/abuse, 154t, 157159. See also Substance abuse.
acute pancreatitis and, 1062
blood alcohol concentration and, 157, 159t
by college students, 1046b
by surgical patients, 314315
cirrhosis and, 1044, 1045f
collaborative care for, 159
dependency in, 159
drug interactions and, 159
effects and complications of, 153155, 159t
gastritis and, 962
in diabetes mellitus, 1202t, 1203
in Hodgkins lymphoma, 674
intoxication in, 159160
Korsakoffs psychosis and, 159160
stroke and, 14251426
surgery and, 165, 165t
Wernickes encephalopathy and, 157160
withdrawal in, 160, 160t
postoperative, 353
Aldactone. See Spironolactone (Aldactone).
Aldara (imiquimod), 439440
for human papillomavirus, 1308
Aldesleukin (interleukin-2), for cancer, 269t270t
Aldolase, in muscle disorders, 1540t1542t
Aldomet (methyldopa), for hypertension, 724t727t
Aldosterone, 1177
excess of, 291292, 1254
in fluid and electrolyte balance, 287288, 287f, 1078, 1079f
Aldosterone antagonists, for heart failure, 784
Aldosterone receptor blockers, for hypertension, 724t727t, 727
Alemtuzumab (Campath), for cancer, 269t270t
Alendronate (Fosamax), for osteoporosis, 1596
Aleve (Naproxen), 123t
Alginate dressings, 181t
Aliskiren (Tekturna), for hypertension, 724t727t
Alkali ingestion, 1731t
Alkaline phosphatase, 896t
in musculoskeletal assessment, 1540t1542t
Alkalosis, 300. See also Acid-base imbalances.
Alkylating agents, 255t256t
Allegra (fexofenadine), for allergic rhinitis, 496t497t

Allen test, 1644
Allergens
avoidance of, 496t, 581583
in asthma, 562564, 568569
Allergic conjunctivitis, 388
Allergic contact dermatitis, 425, 433434, 435t
Allergic disorders/reactions, 204207. See also Hypersensitivity
reactions.
allergen recognition and control in, 206
anaphylaxis in. See Anaphylactic shock; Anaphylaxis.
chronic, 206
diagnosis of, 205
drug therapy for, 206207
drug-related, preoperative assessment for, 318
food allergies, 208
hygiene hypothesis for, 563
immunotherapy for, 207
multiple chemical sensitivities, 208
ocular, 371t
patch testing for, 422, 423f, 423t, 434
preoperative assessment for, 319
skin testing for, 205, 422, 423f, 423t
to insulin, 1199
to latex, 207208, 208t, 343
to local anesthetics, 340
transfusion-related, 682, 683t
Allergic rhinitis, 201, 495, 496t497t
asthma and, 500b, 564
sinusitis and, 500
Allodynia, 117
Allografts. See Graft(s).
Allopurinol (Alloprim, Zyloprim), for gout, 1621
Allow natural death orders, 145
Aloe, 85t
Alopecia, 421t
age-related, 416
in cancer, 262t263t, 266
in systemic lupus erythematosus, 1622
traction, 420421, 422f
Alosetron (Lotronex), for irritable bowel syndrome, 994, 994b
Alpha hydroxy acids, 441t
Alpha1-adrenergic receptors, in vascular regulation, 693
Alpha1-antitrypsin deficiency, 585586, 586b
Alpha2-adrenergic agonists, for pain, 126t, 127
Alpha-adrenergic blockers
for benign prostatic hyperplasia, 1348for glaucoma, 399t400t
for hypertension, 724t727t, 727
Alpha-fetoprotein, 248, 896t

in liver cancer, 10581059
Alphagan (brimonidine), for glaucoma, 399t400t
Alport syndrome, 11151116
Alprazolam (Xanax), abuse of, 154t, 161
Altace (ramipril), for hypertension, 724t727t
Alteplase (Activase)
for acute coronary syndrome, 737, 752t
for angina, 752t
for pulmonary embolism, 555556
Alupent (metaproterenol), for respiratory failure, 1709
Alveolar ducts, 471, 472f
Alveolar hyperventilation. See also Hyperventilation.
ventilator-associated, 1665
4
th
Alveolar hypoventilation. See also Hypoventilation.

Alveolar macrophages, 476
Alveolar sacs, 471, 472f
Alveolar-capillary membrane, 471, 472f
Alveoli, 471, 472f
collapsed. See Atelectasis.
surfactant and, 472
Alveolitis, extrinsic allergic, 535, 535t
Alvesco (ciclesonide), for asthma, 571, 573t574t
Alzheimers disease, 14851490
amyloid plaque in, 1486, 1487f
behavioral problems in, 14911494
caregiver support in, 1494s
clinical manifestations of, 1484t, 1488, 1488t
complementary and alternative therapies for, 1489, 1490b
delegation in, 1497b
diagnosis of, 1489, 1489f, 1489t
drug therapy for, 1489, 1490t
early warning signs of, 1488t
eating/swallowing problems in, 1494
epidemiology of, 14851587
familial, 1485
family/caregiver teaching for, 1488t, 1496t
gender differences in, 1486b
genetic factors in, 1486b, 1486
health promotion for, 1490
home care for, 14911495
implementation in, 14911495
memory loss in, 1488
vs. normal forgetfulness, 1485t
neurofibrillary tangles in, 1484t, 1486, 1487f
nutritional therapy in, 1494
oral care in, 1494
pain management in, 1494
pathophysiology of, 1482, 14851488, 1487f1488f
planning in, 1490
pneumonia in, 1495
safety concerns in, 1494
sexual dysfunction in, 1495
skin care in, 1495
support groups for, 1495
tau proteins in, 1486, 1487f
urinary tract infections in, 1495
vs. mild cognitive impairment, 1485t
Amantadine (Symmetrel), for Parkinsons disease, 1472
Amaryl (glimepiride), for diabetes mellitus, 1200, 1200t
Amaurosis fugax, 1427
Ambien (zolpidem), for insomnia, 104
Ambrisentan (Letairis), for pulmonary hypertension, 557
Ambu bag, 1655
Ambulation
after amputation, 1574
assistive devices for, 1563
fractures and, 1563
postoperative, 352
Ambulatory care, 75, 75t. See also specific disorders.
Ambulatory electrocardiography, 703t707t, 708, 801

Ambulatory monitoring
of blood pressure, 720
of heart rate, 692, 703t707t, 708, 800801
Ambulatory phlebectomy, 868
Ambulatory surgery, 314324, 315, 323
discharge from, 358360, 359t
patient teaching for, 327, 323t
postoperative care in, 359360, 359t
preoperative care in. See Preoperative care.
Amebic dysentery, 983t
Amenorrhea, 1264, 1268, 1318, 13201321, 1320t
primary, 1320
secondary, 1320
American Diabetes Association (ADA), 12121213
American Holistic Nurses Association (AHNA), 82
American Nurses Association (ANA)
nursing definition of, 23
nursing practice domain and, 2
nursing terminologies and, 9, 9t. See also Standardized nursing
terminologies.
American Spinal Association Impairment Scale, 1510, 1512f
American Urological Association symptom index, 13461347, 1348t
Amicar (epsilon-aminocaproic acid), for hemophilia, 656, 660t
Amidate (etomidate), in general anesthesia, 340t
Amifostine, 265
Amiloride (Midamor)
for cirrhosis, 1053t
for hypertension, 724t727t
-Aminobutyric acid (GABA), 1374t
Aminoglutethimide (Cytadren), for breast cancer, 1289t, 1290
Aminophylline, for asthma, 573t574t, 572
5-Aminosalicylates, for inflammatory bowel disease, 1002t
Amiodarone (Cordarone), for dysrhythmias, 809t
Amish, health beliefs and practices of, 26t
Amitiza. See Lubiprostone (Amitiza).
Amitriptyline (Elavil), for interstitial cystitis, 11021103
Amlodipine (Norvasc)
for angina/acute coronary syndrome, 724t727t
Ammonia, 896t
Amobarbital (Amytal), abuse of, 154t, 161
Amoxicillin, for H. pylori infection, 963t
Amphetamines, abuse of, 153t154t, 160, 161t
Amphiarthrotic joints, 1532f
Amphotericin B (Fungizone), for infective endocarditis, 822t
Ampicillin, for infective endocarditis, 822t
Amputation, 15711572, 1572f1574f
bandaging for, 15731574, 1574f
diagnostic studies for, 1572, 1572t
for peripheral arterial disease, 854
guillotine, 1572
indications for, 1571
lower extremity, in diabetes mellitus, 1221
patient teaching for, 1574t
phantom limb sensation and, 1573
prostheses for, 15731574, 1573f
residual limb (stump) in, 1572
sites and types of, 1572f
Syme, 1572
upper limb, 1573f, 1574
5
th
Ampyra (famipridine), for multiple sclerosis, 1467

Amsler grid test, 374t
Amylase, serum, 891t894t
in acute pancreatitis, 1062, 1063t
Amylin, 1172t
Amyloid plaque, 1486, 1487f
Amyloid precursor protein, 1486
Amyloidosis, renal involvement in, 1116
Amyotrophic lateral sclerosis (ALS), 14781479
pulmonary complications of, 551t
Amytal (amobarbital), abuse of, 154t, 161
Anabolic hormones, 1178
Anakinra (Kineret), for rheumatoid arthritis, 1605t1607t, 16131614
Anal fissures, 890t, 1028
Anal fistulas, 1028, 1028f
Analgesic ceiling, 122
Analgesic titration, 128
Analgesics. See also Pain management.
adjuvant, 126t, 127128
antidepressants as, 117, 119, 126t, 127
antiseizure drugs as, 119, 126t, 127
cannabinoids as, 127128
for substance abusers, 136137
in patient-controlled analgesia, 130
intraspinal, 129130, 129f
mechanism of action of, 117
muscle relaxants as, 126t, 127
nonopioid, 117, 122123
NSAIDs as, 116. See also Nonsteroidal antiinflammatory drugs
(NSAIDs).
opioid, 117, 120, 123127. See also Opioids.
opioid-sparing effect of, 122
side effects of, 122, 122t
topical, 129
Anaphylactic shock, 1677. See also Shock.
clinical manifestations of, 1676t
collaborative care for, 1689t, 1690
hemodynamic parameters in, 1674t
precipitating factors in, 1673t
Anaphylaxis, 201203, 202f, 202t, 222, 223t
in surgical patients, 343
transfusion-related, 682, 683t
Anasarca, in nephrotic syndrome, 1107
Anastrozole (Arimidex), for breast cancer, 1289t, 1290
Anatacids, for peptic ulcers, 969972
Anatomic dead space, 471
Andragogy, 46
Androgen(s), 1172t, 1177, 1247, 12611262, 1262f. See also
Corticosteroids.
age-related decrease in, 1368, 1369t
Androgen deprivation therapy, for prostate cancer, 13581360, 1359t
Android obesity, 922923, 923f, 923t
Andropause, 13681369, 1369t
Anemia, 635637
aplastic, 645, 645t
cardiopulmonary symptoms in, 636637, 637t
classification of, 635, 636t637t
clinical manifestations of, 636, 637t
decreased erythropoiesis and, 637t, 639640
definition of, 635
etiology of, 636f, 636t637t
folic acid deficiency and, 644
from blood loss, 641t, 646, 646t
hemolytic, 641t, 647, 647f
acquired, 650
in sickle cell disease, 647649
laboratory findings in, 641t

hypoxia and, 635
in chronic kidney disease, 1143, 1148
in inflammatory bowel disease, 1004
in thalassemia, 642
iron-deficiency, 640641, 641t, 1004
macrocytic, normochromic, 636t
megaloblastic, 643, 643t
microcytic, hypochromic, 636t
morphology of, 636, 636t
normocytic, normochromic, 636t
of chronic disease, 641t, 644645
pernicious, 641t, 643644, 963
postgastrectomy, 975
planning in, 637
severity of, 636, 637t
sickle cell, 641t, 647649. See also Sickle cell disease.
skin changes in, 636, 637t
vitamin B12 deficiency and, 643644
Anergy, 200
Anesthesia, 337. See also Pain management; Postoperative care.
agents for, 126t, 127
anaphylaxis and, 343
classification of, 338342, 338t
delayed emergence from, 353
dissociative, 339, 340t
emergence delirium and, 352353
fear of, 316
general, 338339, 338t
adjuncts to, 339, 341t
airway management in, 338339
balanced technique in, 338
inhalation agents in, 338339, 340t
intravenous agents in, 338, 340t
phases of, 339t
in older adults, 342, 360
local, 126t, 127, 338t, 339342
administration of, 341342
allergic reactions in, 343
malignant hyperthermia and, 343
monitored anesthesia care and, 337, 338t
nurses role in, 332334, 336, 339t
physical status classification for, 320, 321t, 337
preoperative fasting and, 323, 324t, 325b
recovery from, 345347
regional, 130, 338t, 339342
ultrasonic-guided, 343
spinal, 342, 342f
total intravenous, 338
Anesthesia care provider, 333, 339t
Anesthesiologist, 333, 339t
Anesthesiology, 333
Aneurysms
aortic, 844847
cerebral
clipping of, 1435, 1435f
rupture of, 1428, 1429b
6
th
classification of, 845, 845f

definition of, 844
false, 845, 845f
fusiform, 845, 845f
rupture of, in stroke, 14351437
saccular, 845, 845f
true, 845, 845fventricular, 757
Anger, in dying patient, 147
Angina
assessment of, 748t
chronic stable, 748750, 750t. See also Angina.
collaborative care for, 750754, 751f, 750t
clinical manifestations of, 749, 749f
drug therapy for, 750753, 751f
ACE inhibitors for, 750t, 754
antiplatelet agents for, 747
aspirin for, 752t, 747
beta-adrenergic blockers for, 752t, 751753
calcium channel blockers for, 752t, 753
lipid-lowering drugs for, 745747, 746b, 747t
nitrates for, 752t, 750751
sodium current inhibitors for, 745t, 753
microvascular, 749, 750t
nocturnal, 749
pain location in, 749, 749f
precipitating factors for, 749t
Prinzmetals (variant), 749, 750t
unstable, 750t, 754, 754f. See also Acute coronary syndrome.
collaborative care for, 751f, 750t, 758761
diagnosis of, 757758
Angina decubitus, 749
Angioedema, 203
Angiogenesis, 181
collateral circulation and, 738
tumor, 246
Angiogenesis inhibitors, for cancer, 269t270t, 270
of breast, 1290
Angiography
cerebral, 1386, 1388f, 1388t1389t
in stroke, 14301431
computed tomography, 703t707t
in stroke, 1430
coronary, 703t707t, 710, 757
fluorescein, ocular, 374t
intraarterial digital subtraction, in stroke, 1431
magnetic resonance
cerebral, 1086t1090t
in stroke, 1430
renal, 1086t1091t
of aortic aneurysms, 846
peripheral, 703t707t, 711
pulmonary, 487t488t, 555
renal, 1086t1091t, 1088f
Angiomas, 419, 421t, 626t627t
spider, in cirrhosis, 1046
Angiomax (bivalirudin), for venous thromboembolism, 863t, 864
Angiopathy, diabetic, 12181219
Angioplasty, balloon, 753, 753f
complications of, 754, 759
emergent, 759
for peripheral arterial disease, 851b, 855
transluminal, 14321433, 1432f
Angiotensin
in fluid and electrolyte balance, 287f, 287, 1079

in heart failure, 776
Angiotensin II receptor blockers
for angina/acute coronary syndrome, 752t
for heart failure, 782t, 784
Angiotensin-converting enzyme (ACE) inhibitors
for acute coronary syndrome, 752t, 761
for angina, 750t, 751
for heart failure, 780, 782t, 783
nephrotoxicity of, 1141
side effects of, 784
Angle of Louis, 471, 471f, 699, 700f
Anicteric hepatitis, 1036
Animal bites, 1730
Anion gap, 306
Anions, 282
Anismus, 989
Anisocoria, 371t, 1387t
Ankle arthroplasty, 1577
Ankle-brachial index, 852
Ankylosis, 1539t
Annuloplasty, 834
Anorectal abscess, 1028, 1028f
Anorectal disorders, 10261027
Anorectal gonorrhea, 1301
Anorexia
in dying patient, 148t150t
nausea and, 940
Anorexia nervosa, 918
Anosognosia, 1387t
Anovulatory cycles, 1263, 1320
Antacids
drug interactions with, 969
for GERD, 951
for peptic ulcers, 968
for upper GI bleeding, 960t
preparations of, 968t
side effects of, 968t
Antagon (ganirelix), for infertility, 1316t
Antalgic gait, 1539t
Antegrade pyelogram, 1086t1090
Anterior cerebral artery, 1378, 1379f
Anterior chamber, 365, 365f
Anterior colporrhaphy, 1341
Anterior cord syndrome, 1510, 1512f
Anterior cruciate ligament injury, 1550, 1550f
Anthrax, in terrorism, 17321734, 1733t1734t
Anthropometric measurements, 905
Anti-A antibodies, 629
Antiandrogen therapy, for prostate cancer, 13591360, 1359t
Anti-B antibodies, 629
Antibiotics
antitumor, 255t256t
for bacterial meningitis, 1417, 1419t
for burns, 459460, 460b
for chlamydial infections, 1305, 1305t
for gonorrhea, 13011303, 1302t
for H. pylori infection, 963t, 969
for infective endocarditis, 822823, 822t
for neutropenia, 666
for osteomyelitis, 1583
for pelvic inflammatory disease, 1328
7
th

for pneumonia, 525, 524t
for prostatitis, 1362
for septic shock, 1688
for sinusitis, 501
for syphilis, 1301t, 1304
for urethritis, 1101
for urinary tract infections, 10951097, 1097t, 1098
preoperative, 325327, 327t
prophylactic
for infective endocarditis, 822, 821t, 821b
for rheumatic fever, 829
resistance to, 220221, 220t
in pneumonia, 523, 525
sensitivity testing for, 1096
topical, 180, 438439
Antibodies (immunoglobulins), 197t, 200, 212
Anticholinergics
for allergic rhinitis, 495, 496t497t
for asthma, 573t574t, 572
for COPD, 591594
for Parkinsons disease, 1471
Anticholinesterases, for myasthenia gravis, 14761477
Anticipatory grief, 143
Anticoagulants
bleeding due to, 886, 886b
complementary and alternative therapies and, 864b
drug interactions with, 860t, 864
for acute arterial ischemia, 858
for atrial fibrillation, 804805, 805t, 805b
for burns, 459t, 460
for disseminated intravascular coagulation, 664
for prosthetic valves, 818, 834, 836
for stroke, 1431, 1433
for venous thromboembolism, 861866, 862t, 866b
nursing interventions for, 866t
Anticonvulsants. See Antiseizure drugs.
Antidepressants
abuse of, 153t154t, 160161
for Alzheimers disease, 1490
for burns, 459, 459t
for chronic fatigue syndrome, 16341635
for diabetic neuropathy, 12201221
for insomnia, 105, 104t
for interstitial cystitis, 11021103
for menopausal symptoms, 1324
for narcolepsy, 106107, 107t
for obesity, 930, 930b
for pain, 116, 118, 126t, 127
for smoking cessation, 155156, 156t, 155b
overdose of, 1780t
Antidiarrheals, 984, 984t
for inflammatory bowel disease, 1002t
for short bowel syndrome, 1026
Antidiuretic hormone (ADH), 1078, 1172t, 11751176
functions of, 1176
in diabetes insipidus, 287, 12311232
in fluid balance, 286287
in hypernatremia, 291
inappropriate secretion of. See Syndrome of inappropriate antidiuretic
hormone.
plasma osmolality and, 1176, 1176f

regulation of, 1176t
Antidiuretic hormone stimulation test, 1184t1187t
Anti-DNA antibodies, 1540t1542t
Antidysrhythmics, 810, 809t
prodysrhythmias and, 809
Antiembolism stockings, 862
Antiemetics, 941942, 942t
in anesthesia, 341t
in chemotherapy, 262t263t, 264
Antiepileptics. See Antiseizure drugs.
Antiestrogens, for cancer, 255t256t
Anti-factor Xa, 864t
Antifibrinolytics, for hemophilia, 658
Antifreeze (ethylene glycol) poisoning, 1731t
Antifungal agents
for pulmonary infections, 534
Anti-GBM antibodies, 1103
Antigens, 195
CD, 195
human leukocyte, 211212, 211f
major histocompatibility, 211212
oncofetal, 248
tumor-associated, 250
Antihistamines, 439
for allergic disorders, 206
for pruritus, 442
for sinusitis, 501
Antihypertensives, 723729, 724t727t. See also Hypertension, drug
therapy for.
for chronic kidney disease, 1147
for stroke, 14331434
Anti-IgE, for asthma, 573t574t, 572
Antiinflammatory drugs, 174, 174t. See also Corticosteroids;
Nonsteroidal antiinflammatory drugs (NSAIDs).
Antimalarial drugs, for systemic lupus erythematosus, 1605t1607t,
16241625
Antimetabolites, 255t256t
Antinuclear antibodies, 1540t1542t
Antiparkinsonian drugs, 1471, 1472t
Antiplatelet drugs
for coronary artery disease, 740t, 747748
Antipruritics, for allergic disorders, 206207
Antipsychotics
for delirium, 1497
Antipyretics, 174, 174t
Antireflux surgery, 951, 951f
Antiretroviral therapy, 228, 229t230t, 234
adherence to, 235, 235t
initiation of, 234235
patient teaching for, 234t235t
side effects of, 236237, 236f
Antiseizure drugs, 14591460, 1459t
compliance with, 1460
for migraine prevention, 1453
for pain, 119, 126t, 127
8
th
for seizures, 14591460, 1459t

for trigeminal neuralgia, 15011502
withdrawal of, 1460b
Antisepsis, surgical hand, 335336
Antitachycardia pacing, 812
Antithrombin, 630t
Antithymocyte globulin, for aplastic anemia, 645
Antithyroid drugs, for hyperthyroidism, 1236
Antitumor antibiotics, 255t256t
Antitumor necrosis factor, for inflammatory bowel disease, 1002
1003, 1002t
Antiviral drugs
for encephalitis, 1419
for genital herpes, 13071308, 1308t
for influenza, 499
Antiviral protein, 198, 199f
Antrectomy, 884t
Antrum, 878f, 879
Anuria, 1085t
Anus, 880, 881f
abscess of, 1028, 1028f
assessment of, 626t627t
disorders of, 10271028
examination of, 889, 1269
fissures of, 890t, 1028
fistulas of, 1028, 1028f
gonococcal infection of, 1302
in older adults, 882883, 883t
Anxiety
complementary and alternative therapies for, 97b
in acute coronary syndrome, 765, 766t
in COPD, 590
in critical care, 1639
in dying patient, 146
preoperative, 316
Anxiolytics, for insomnia, 102105
Anzemet (dolasetron), for nausea and vomiting, 941
AOD area, 331
Aorta, 691, 691f
Aortic aneurysms, 844847
abdominal, 844845, 845f847f
diagnosis of, 846
etiology of, 844845
surgery for, 846847
thoracic, 844845
Aortic dissection, 849850, 849f, 850t
Aortic valve, 690, 691f
Aortic valve regurgitation, 831t, 832833. See also Valvular heart
disease.
Aortic valve stenosis, 831t, 832. See also Valvular heart disease.
Aphakia, 383
Aphasia, 1387t, 1430t, 1443t
after stroke, 1430, 1442, 1443t, 1447
Brocas, 1430t
communication in, 1443t, 1443
global, 1430t
Wernickes, 1430t
Apheresis, for autoimmune disorders, 209210
Aphthous stomatitis, 890t, 945t
aphthous, 945t
HIV-related, 225, 226f, 227t
in cancer, 262t263t, 265, 512
Apical pulse, 699t700t, 701
Apidra (glulisine), 1196
Aplastic anemia, 641t, 645, 645t
Apnea, obstructive sleep, 108, 108f, 109b
Apneustic breathing, 1400f
Apocrine sweat glands, 414f, 415
Apolipoproteins, 703t707t, 708
Apomorphine (Apokyn), for Parkinsons disease, 1472
Apoptosis, 670
Appendectomy, 884t, 997
Appendicitis, 991f, 996
Appendix, 880, 881f
Appetite, 877
in diabetes mellitus, 11911192
loss of. See Anorexia.
regulation of, 924925, 924t
Appetite suppressants, 930
Apple- vs. pear-shaped body, 922, 923f, 923t
Approach magnification, 385
Apraclonidine (lopidine), for glaucoma, 399t400t
Apraxia, 1387t
after stroke, 1430
Aprepitant (Emend), for nausea and vomiting, 942
Apresoline. See Hydralazine (Apresoline).
Aquatab (benzthiazide), for hypertension, 724t727t
Aqueous humor, 366
Arachnoid layer, 1379
Arachnoid villi, 1377
Aranesp (darbepoetin ), for cancer, 271272, 271t
Arava (leflunomide), for arthritis/connective tissue disease, 1605t1607t
Arcus senilis, 367t, 368f
ARDS. See Acute respiratory distress syndrome (ARDS).
Aredia (pamidronate), 297
for multiple myeloma, 679
Areola, 1261
Arfonad (trimethaphan), for hypertension, 724t727t
Arformoterol (Brovana), for asthma, 573t574t, 572
Argatroban (Acova), for venous thromboembolism, 863t, 864
Arginine vasopressin. See Antidiuretic hormone.
Arginine-GHRH test, 1184t1187t
Argon laser trabeculoplasty, 399400
Aricept (donepezil), for Alzheimers disease, 1489
Aromasin (exemestane), for breast cancer, 1289t, 1290
Aromatase inhibitors
for breast cancer, 1289t, 1290
for cancer, 255t256t
Arrhythmias. See Dysrhythmias.
Arsenic trioxide (Trisenox), for leukemia, 671
Arterial blood gas analysis, 474, 474t, 487t488t
in acid-base imbalances, 303304, 304t
normal values for, 474t
Arterial blood pressure, 694. See also Blood pressure.
Arterial bruits, 698699, 699t700t
abdominal, 890t, 1084
Arterial embolism, 857858
Arterial hemoglobin oxygen saturation, 1643t
Arterial ischemia, acute, 857858
Arterial thrombosis, 857858
coronary artery, 755
Arterial ulcers, 851, 853
9
th
prevention of, 857, 857t

Arteries, 693, 693f. See also Circulation; specific arteries.
neural control of, 693
Arteriography. See Angiography.
Arterioles, 693, 693f
Arteriovenous fistulas, in hemodialysis, 1155, 1155f1156f
Arteriovenous grafts, in hemodialysis, 1155, 1155f
Arteriovenous malformations, rupture of, stroke and, 14351437
Arteritis, temporal, 402t
Arthralgia, in infective endocarditis, 822
Arthritis, 1601
gouty, 16201621
in rheumatic fever, 828
lupus-related, 1622
osteoarthritis, 16011608. See also Osteoarthritis.
psoriatic, 1619
race/ethnicity in, 1610b
reactive, 1619
rheumatoid, 16091614. See also Rheumatoid arthritis.
septic, 16191620
total joint arthroplasty for, 15751577. See also Arthroplasty.
Arthrocentesis, 1540t1542t, 1543
Arthrodesis, 1577
Arthroplasty, 15751577
ankle, 1576
elbow, 1576
finger joint, 1576
hip, 1576, 1576f
knee, 15751576
shoulder, 1577
Arthroscopy, 15401543, 1540t1542t
Artificial airways, 16541656. See also Endotracheal intubation.
Artificial larynx, 517, 516f
Artificial skin, 463464
Arxitra (fondaparinux), for venous thromboembolism, 863t, 864
Arzerra (ofatumumab), for cancer, 269t270t
Asbestos, lung cancer and, 535
Asbestosis, 535, 535t
Ascending tracts, 1374
Aschoffs bodies, 828
Ascites, 890t, 1048, 1047f1048f, 1048t
abdominal measurement in, 10541056
in cirrhosis, 1048, 1047f, 1048t, 1049, 1084f
management of, 1050
peritoneovenous shunt for, 1050
spontaneous bacterial peritonitis and, 1048
Aseptic technique, surgical, 336, 336t
Asians. See also Race/ethnicity.
Asmanex (mometasone)
for asthma, 573t574t
Aspart (NovoLog), 1196
Aspartate, 1374t
Aspartate aminotransferase, 896t
Aspercreme (trolamine salicylate), 129
Aspergillosis, 534, 533t
Aspiration
joint, 1543. See also Synovial fluid analysis.
pulmonary
in endotracheal intubation, 1659
in enteral nutrition, 911
postoperative, 348t, 347
prevention of, 525
with tracheostomy, 507

transthoracic needle, 489, 490f
Aspiration biopsy. See Biopsy.
Aspiration pneumonia, 522
in stroke, 1438
prevention of, 525
Aspirin, 122, 123t
asthma and, 563
for coronary artery disease, 740t, 747748
for venous thromboembolism, 862863
gastritis and, 962963
gastrointestinal bleeding and, 958
peptic ulcers and, 965, 967969
Assessment, 1011, 10f, 34
caregiver, 78, 79t
clinical application of, 4243, 43t
comprehensive, 42, 43t
cultural, 24, 2932, 30t
data collection in, 11, 3436
objective data in, 35, 3942. See also Physical examination.
subjective data in, 3639. See also Health history.
definition of, 34
delegation for, 43b
emergency, 42, 43t, 17241725
focused, 42, 43t
gaining experience in, 43
in culturally competent care, 36
in patient/caregiver teaching, 4850
nurses self-assessment, 2829
nutritional, for older adults, 63, 63t
of family caregivers, 78, 79t
pain, 119121, 119t, 121t
in nonverbal patients, 136, 136t
problem identification in, 44, 44f
sleep, 104105, 106t
spiritual, 143t
terminology for, 34
types of, 4244
Assignment, 14
Assimilation, 22
Assist-control ventilation, 1661, 1662t
Assisted coughing, 1519, 17071708, 1708f
Assisted listening devices, 410
Assisted reproductive technology, 13151316
Assisted suicide, 135
Assistive devices
for eating, 1444, 1445f
for older adults, 68
Astelin (azelastine), for allergic rhinitis, 496t497t
Astereognosis, 1387t
Asterixis
in acute kidney injury, 1138
in cirrhosis, 1049
Asthma, 562578
action plan for, 581582, 580t, 583t
air pollution and, 563564
allergens in, 563, 568
allergic response in, 201202
allergic rhinitis and, 500b, 564
aspirin and, 564
breath sounds in, 566, 567b
10
th
chest examination in, 486t

cough-variant, 566
drug therapy for, 569f, 571578, 573t574t
adherence with, 577
corticosteroids in, 571572
for acute exacerbations, 570
for intermittent/persistent asthma, 569570
for long-term control vs. quick relief, 571t
for severe/life-threatening exacerbations, 570571
inhalation devices for, 575, 576f, 575577, 576f577f
leukotriene modifiers in, 572
nonprescription drugs for, 578, 578t
drug-related, 564
early-phase response in, 564
evaluation in, 584
exacerbations of, 566, 567t
acute, 570
severe/life-threatening, 566, 567t568t
exercise-induced, 563
food additives and, 564
gastroesophageal reflux disease and, 564
genetic aspects of, 563
health care disparities and, 563b
hygiene hypothesis for, 563
immune response in, 563
late-phase response in, 564
level of control in, 569, 570t
nasal polyps and, 564
nursing care plan for, 579b
occupational, 564
pathophysiology of, 564565, 565f566f
patient teaching for, 581, 581t583t
planning in, 580
psychologic factors in, 564
quality of life in, 569, 570t
race/ethnicity and, 563b
respiratory infections and, 564
risk factors for, 563564
silent chest in, 566, 567b
sinusitis and, 501, 564
treatment of, 569571, 569f
for acute exacerbations, 570
for intermittent/persistent asthma, 568t, 569f, 569570
for severe/life-threatening exacerbations, 568t, 570571
stepwise approach in, 569571, 569f
triggers of, 563564, 563t
vs. COPD, 568t
Asthma Control Test, 569Asthma triad, 564
Astigmatism, 366, 382383
correction of
nonsurgical, 383, 384t
surgical, 383
Astrocytes, 1373
Astrocytomas, 1410. See also Brain tumors.
Asymmetric septal hypertrophy, 839

Asymptomatic bacteriuria, 1094
Asystole, 803, 809
Ataque de nervios, 29t
Ataxia, 1387t
Ataxic breathing, 1400f
Ataxic gait, 1539t
Atelectasis, 472f, 473, 552t, 553
absorption, 595
dialysis-related, 1155
in ARDS, 1712
postoperative, 348t, 349f, 354
Atenolol (Tenormin)
for dysrhythmias, 809
Atgam (lymphocyte immune globulin), for transplantation, 214t, 215
Atherectomy, for peripheral arterial disease, 854
Atherosclerosis
acute arterial ischemia in, 857858
aortic aneurysms in, 845
coronary artery disease and, 737. See also Coronary artery disease.
hypertension and, 719
in cerebral arteries, 1426f
lesion locations in, 844f
peripheral artery disease in, 843, 844f
stroke and, 1426, 1426f
Athetosis, 1384
antipsychotic-induced, 1498
Athletes foot, 433, 433t
Athletic injuries, 1545t
Atonia, 1387t
Atonic seizures, 1457
Atopic dermatitis, 203, 203f, 435t
Atopic reactions, 201203
asthma and, 568569
Atorvastatin (Lipitor), 747t
Atrial fibrillation, 802t, 804, 804f, 805t, 805b
Atrial flutter, 802t, 804, 804f
Atrial gallop, 701
Atrial natriuretic peptide, 287, 702, 703t707t, 1078
in heart failure, 777, 780
Atrial septoplasty, for pulmonary hypertension, 557
Atrioventricular block
first-degree, 802t, 806, 806f
second-degree
type I (Mobitz I), 802t, 806
type II (Mobitz II), 802t, 806, 806f
third-degree (complete), 802t, 807
Atrioventricular node, 691, 691f
Atrophy
muscle, 1533, 1539t
skin, 419t
Atropine (Atropisol, Atropair, Bufopto, Atropine-1, Isopto Atropine,
Ocu-Tropine), for pupillary dilation, 413t
Atrovent (ipratropium bromide). See Ipratropium bromide (Atrovent).
Atypical mycobacterial infections, 533534
Atypical nevi, 428t, 429f, 429430
Audiometry, 380t, 381
AUDIT questionnaire, 163, 163t, 166
Auditory brainstem response, 380t
Auditory evoked potentials, 380t
Auditory problems. See also Hearing loss.
cultural factors in, 383b
Auditory system. See also Ear; Hearing.

11
th

audiometry in, 380t, 381
diagnostic studies in, 379381
focused, 378, 378b
functional health patterns in, 376378
health history in, 376, 377t
hearing tests in, 379381, 380t
medication history in, 376
physical examination in, 378379, 378t, 378b
structures and functions of, 373375, 375f
Augmented coughing, 1519, 17071708, 1708f
Aura, in migraine, 1451
Auricle, 374, 375f
Auscultation, 3536, 39, 40f
in blood pressure measurement, 694
of abdomen, 887, 1084
of arteries, 698699
of bowel sounds, 878
of chest
in cardiovascular assessment, 698699, 700f, 701
in respiratory assessment, 482483, 483f, 484t485t
Auscultatory gap, 733
Austin-Flint murmur, 832
Autografts. See Graft(s).
Autoimmune disorders, 209210, 650
apheresis for, 209210
plasmapheresis for, 209210
Autoimmune gastritis, 963
Autoimmunity, 208210
Automated peritoneal dialysis, 11541155, 1154f
Automatic external defibrillator, 810
Automatic tube compensation, 1664
Automaticity, 799
Automatisms, 1458
Autonomic dysreflexia, 1552t
Autonomic nervous system (ANS), 1377. See also Nervous system.
cardiovascular system and, 693
Autonomic neuropathy, diabetic, 12201221
Auto-PEEP, 1663
Autosomes, 190
Autosplenectomy, 648
Autotransfusion, 685687
Avandamet (rosiglitazone-metformin), 1558
Avandaryl (rosiglitazone-glimepiride), 1200t
Avandia (rosiglitazone), for diabetes mellitus, 1200t, 1201
Avapro (irbesartan), for hypertension, 725t727t
Avascular necrosis, 1547
Avastatin (bevacizumab)
for cancer, 269t270t, 270
of brain, 1412
of breast, 1290
for macular degeneration, 396
Aventyl. See Nortriptyline (Aventyl).
Avian influenza, 218, 498
Avinza. See Morphine.
Avodart (dutasteride), for benign prostatic hyperplasia, 1349, 1349b
Avonex (interferon--1a), for multiple sclerosis, 14661467
AVPU mnemonic, 1721
Avulsion fractures, 1545
Axid (nizatidine), for upper GI bleeding, 960t
Axillary lymph nodes, 1262, 1287f
dissection of, 1284, 1286
lymphedema and, 1286, 1287f, 1294
postoperative care and, 12911294
in breast cancer, 1284, 1286

Axons, 1372, 1373f
Axulfidine (sulfasalazine), for rheumatoid arthritis, 1605t1607t, 1613
Ayurveda, 83t
Azacitidine (Vidaza), for myelodysplastic syndrome, 668669
Azatadine (Optimine), for allergic rhinitis, 496t497t
Azathioprine (Imuran)
for systemic lupus erythematosus, 1605t1607t, 1624
Azelastine (Astelin), for allergic rhinitis, 496t497t
Azilect (rasagiline), for Parkinsons disease, 1472
Azithromycin (Zithromax)
for chlamydial infections, 1305, 1305t, 1326t
for gonorrhea, 13011303, 1302t, 1303b
Azopt (brinzolamide), for glaucoma, 399t400t
Azotemia, 1135
Azulfidine (sulfasalazine)
for inflammatory bowel disease, 10011003, 1002t, 1001b, 1004
for rheumatoid arthritis, 1605t1607t, 1613
B
B blood type, 629630, 630t
B cell(s), 195197, 196f, 199, 619 See also Lymphocyte(s).
in cancer, 247, 248f
B cell lymphoma, 676, 676f, 677
Babinskis sign, 1387t
Bacille Calmette-Gurin vaccine
of bladder, 1118
for tuberculosis, 532
Back pain, 1587, 1590b
cervical, 15911592, 1592t
low, 1587, 1590b
acute, 1587
chronic, 1589
in intervertebral disk disease, 15891590. See also Intervertebral
disk disease.
nursing management for, 15871589
prevention of, 1588, 1590b
Baclofen (Lioresal), for pain, 126t, 127
Bacteria
antibiotic-resistant, 220221, 221t
-lactamase, 220
Bacterial arthritis, 1619
Bacterial infections, 217, 218t
Bacterial meningitis, 1396t, 1416, 1417, 1418t
Bacterial vaginosis, 13261328, 1326t
Bacteriuria, asymptomatic, 1094
Bactrim (trimethoprim-sulfamethoxazole), for urinary tract infections,
10961097
Bag-valve-mask, 1655
Balance, assessment of, 1384
Ball and socket joints, 1533f
Balloon angioplasty, 753, 753f
emergent, 759
for peripheral arterial disease, 851b, 854
transluminal, 14321433, 1432f
12
th
Balloon pump, intraaortic, 781, 783, 1653t

Balloon tamponade, for variceal bleeding, 1051, 1051f, 1054
Balloon thermotherapy, for menorrhagia, 1321, 1321f
Balloon valvuloplasty, 833f, 834
Band ligation
for bleeding varices, 1050
for hemorrhoids, 1027
Bandages. See also Dressings.
compression
for amputation stump, 15731574, 1574f
for strains and sprains, 1546
Bands, 617f, 618
Banduras social-cognitive theory, 4647
Baraclude (entecavir), for hepatitis, 10381039, 1038b
Barbiturates
abuse of, 153t154t, 161
in general anesthesia, 340t
overdose of, 162
respiratory depression and, 551t
withdrawal from, 178
Bariatric surgery, 931934, 931t
biliopancreatic diversion, 931t, 932f, 933
evaluation in, 936
patient selection for, 933b
roux-en-Y gastric bypass, 931t, 932f, 933
Barium sulfate, 889
Barium swallow, 891, 891f892f, 891t894t
Baroreceptors
cardiac, 694
in blood pressure regulation, 713714
Barotrauma, in mechanical ventilation, 16651666, 1714
Barretts esophagus, 949
Barrier contraceptives, 232, 13011302, 1310
sexually transmitted diseases and, 1301
Bartholinitis
chlamydial, 1305
gonococcal, 13011302
Bartholins glands, 1261
Basal body temperature, in fertility workup, 1272t1275t, 1315, 1315f
Basal cell carcinoma, 427, 428t, 429f
Basal ganglia, 1375, 1376t
Basilar skull fractures, 14041405, 1405t
Basiliximab (Simulect), for transplantation, 215
Basophils, 614f, 618619, 618t
Baths
sitz, 10271028
therapeutic, 441
Battles sign, 1404, 1405f
Baxter formula, 457, 457t
BCG vaccine. See Bacille Calmette-Gurin vaccine.
Becaplermin (Regranex), 182
Becker muscular dystrophy, 15861587, 1587t
Beclomethasone (Qvar, Vancenase)
for asthma, 571, 573t574t
Bedbugs, 433434, 434t
Beds, kinetic therapy, 1516, 17151716, 1716f
Bee stings, 433434, 434t, 1730
Behavior modification. See also Cognitive-behavioral therapy.
for obesity, 930
Bells palsy, 15041505, 1504f
Benadryl. See Diphenhydramine (Benadryl).
Benazepril (Lotensin), for hypertension, 726t

Bence Jones protein, 632t, 678
Bendroflumethiazide (Naturetin), for hypertension, 724t
Benemid (probenecid)
for gout, 1620
for syphilis, 1301t
Benicar (olmesartan), for hypertension, 727t
Benign neoplasms, 244, 244t. See also Tumor(s).
Benign paroxysmal positional vertigo, 406
Benign prostatic hyperplasia, 13461351, 1347f
assessment in, 1351, 1352, 1351t
etiology of, 1355
evaluation in, 1355
invasive therapy for, 1350t, 1351
laser prostatectomy for, 1350t, 13501351
minimally invasive therapy for, 13491350, 1350t
planning in, 1352
severity index for, 13461347, 1348t
transurethral incision of prostate for, 1350t, 1351
transurethral microwave thermotherapy for, 1349, 1350t
transurethral needle ablation for, 13491350, 1350t
transurethral resection of prostate for, 1350t, 1351, 1351f
Bentyl (dicyclomine), for irritable bowel syndrome, 993994
Benzodiazepine-receptorlike agents, for insomnia, 104, 104t
Benzodiazepines
abuse of, 153t154t, 161
for alcohol withdrawal, 159160, 159t
for delirium, 1497
in anesthesia, 341t
overdose of, 162
Benzthiazide (Aquatab, Exna), for hypertension, 724t
Bereavement, 142143
Berylliosis, 535, 535t
Best interest standard, 953b
Beta cells, in insulin production, 1189
Beta-adrenergic blockers
for angina, 749t, 751752
for asthma, 569571, 573t574t, 572
in acute exacerbations, 570
in severe/life-threatening exacerbations, 570572
for COPD, 592593
for glaucoma, 399t400t, 400
for heart failure, 782783, 782t
for hypertension, 725t, 728t
for hyperthyroidism, 1237
for variceal bleeding, 10511052
13
th

Beta-amyloid, in Alzheimers disease, 1485
Betagan (levobunolol), for glaucoma, 399t400t
Beta-lactamase bacteria, 220
Betapace (sotalol), for dysrhythmias, 809t
Betaseron (interferon--1b), for multiple sclerosis, 14651466
Betaxolol (Betoptic, Kerlone)
for glaucoma, 399t400t
for hypertension, 725t
Bevacizumab (Avastin)
for brain tumors, 1412
of breast, 1290
Bexxar (tositumomab)
for non-Hodgkins lymphoma, 676677
Bias, 23. See also Discrimination.
toward elderly, 2122, 6061
Biaxin (clarithromycin), for H. pylori infection, 963t
Bicalutamide (Casodex), for prostate cancer, 1359t, 1359
Bicarbonate
for hyperkalemia, 1139t
in arterial blood, 474, 474t
in urinary disorders, 1086t1090t
Bicarbonate buffer system, 301302
Biceps reflex, 1385, 1385f
Bichloroacetic acid, for genital warts, 1308
Biculturalism, 23. See also under Cultural.
BiDil, for heart failure, 784
Biguanides, for diabetes mellitus, 1200, 1200t, 1201b
Bile, 879t, 880, 882
gallstones and, 10681069
obstructed flow of, 1069, 1069t
Bile acid sequestrants, 747, 747t
Bile duct stones, 10691070
Bile ducts, 881f, 882
Bile reflux gastritis, 974
Bile stasis, 1069, 1069t
Bilevel positive airway pressure, 1641
Biliary colic, 1069
Biliary system, 877f, 882, 883
Bilis, 29t
Billroth I operation, 974, 974f
Billroth II operation, 974
Bilopancreatic diversion, 931t, 932f, 933
with duodenal switch, 931t, 932f, 933
Bimatoprost (Lumigan), for glaucoma, 399t400t
Binge-eating disorder, 918
Biofeedback
for constipation, 988
for fecal incontinence, 987
for headaches, 1451
for seizures, 1460
for urinary incontinence, 1121b
Biologic aging, 61. See also Older adults.
Biologic and targeted therapy, 268270, 269t270t, 270f
for arthritis, 1605t1607t
for breast cancer, 1290
for cancer, 268270, 269t270t, 270f
for connective tissue disorders, 1605t1607t
for lung cancer, 540

Biologic response modifiers, 268. See also Biologic and targeted
therapy.
Biologic therapy, 268. See also Biologic and targeted therapy.
Biologic-based therapies, 8283
Biomedical health care model, 8182, 82t
Biopsy, 251252
bone marrow, 631633, 632t, 633f
in thrombocytopenia, 655
brain, 14111412
breast, 1272t1275t, 1279
cervical, 1332
endometrial, 1272t1275t, 1333
endomyocardial, 827
liver, 892t894t, 895
lung, 487t488t, 490, 490f, 538539
lymph node, 632t, 633
prostate, 1355
punch, 440, 440f
renal, 1086t1090t
skin, 422, 423t
Bioterrorism, 17321734
Biots breathing, 481
Bird fanciers lung, 535, 535t
Bird flu, 218, 498
Bisacodyl (Dulcolax), 988989, 989t
for constipation, 989t
Bismuth, for H. pylori infection, 963t
Bismuth subsalicylate (Pepto-Bismol), for diarrhea, 984t
Bisoprolol (Zebeta), for hypertension, 725t
Bisphosphonates
for osteoporosis, 1596, 1597b
Bites, 1730
animal, 1730
human, 1730
insect, 433, 434f, 434t
tick, 433, 434t, 1730
Bivalirudin (Angiomax), for venous thromboembolism, 863t, 864
Biventricular assist devices, 781, 783, 1654f
Biventricular pacing, 783
Biventricular Support System, 791
Black cohosh, 85t, 1325
Black lung, 534, 535t
Black wounds, 176, 178t, 180
Blacks. See African Americans.
Bladder, 1079, 1080f
cancer of, 1117, 1117t
chemotherapy for, 256257
catheterization of. See Urinary catheterization.
cystoscopic examination of, 1089f
flaccid, in multiple sclerosis, 1502
in obstructive uropathies, 1465
irrigation of
after transurethral resection of prostate, 13531355
delegation of, 1359b
irritant foods affecting, 1103
neurogenic, 15221523, 1523t
in spinal cord injury, 15221523, 1523t
painful, 11021103, 1102t
postmenopausal changes in, 1323
prolapsed, 1340, 1340f
Bladder distention, in spinal cord injury, 15201521
autonomic dysreflexia and, 1521
14
th
Bladder outlet obstruction, 1106

urinary retention and, 1119
Bladder reconstruction, orthotopic, 11291131
Bladder retraining, 1122t, 1124
after stroke, 1443, 1446
Bladder spasticity
after prostate surgery, 1354
in multiple sclerosis, 1464, 1465
Blast injuries, 1734
Blastomycosis, 533, 533t
Blebs
facial skin grafts and, 462
pulmonary, 542, 588, 588f
in COPD, 588, 588f
Bleeding. See also Hemorrhage.
abnormal vaginal, 1268, 13201321
acute, clinical manifestations of, 646t
anemia from, 641t, 645, 646, 645t
anorectal, from hemorrhoids, 1026
anticoagulant-related, 866, 866b
dysfunctional uterine, 1326
gastrointestinal. See Gastrointestinal bleeding.
in disseminated intravascular coagulation, 662, 662f
in hemodialysis, 1158
in hemophilia, 657659, 660f
in myelodysplastic syndrome, 668
in peptic ulcer disease, 967, 972
in peritoneal dialysis, 1154
in thrombocytopenia, 645, 656657
intraocular, 368
joint, 625, 1545
menstrual. See also Menstruation.
breakthrough, 1320, 1323
excessive, 1268, 13201321, 1330
nasal, 493, 494f, 626t627t
postcoital, 1268
variceal, 10461047, 1050, 1054
Bleeding disorders, 652
disseminated intravascular coagulation, 661662
hemophilia, 657659
thrombocytopenia, 653657
von Willebrand disease, 657659
Bleeding time, 630t
Blepharitis, 371t, 387389
Blepharoplasty, 443444
Blindness, 384. See also Visual impairment.
Blocadren (timolol), for hypertension, 725t
Blom-Singer prosthesis, 516, 516f
Blood. See also under Hematologic., 616618
components of, 616618, 618f
functions of, 616, 617t
in sputum, 479
in stool, 640, 890t, 961962
in urine, 1085t
in vomitus, 479, 622623, 890t
oxygenation of, 473474
states of, 29t
thin, 29t
Blood cell count, nadir in, 261
Blood cell production, 616, 617f
Blood component therapy, 680687. See also Transfusion(s).
Blood cultures, 222b
Blood flow. See also Circulation.
cerebral, 13921393
Blood gas values

arterial, 474, 474t, 487t488t
in acid-base imbalances, 303304, 304t
mixed venous, 475
Blood glucose monitoring, 12041206, 1205f, 1205t
Blood loss. See Bleeding; Hemorrhage.
Blood pressure, 694
arterial, 694
cardiac output and, 713
diastolic, 694
endothelial dysfunction in, 718
in cerebral autoregulation, 1392, 1425
measurement of, 694, 698, 729730, 729t
ambulatory, 720
at home, 730731auscultatory gap in, 731
invasive methods of, 16431651
normal variation in, 720
regulation of, 713715, 715f
baroreceptors in, 713714
endocrine system in, 715
kidney in, 714715, 715f
renal system in, 714715
sympathetic nervous system in, 713714, 714t, 715f
vascular endothelium in, 714, 717
systemic vascular resistance and, 713
systolic, 694
Blood smear, peripheral, 628
Blood substitutes, 332Blood typing, 629630, 630t
Blood urea nitrogen (BUN), 1086t1090t
Blood urea nitrogen/creatinine ratio, 1086t1090t
Blood vessels, 693, 693f
Blood volume expanders, 343
Blood-brain barrier, 1379
chemotherapy and, 14121413
Blue toe syndrome, 845
Bobath method, 1445
Body fat. See Fat, body.
Body jacket, 1516
Body jacket casts, 15541555, 1555f
Body language, 2526
in patient teaching, 4748
Body lice, 431432, 432t
Body mass index (BMI), 742743, 906
in COPD, 617
Body temperature. See Fever; Temperature.
Body water content, 281282, 282f. See also under Fluid.
Body weight. See Weight.
Body-based therapies, 8486
Bombs, in terrorism, 1732
Bone
avascular necrosis of, 1547
cancellous, 1530
cortical, 1530
ossification of, 1530
in fracture healing, 1552, 1552f
Pagets disease of, 15971598
remodeling of, 1530, 1595
resorption of, 1530
15
th
types of, 1530

Bone cancer, 15851586, 1585t
limb salvage for, 1585
metastatic, 1586
osteosarcoma, 1585, 1585t
Bone cancer, 15851586, 1585t
metastatic, 1586
Bone disorders
in chronic kidney disease, 1145, 1145f, 1147
metabolic, 1593
Bone grafts, in spinal fusion, 15881589
Bone loss. See also Osteoporosis.
age-related, 1594
Bone marrow, 616617, 1531
in hematopoiesis, 616617
Bone marrow biopsy, 631633, 632t, 633f
Bone marrow suppression, in cancer therapy, 261268, 262t263t
Bone marrow transplantation, 271. See also Hematopoietic stem cells,
transplantation of.
Bone mass, peak, 1595
Bone metabolism
assessment of, 1540t1541t
disorders of, 1596
Bone mineral density, measurement of, 1540t1541t, 1597
Bone scans, 1540t1541t
Bone tumors, 1586
benign, 1586, 1587t
malignant, 15841585, 1584t
metastatic, 1585
types of, 1586, 1587t
Bonefos (clodronate), for osteoporosis, 1596
Boniva (ibandronate)
Borborygmi, 887, 889, 1009
Borg Rating of Perceived Exertion Scale, 767, 768t
Bortezomib (Velcade), for cancer, 268t269t
Bosentan (Tracleer), for pulmonary hypertension, 557
Botulinum antitoxin, 1507
Botulinum toxin
for achalasia, 957
for headaches, 1454
Botulism, 979t, 1507
in terrorism, 17321734, 1732t1733t
Bouchards nodes, 1602
Boutonnire deformity, 1539t, 16111612, 1612f
Bowel, neurogenic, 1513, 1523, 1524t
Bowel elimination. See also Constipation; Diarrhea.
after stroke, 1430, 1441, 14441445
in spinal cord injury, 1514, 1520, 1522
Bowel elimination pattern, 987988
Bowel preparation
for colonoscopy, 1015
for urinary imaging, 10911092
Bowel sounds
absent, 887, 890t
auscultation of, 887
Brace, SOMI, 1519, 1519f

Brachiocephalic artery, 1379f
Brachioradialis reflex, 1385f
Brachytherapy, 259260, 13371338. See also Radiation therapy.
definition of, 510
for breast cancer, 1280, 1289f
for female reproductive cancers, 13371338
for head and neck cancer, 510, 512
for prostate cancer, 1357, 1358f
Braden scale, 185
Bradycardia
sinus, 801, 801f, 802t
Bradykinesia, in Parkinsons disease, 1471
Brain. See also under Cerebral; Nervous system.
biopsy of, 14111412
blood supply of, 13781379
cancer of. See Brain tumors.
chemo, 262t263t, 1289
components of, 1378f
concussion of, 1405
contusions of, 1405, 1406f
coup-contrecoup injury of, 1406, 1406f
functional areas of, 1414f
inflammatory conditions of, 14161417
lacerations of, 1405
traumatic injury of, 1403, 14051415. See also Head injury;
Traumatic brain injury.
Brain abscess, 1415t, 1416
Brain attack, 1424
Brain death, 141, 1410b
Brain fag, 28t
Brain stents, 14311432, 1432f
Brain tumors, 14111413
collaborative care in, 14111412
locations of, 1412
metastatic, 1412t1413t
radiation therapy for, 1412
stereotactic radiosurgery for, 1412
surgery for, 1726, 1412. See also Cranial surgery.
targeted therapy for, 14121413
types of, 1412, 1413f, 1413t
ventricular shunts for, 1416
Brainstem, 1376f, 1377
Bravelle (urofollitropin), for infertility, 1316t
BRCA mutations
breast cancer and, 12821283
ovarian cancer and, 1334, 1334b
Breakthrough bleeding, 1268, 1320, 1323
Breakthrough pain, 120
Breast
biopsy of, 1272t1275t
fine-needle, 1279
stereotactic, 1279
ultrasound core, 1279
calcifications in, 1278
dimpling of, 1270t
disorders of, 1270t, 1277
16
th
benign, 1279
male, 1281
malignant. See Breast cancer.
nipple discharge in, 1270t, 1281
cytologic study of, 1272t1275t, 1275
pain in, 1279
ductal ectasia of, 1277
fibroadenoma of, 12801281, 1281f
fibrocystic changes in, 1279t, 1280, 1280f
infections of, 12791280
intraductal papillomas of, 1277
lactating, 1261, 1262f
lymphatic drainage of, 1262, 1287f
male, enlarged, 1281
masses in, 1270t
benign, 1279t, 12801281
malignant. See Breast cancer.
palpation of, 12691270
Breast augmentation, 1297
Breast cancer, 12821290
adjuvant therapy for, 12871289, 1288f
axillary lymph node dissection in, 1284, 1286
cultural factors in, 1290, 1290b
ductal, 1283
ductal carcinoma in situ, 1283
evaluation in, 1295
follow-up and survivorship care in, 1287
genetic factors in, 12821283, 1283b
hormonal therapy for, 12891290, 1289t
inflammatory, 1283
lobular, 1283
lobular carcinoma in situ, 1283
lymphedema in, 1285
metastatic, 1282t, 1284, 1285t
noninvasive, 1283
palliative therapy for, 1288
peau dorange skin in, 1283
planning in, 1291
prognostic factors in, 12841285
psychologic aspects of, 12941295
race/ethnicity and, 1290, 1290b
radiation therapy for, 1284b, 12861288, 1288t, 1289f
recurrent, 1282t, 1284, 1284b
rehabilitation in, 1294
risk factors for, 1279t, 12821283, 1282t
screening for, 1272t1275t, 1276, 12781279
sexuality and, 1295sites of, 1284, 1284f

staging of, 12851286, 1286t
surgery for, 1288t
axillary node dissection, 1284, 1286
breast-conserving, 12861287, 1288t
mastectomy, 12851287, 1288t. See also Mastectomy.
nursing care plan for, 1292b1293bpostoperative care in, 1291
1295reconstructive, 12951297, 1296f1297f
triple-negative, 1285
tumor markers for, 1285
types of, 1282t, 1283
Breast implants
augmentation, 1297
reconstructive. See Breast reconstruction.
Breast prosthesis, 1294
Breast reconstruction, 1288t, 12951297, 1296f1297f
Breast reduction, 12971299
Breast self-examination, 1278, 1278f
Breast-conserving surgery, 12861287, 1288t
Breastfeeding. See Lactation.
Breath sounds
adventitious, 483, 484t485t
auscultation of, 483, 484t485t, 489f
in asthma, 566, 566f
normal, 483, 483f
Breathing. See also Respiration.
abdominal, 94, 598
apneustic, 1400f
ataxic, 1400f
Biots, 481
cluster, 1400f
deep, postoperative, 350
diaphragmatic, 598in emergency assessment, 1722, 1722t
in resuscitation, 17211723, 1722t
pursed-lip, 484t485t, 581t, 597
relaxation, 94, 94t
sleep-disordered, 107108
Breathing retraining, 597598
Breslow measurement, 428429, 429f
Bretylium (Bretylol), for dysrhythmias, 809t
Brevibloc. See Esmolol (Brevibloc).
Brevital (methohexital), in general anesthesia, 340t
Brimonidine (Alphagan), for glaucoma, 399t400t
Brinzolamide (Azopt), for glaucoma, 399t400t
Broad ligament, 1261
Brocas aphasia, 1430t
Brocas area, 1375, 1376f, 1376t
Bromocriptine (Parlodel), for Parkinsons disease, 1472, 1472b
Brompheniramine (Dimetane), for allergic rhinitis, 496t497t
Bronchi, 472, 472f
Bronchial breath sounds, 484, 483f
Bronchial circulation, 472
Bronchiectasis, 610612, 610f
Bronchioles, 471, 471f
Bronchiolitis, in cystic fibrosis, 606
Bronchiolitis obliterans, 535
after lung transplant, 558
Bronchitis
acute, 520
Bronchoalveolar lavage, 488489, 489f
Bronchoconstriction, 471
reflex, 476
17
th
Bronchodilation, 471
Bronchodilator challenge test, 489
in asthma, 567
Bronchodilators
for COPD, 591592
Bronchophony, 484, 484t485t
Bronchoscopic laser therapy, 539
Bronchoscopy, 487t488t, 486488, 489f, 538539
Bronchospasm
Bronchovesicular breath sounds, 484, 483f
Brooke formula, 457, 457t
Brovana (arformoterol), for asthma, 573t574t, 575
Brown-Squard syndrome, 1510, 1512f
Bruising. See Ecchymoses.
Bruits, 698699, 699t700t
abdominal, 890t, 1084
B-type natriuretic peptide, 288, 702, 703t707t
in heart failure, 777, 780, 781t
Bubonic plague, 220t
Bucks traction, 1554
Buddhists, health beliefs and practices of, 26t
Budesonide (Pulmicort Turbuhaler, Rhinocort)
Budesonide/formoterol (Symbicort), for asthma, 573t574t, 575
Buergers disease, 858
Buffers, 301
Bufopto (atropine), for pupillary dilation, 392t
Bulbourethral glands, 1259f
Bulimia nervosa, 919920
Bulking agents
for constipation, 989, 989t
for urinary incontinence, 1123
Bullae, pulmonary, in COPD, 587, 587f
Bullectomy, 597
Bumetanide (Bumex), for hypertension, 724t727t
Bunions, 1593f, 1594t
in rheumatoid arthritis, 16111612, 1612f
Buprenorphine (Buprenex), 124t
Bupropion (Zyban), for smoking cessation, 155156, 156t
Burkitts lymphoma, 676
Burn center, referral to, 448, 449t
Burn shock, 454455, 453f454f
Burns, 446
acute tubular necrosis and, 448, 455
airway, 446448, 451, 452t, 455457, 455t456t, 456f
altered mental status in, 454
caregiver stress and, 466467
case study of, 467b
chemical, 446, 451, 453t
classification of, 448451
clinical manifestations of, 455, 461, 465
complications of, 455, 456t, 465
cardiovascular, 455
endocrine, 462
gastrointestinal, 462
musculoskeletal, 462
neurologic, 462
renal, 448, 455
respiratory, 455, 455t
contractures from, 465, 466f
Curlings ulcer and, 459t, 461462
debridement of, 457, 458f, 462
definition of, 446

depth of, 449, 449f, 449t
electrical, 448, 448f, 452t
extent of, 450, 450f
first-degree, 449, 449f, 449t
fluid and electrolyte shifts in, 453454, 453f454f, 461
fourth-degree, 449, 449f, 449t
full-thickness, 447f, 449, 449t
healing of, 454, 465
hypermetabolic state and, 461
hypovolemic shock and, 453454, 453f454f
infection of, 461
inflammation in, 454
inhalation injury and, 446448, 455457, 455t
management of, 453, 452t, 457, 456f, 456t
laboratory findings in, 462
location of, 450
management of, 450
ABCs of, 451
acute-phase, 456t, 461462
airway management in, 453, 452t, 457, 456f, 456t
collaborative care in, 455, 456t, 462, 466
drug therapy in, 459460, 459t
emergency, 453455, 451t453t, 456t
fluid therapy in, 456t457t, 457
nursing, 455, 455t, 462, 466
phases of, 450
prehospital, 450451
psychosocial care in, 464467, 466t
rehabilitation-phase, 465
nursing staff needs and, 467468
nutritional support and, 459t, 460, 464
occupational therapy for, 464
of ear, 450, 449
of eye, 386t
of face, 450, 454f, 449
of hand, 450, 459
of perineum, 459
pain management for, 459460, 459t, 464
partial-thickness, 447f, 449, 449t
pathophysiology of, 453454, 453f, 461, 465
physical therapy for, 459, 464
pneumonia and, 455, 456t
potassium imbalance in, 454, 454f, 461
pressure garments for, 465
psychosocial aspects of, 464467, 466t
referral for, 448, 449t
rule of nines for, 450, 450f
scald, 447f
scars from, 465
second-degree, 449, 449f, 449t
sexuality and, 467
sludging and, 454
sodium imbalance in, 454, 454f, 461
solar, 425
tetanus immunization for, 460
thermal, 447, 447f
third-degree, 449, 449f, 449t
thromboembolism and, 455, 460
types of, 446448
wound care for, 458457, 458f, 462
debridement in, 459
18
th
dressings in, 457, 458f, 460b

escharotomy in, 454455, 456f, 463
excision and grafting in, 458, 459t, 462464, 463f
Bursae, 1534
Bursitis, 1534, 1550
Buserelin (Suprefact), for prostate cancer, 13591360, 1359t
Butorphanol (Stadol), 124t, 128
Butterfly rash, in systemic lupus erythematosus, 1622, 1623f
Byetta (exenatide), 1200t
for diabetes mellitus, 1200t, 1201
Bypass grafting. See Graft(s).
Byssinosis, 535t
Bystolic (nebivolol), for hypertension, 724t727t
C
C fibers, 115116
CA15-3, in breast cancer, 1285
CA27-29, in breast cancer, 1285
CA-125, in ovarian cancer, 1335
Caffeine, 153t, 160
common sources of, 106t
Caffeine withdrawal headache, postoperative, 320
CAGEAID questionnaire, 164, 164t, 167
Calan. See Verapamil.
Calcifications
breast, 1277
Calcimar (salmon calcitonin)
Calcimimetic agents, for hyperparathyroidism, 1246
Calcineurin inhibitors, for transplantation, 214, 214t
Calcitonin, 1172t, 1176
Calcitriol (1,25-dihydroxycholecalciferol), for hypoparathyroidism,
1247
Calcium
dietary
kidney stones and, 1111
sources of, 295, 1597t
functions of, 296
in musculoskeletal assessment, 1540t1542t
measurement of, 297, 1184t1187t
regulation of, 295
supplemental, 291
for hypoparathyroidism, 12461247
for menopausal women, 1325
for osteoporosis, 1595, 1597t
Calcium acetate (PhosLo), for hyperphosphatemia, in chronic kidney
disease, 1147
Calcium balance, 1078, 1144
regulation of, 1078
Calcium carbonate (Caltrate), for hyperphosphatemia, in chronic kidney
disease, 1147
Calcium channel blockers
for angina/acute coronary syndrome, 749t, 753
Calcium gluconate, for hyperkalemia, 1139t
Calcium glycerophosphate (Prelief), for interstitial cystitis, 1102
Calcium imbalances, 296297, 297t
after parathyroidectomy, 1246
hypercalcemic, 297, 297t
hyperparathyroidism and, 1275

hypocalcemic, 297t, 298
hypoparathyroidism and, 1246
in cancer, 294295, 297
Calcium imbalances (Continued)
tetany and, 1182t1183t, 1246
Calcium oxalate stones, 1109t. See also Urinary calculi.
Calcium phosphate stones, 1109t. See also Urinary calculi.
Calcium polycarbophil (Mitrolan), for diarrhea, 984t
Calcium-scoring CT scan, 703t707t
Calculi, urinary, 11071111
Callus, fracture, 1551, 1552f
Calluses, 1633t
Caloric requirements, 899, 901t
Caloric restriction, 928930, 928t. See also Weight loss.
Caloric test stimulus, 380t
Caltrate (calcium carbonate), for hyperphosphatemia, in chronic kidney
disease, 1147
Campath (alemtuzumab), for cancer, 269t270t
Campylobacter jejuni diarrhea, 983t
Canal of Schlemm, 366, 365f
Canalith repositioning, 406
Cancellous bone, 1530
Cancer, 241, 248251, 249t. See also Tumor(s).
after renal transplant, 1165
biology of, 242248, 243f
bladder, 257, 1117, 1118t
bone, 1584, 1726
brain, 14101412. See also Brain tumors.
breast, 12821290
cardiac tamponade in, 276
carotid artery rupture in, 276
cell growth and differentiation in, 243244, 243f
cervical, 1329t, 13321333, 1333t
colorectal, 10101014
cultural factors in, 242, 242b
development of, 244247, 245f
early detection of, 250, 250b
emergencies in, 274276
endometrial, 13331334
esophageal, 954955
gallbladder, 10731074
gender differences in, 241, 242t
head and neck, 510512, 945947
histologic grading of, 249
hypercalcemia in, 275, 297
immune response in, 247248, 248f
in HIV infection, 225226, 226f, 227t
incidence of, 241, 242t
infections in, 274
initiation of, 244245, 245f
kidney, 11161117, 1116f1117f, 1117t
laryngeal, 503, 509512, 511f
liver, 10581059
lung, 536540, 559b
malnutrition in, 273274
metabolic disturbances in, 275276
metastasis in, 246247, 246f
mortality in, 241242, 242t
mutations in, 244245, 254
obesity and, 926, 926f
19
th
oral, 510512, 945947, 946t947t

ovarian, 13341335, 1334t
pain management in, 276277, 276t
palliative care in, 253254
pancreatic, 10671068
paraneoplastic syndromes in, 538
penile, 1363
prevention of, 250, 250t, 253
progression of, 245f, 246247
promotion in, 245f, 245246
prostate, 13551360
psychologic support in, 277278
recurrence of, 248
renal, 1116, 1116f1117f
secondary, 245
skin, 245, 415, 426
of ear, 402
societal impact of, 242
spinal cord, 15261527
spinal cord compression in, 275
staging of, 249250, 249t, 538539
stomach, 976977, 975f, 976t, 977f
superior vena cava syndrome in, 274275, 275f
survivors of, 278280, 278t
syndrome of inappropriate antidiuretic hormone in, 275, 1230
terminal care in. See End-of-life care.
testicular, 1363f, 1365
third space syndrome in, 275
thyroid, 1233
treatment of, 251253
biologic and targeted therapy in, 268271, 269t270t, 270f
chemotherapy in, 254258, 254f. See also Chemotherapy.
gene therapy in, 273
goals of, 251253, 252f
hematopoietic growth factors in, 271, 271t
hematopoietic stem cell transplant in, 271273, 272f, 272t
late effects of, 268
multimodality therapy in, 253
nursing management in, 261268
psychoemotional issues in, 268
radiation therapy in, 258261. See also Radiation therapy.
side effects of, 261268, 262t263t
surgery in, 253254
tumor lysis syndrome in, 275276
vaginal, 13351336
vulvar, 1336
warning signs of, 250, 250t
Candesartan (Atacand), for hypertension, 724t727t
Candidiasis
cutaneous, 433, 433f, 433t
oral, 890t, 945t
HIV-related, 225226, 226f, 227t
pharyngeal, 502
pulmonary, 534, 533t
vulvovaginal, 13261327, 1326t
Canes, 1563
Canker sores, 945t
Cannabinoids, for pain, 127128
Cannabis. See Marijuana.
Capecitabine (Xeloda)
for colorectal cancer, 1014, 1014b
Capillaries, 693, 693f. See also Circulation.
fluid movement in, 285286, 286f
lymphatic, 621
Capillary fragility test, 630t

Capillary refill, 698, 699t700t
Capsaicin, 126t, 129, 1605t1607t
Capsule endoscopy, 891t894t, 895, 895f
Captopril (Capoten), 784b
Carafate (sucralfate), for GERD, 951
Carbachol (Isopto Carbachol), for glaucoma, 399t400t
Carbamazepine (Tegretol)
for seizures, 1459, 1460b
Carbidopa/levodopa (Sinemet), for Parkinsons disease, 1471, 1471b
Carbidopa/levodopa/entacapone (Stalevo), for Parkinsons disease, 1473
Carbohydrate counting, 1203
Carbohydrates, 899
for hypoglycemia, 1217
in diabetic diet, 1202t, 1203
metabolism of, in chronic kidney disease, 1142
Carbon dioxide, in acid-base balance, 300301
Carbon dioxide narcosis, in oxygen therapy, 595596
Carbon dioxideoxygen exchange, 473474, 474f
Carbon monoxide poisoning, 447, 452t, 1731t
Carbonic acid-bicarbonate buffer system, 301
Carbonic anhydrase inhibitors, for glaucoma, 399t400t
Carboprost (Hemabate), for induced abortion, 1317t
Carboxyhemoglobinemia, 447
Carbuncles, 430t, 439
Carcinoembryonic antigen, 248
Carcinogens, 244246
Carcinoma, 241, 249t. See also Cancer.
Carcinoma in situ, 249250
Cardene. See Nicardipine (Cardene).
Cardiac action potential, 691, 796f
Cardiac arrest, 770
therapeutic hypothermia for, 1726
Cardiac arrhythmias. See Dysrhythmias.
Cardiac automaticity, 799
Cardiac blood pool scan, 703t707t
Cardiac catheterization, 753, 703t707t , 710
delegation for, 770b
for acute coronary syndrome, 758759
Cardiac cells
depolarization/repolarization of, 796, 796f
properties of, 795t
Cardiac cirrhosis, 1044
Cardiac computed tomography, 703t707t, 710, 710f
Cardiac conduction system, 691, 692f, 795, 795t, 796f
intrinsic rates of, 800t
Cardiac contractility, 16421643
Cardiac cycle, 701f
Cardiac disorders. See Heart disease.
Cardiac index, 692, 1642, 1643t
Cardiac markers, 702, 703t707t
in myocardial infarction, 756757, 757f
Cardiac output, 692, 713, 1642
blood pressure and, 694
Cardiac output (Continued)
monitoring of
invasive, 16491650
minimally invasive, 1650
noninvasive65, 1650
Cardiac pacemaker. See Pacemaker (physiologic); Pacemakers
20
th
(electronic).
Cardiac rehabilitation, 765t, 766
activity and exercise in, 767, 768t769t
patient teaching in, 767, 767t769t
sexual activity and, 768, 769t
Cardiac reserve, 693
Cardiac resynchronization therapy, 783, 783f, 812
Cardiac rhythms
abnormal. See Dysrhythmias.
identification of, 795814
Cardiac tamponade, 543t
in aortic dissection, 849
in cancer, 276
in pericarditis, 824
Cardiac transplantation, 791794, 791t
for dilated cardiomyopathy, 838
Cardiac troponin, 702, 703t707t
Cardiac valves. See also Valvular heart disease.
prosthetic, 834, 835f, 835t
antibiotic prophylaxis for, 821, 821t, 821b
Cardiac-specific troponin, 757, 757f
Cardiogenic shock, 756, 16721674. See also Shock.
pathophysiology of, 1674f
Cardiomegaly, in dilated cardiomyopathy, 837, 838f
Cardiomyopathy, 836837
collaborative care for, 837t
diagnosis of, 837t
dilated, 837, 775, 837838, 838f
etiology of, 837t
hypertrophic, 837t, 839, 839f
restrictive, 837, 837t, 840
Takotsubo, 837
Cardioneurogenic syncope, 816817
Cardiopulmonary bypass, 760
Cardiopulmonary resuscitation, 17211723
in end-of-life care, 144145, 145t
Cardiotoxicity, of chemotherapy, 262t263t
Cardiovascular disorders
in burn injury, 454455
insulin resistance and, 1219
postmenopausal, 1323
postoperative, 350351
in clinical unit, 351
skin manifestations of, 437t
stroke and, 1425
Cardiovascular instability, in spinal cord injury, 1512, 1519
Cardiovascular system, 860. See also under Cardiac; Heart; Vascular.
adverse drug effects on, 696t
common abnormalities on, 699t700t
diagnostic studies in, 702712, 703t707t
documentation of, 701, 701t
focused, 889, 889b

imaging studies in, 703t707t
physical examination in, 695
preoperative, 318
surgical history in, 695
gender differences in, 698bin older adults, 694695, 695t
regulation of, 693694
structures and functions of, 690694, 691f692f
Cardioversion
implantable cardioverter-defibrillator for, 811, 811f
safety concerns for, 811b
synchronized, 810
Carditis, rheumatic, 829
Cardizem. See Diltiazem (Cardizem).
Cardura (doxazosin), for hypertension, 724t727t, 728b
Care plan. See Nursing care plan.
Caregiver, family, 75, 7778. See also Home health care.
Caregiver assessment, 78, 79t
Caregiver stress, 48, 7780, 79t
burns and, 466467
in chronic illness, 59
Caregiver support, 7879
in chronic illness, 59
in end-of-life care, 141143, 150151
teaching in. See Patient and caregiver teaching.
Carina, 471
Carotenemia, 421t
Carotid arteries, 1379f
internal, 1378, 1379f
rupture of, in cancer, 276
stents for, 14321433, 1432f
ultrasonography of, 1388t1389t
Carotid duplex studies, 1388t1389t
Carotid endarterectomy, 1432, 1432f
Carpal tunnel syndrome, 1548, 1548f
Cart shower, 458f
Carteolol (Cartrol, Ocupress)
Cartilage, 1532
elastic, 1532
fibrous, 1532
hyaline, 1532
Carvedilol (Coreg)
side effects of, 784b
Cascade disease pattern, 66
Cascara sagrada, for constipation, 989t
Case management, 3
Casodex (bicalutamide), for prostate cancer, 1359t, 1360
Casts (fracture), 1554, 1562
application of, 1554
body jacket, 1554, 1555f
care of, 1562
hip spica, 1555, 1555f
long arm, 1554, 1555f
long leg, 1555, 1555f
lower extremity, 1555, 1568t
21
th
materials for, 1554

petaling of, 1554
removal of, 1562
short arm, 1554, 1555f
short leg, 1555, 1555f
slings for, 1554
types of, 1554, 1555f
upper extremity, 1554, 1555f
Casts (urinary), 1091, 1091t
Cat bites, 1730
Cataflam (diclofenac K), 123t
Cataplexy, 107
Catapres. See Clonidine (Catapres, Duraclon).
Cataracts, 371t, 390392
Cataracts (Continued)
diagnosis of, 391
etiology of, 390
senile, 390
treatment of
surgical, 390392, 392t
Catecholamines, 1177
Cathartic colon syndrome, 988
Cathartics, for poisoning, 1732
Catheter(s)
central venous, 308310, 309f, 310t. See also Central venous access
devices.
Groshong, 309
Hickman, 309
jugular venous bulb, 1398, 1400f
LICOX, 1398, 1400f
Swan-Ganz, 16451651
Tenckhoff, 1153, 1154f, 1155
Catheter ablation
for atrial fibrillation, 805
for atrial flutter, 804
Catheterization
cardiac, 753, 703t707t, 710
in hemodialysis, 1156, 1157f
in peritoneal dialysis, 1153, 1154f
pulmonary artery, 475, 16451651, 1647f, 1646t. See also
Hemodynamic monitoring.
catheter for, 1647f
indications/contraindications for, 1646t
transhepatic biliary, 1071
Cations, 282
Cauda equina syndrome, 1510, 1589
CD 20 monoclonal antibodies, for cancer, 269t270t
CD antigens, 195
CD4 cells, 224, 225f
Cecostomy, 884t
Cecum, 880, 881f
Cefixime (Suprax), for gonorrhea, 1302, 1302t
Ceftriaxone (Rocephin), for gonorrhea, 13011303, 1302t
Celecoxib (Celebrex), 122123, 123f, 123t
Celiac disease, 1025, 1026t
Cell cycle, 242, 243f
Cell death, programmed, 670

Cell division, 190191
CellCept (mycophenolate mofetil), for transplantation, 213215
Cell-mediated immunity, 197f, 199t, 200
Cell-proliferation indices, for breast cancer, 1285
Cellulitis, 430t, 431, 431f
Central cord syndrome, 1510, 1512f
Central diabetes insipidus, 12311232
Central hearing loss, 374, 407
Central nervous system (CNS). See also Brain; Nervous system;
Spinal cord.
Central neurogenic hyperventilation, 1400f
Central parenteral nutrition, 916
Central venous access devices, 256, 308312
centrally inserted catheters, 308309, 309f, 310t
dressings for, 310
flushing of, 308b, 311
indications for, 308, 308t
injection cap changes for, 311
peripherally inserted catheters, 309, 309f, 310t
removal of, 311312
site care for, 310311
Central venous oxygen saturation, 1646t, 16501651
Central venous pressure, 1643t, 16471648
Cephalosporins, for gonorrhea, 13011303, 1302t
Cephulac. See Lactulose (Constulose, Cephulac).
Cerebellum, 13761377
Cerebral aneurysms. See also Aneurysms.
clipping/coiling of, 1435, 1435f
rupture of, 1428, 1429b
Cerebral angiography, 1386, 1388f, 1388t1389t
in stroke, 1431
Cerebral arteries, 1378, 1379f
Cerebral autoregulation, 1392, 1425
Cerebral blood flow, 13921393
factors affecting, 1393
regulation of, 1392, 1425
Cerebral circulation, 13781379, 14241425, 1425f
collateral, 1425
Cerebral cortex
in pain perception, 117
in stress response, 9093, 91f
Cerebral edema, 13931394
cytotoxic, 13931394
etiology of, 1394t. See also Increased intracranial pressure.
interstitial, 1394
vasogenic, 1394
Cerebral herniation
cingulate, 1394f, 1395
infratentorial, 1379
tentorial, 1394f, 1395
uncal, 1394f, 1395
Cerebral oxygenation monitoring, 1398, 1400f
Cerebral perfusion pressure, 1392, 1392t
Cerebral vasospasm, in subarachnoid hemorrhage, 1428, 1436
Cerebrospinal fluid (CSF), 1377
analysis of, 13851386, 1389t
buildup of, 1394. See also Hydrocephalus.
drainage of, 1392f, 1397f1398f, 13971398
in bacterial meningitis, 1418t, 14161418
in brain abscess, 1418t
in viral meningitis, 1418t, 1419
leakage of, 14041405, 1405f, 1408
22
th
in spinal surgery, 15911592

lumbar puncture for, 1385, 1388t1389t, 1431
normal values for, 13851386, 1389t
Cerebrovascular disease, hypertensive, 718t, 719
Cerebrum, structures and functions of, 1375, 1376f, 1376t
Certification, 3
Certolizumab (Cimzia)
for arthritis/connective tissue disease, 1605t1607t
Cerumen, impacted, 379t, 403
Cervical immobilization, 15161519, 1519f, 1721
Cervical immobilization device, 1721
Cervical mucus, postcoital test and, 1315
Cervical smear. See Pap test.
Cervical spine. See also Neck.
intervertebral disk disease in, 15891591. See also Intervertebral disk
disease.
stabilization of, 1721
Cervical stabilization, 15161519, 1519f
Cervicitis, 13261327, 1326t
chlamydial, 1305
gonococcal, 1301, 1301f
Cervidil (dinoprostone), for induced abortion, 1317t
Cervix
biopsy of, 1333
cancer of, 13321333, 1332f, 1333t. See also Reproductive cancers,
female.
screening for, 1272, 1272t1275t, 1272
pain in, 1592, 1592t
polyps of, 1331
structures and functions of, 1261
Cetirizine (Zyrtec), for allergic rhinitis, 496t497t
Cetrorelix (Cetrotide), for infertility, 1316t
Cetuximab (Erbitux), for cancer, 269t270t
of head and neck, 511
CH50 (total hemolytic complement), 1540t1542t
Chalazion, 387
Chancre, 1304f, 1304t
Chantix (varenicline), 155, 156t, 155b
Charcoal, activated, for poisoning, 1731
Charcot foot, 1222
Charcots joints, 1508Cheilitis, 890t
in iron-deficiency anemia, 640
Cheilosis, 890t
Chelation, for thalassemia, 642
Chemical burns, 446. See also Burns.
management of, 453, 453t
Chemical code, 145
Chemical cystitis, 1085t
Chemical peels, 441t
Chemical pleurodesis, 552
Chemical pneumonitis, 522, 535
Chemical weapons, 1734, 1734t
Chemo brain, 262t263t, 1289
Chemoembolization, for liver cancer, 1059
Chemoreceptor(s)
cardiac, 694
in respiration, 475476
Chemoreceptor trigger zone, 941, 941f
Chemotaxis, 170
Chemotherapy, 254258. See also specific drugs and cancers.
administration of, 256258, 257t
agents in, 255t256t
blood-brain barrier and, 14471448

cognitive effects of, 262t263t, 1318
extravasation in, 256, 257f
for bladder cancer, 257
for colorectal cancer, 1014
for head and neck cancer, 511
for Hodgkins lymphoma, 675, 677t
for leukemia, 670673, 672t
for osteosarcoma, 15841585
for ovarian cancer, 1335
for prostate cancer, 1360
Chemotherapy (Continued)
for testicular cancer, 1365
goals of, 253, 254f
intraarterial, 257
intraperitoneal, 257
intrathecal, 257
intraventricular, 257
intravesical bladder, 257
neoadjuvant, 1289
regimens for, 258
regional, 256257
response to, 254
side effects of, 258, 258t, 261268, 262t263t, 1289
Chest
examination of, 41t42t
auscultation in, 483, 489f, 698699, 699t700t, 700f, 701
inspection in, 481, 699
palpation in, 482, 481f, 699
percussion in, 482, 483f, 482t, 484t485t, 701
sequence for, 482f
flail, 543t, 544545, 544f
symmetry of, 482, 481f
Chest drainage. See Chest tubes.
Chest pain. See also Pain.
anginal. See Angina.
causes of, 758t
in mitral valve prolapse, 831
in myocardial infarction, 749f, 755
in pleurisy, 552
Chest physiotherapy, 1708
for COPD, 598599, 598f
in bronchiectasis, 611
in COPD, 598599
Chest retractions, in respiratory failure, 1705
Chest surgery. See Thoracic surgery.
Chest trauma, 541542, 541t542t, 543f
blunt, 541, 541t542t
chest tube for, 545547
chylothorax and, 544
23
th

flail chest and, 543t, 544545, 544f
hemothorax and, 543t, 544
penetrating, 541, 541t542t
pneumothorax and, 542544, 543t, 543f
respiratory complications in, 551t
rib fractures and, 544
tension pneumothorax and, 543544, 543t, 543f
Chest tubes, 545547
clamping of, 547
dislodgment of, 554
flutter (Heimlich) valve for, 546, 546f
insertion of, 545546, 545f
nursing management of, 547548, 547t
pleural drainage systems for, 546547, 545f
removal of, 548
specimen collection from, 547t
Chest wall
disorders of, respiratory failure in, 1703
landmarks on, 471f, 699, 700f
retractions of, in respiratory failure, 1705
structure of, 471f, 476
Chest wall oscillation, 599
Chest x-ray, 487t488t
in cardiovascular assessment, 703t707t, 708, 708f
in infective endocarditis, 821
in lung cancer, 538
in pericarditis, 824, 825f
in pneumonia, 523
in tuberculosis, 530
Cheyne-Stokes respiration, 141, 481, 1400f
Chinese medicine, traditional, 82, 83t
Chlamydial infections, 1311
conjunctival, 387388
sexually transmitted, 13051306, 1306t
Chloral hydrate (Somnote), 154t, 162
Chlordiazepoxide (Librium), abuse of, 154t, 162
Chlorhexidine, for central line site care, 310311
Chloride balance, regulation of, 1078
Chloromas, 626t627t, 670
Chlorothiazide (Diuril)
Chlorpheniramine (Chlor-Trimeton), for allergic rhinitis, 496t497t
Chlorthalidone (Hygroton), for hypertension, 724t727t
Chocolate cysts, 1329
Cholangiocarcinoma, 1059
Cholangiography, 891t894t
percutaneous transhepatic, 1069
Cholangiopancreatography, magnetic resonance, 891t894t
Cholangitis, 10681069
primary sclerosing, 1045
Cholecystectomy, 884t, 10711072, 1070t, 1073t
Cholecystitis, 1068, 1070t, 1072t
Cholecystoduodenostomy, 1070t
Cholecystokinin, 880, 880t, 924t
in obesity, 924t
Cholecystostomy, 884t, 1070t
Choledochojejunostomy, 884t
Choledocholithiasis, 1069
Choledocholithotomy, 884t, 1070t
Cholelithiasis, 1068, 1067f, 1069t1070t, 1072t
ultrasonography of, 892f
Cholesteatoma, 404
Cholesterol, 702, 703t707t, 708, 741. See also Hyperlipidemia;

Lipids/lipoproteins.
serumt, 896t
Cholesterol absorption inhibitors, 746, 747t
Cholestyramine (Questran)
for hyperlipidemia, 747t
for pruritus, in gallbladder disease, 1071
Choline magnesium trisalicylate (Trilisate), 122, 122t
Cholinergic crisis, 1476, 1476t
Cholinergics
for GERD, 951
Cholinesterase inhibitors, for Alzheimers disease, 1489, 1490f, 1491
Chondroitin sulfate, 86t
Chondromas, of lung, 541
Chondrosarcoma, 1585f, 1585t
Chordae tendinae, 690, 691f
Chordee, 1362
Chordoma, 1585t
Chorea, 1384
Sydenhams, 828
Choroid, 365f, 367
Chromosome(s), 189190
Philadelphia, 670, 672
Chronic atrophic pyelonephritis, 1101
Chronic autoimmune thyroiditis, 1234, 1234f
Chronic bronchiolitis, in cystic fibrosis, 606Chronic bronchitis,
584. See also Chronic obstructive pulmonary disease (COPD).
acute exacerbation of, 520
Chronic constrictive pericarditis, 826
Chronic fatigue syndrome, 1632t, 1634
vs. fibromyalgia syndrome, 1632t
Chronic glomerulonephritis, 11051106
Chronic hereditary nephritis, 1115
Chronic illness, 5759
anemia of, 641t, 644
caregiver support in, 60
crisis prevention/management in, 58
impact of, 57, 58t
in older adults, 6163. See also Older adults.
overview of, 57, 58t
prevention of, 5859
psychosocial adaptation in, 58
self-management in, 60
seven tasks of, 57, 59t
sleep disturbances in, 101102, 103t
symptom control in, 58
trajectory of, 5758, 59f, 59t
treatment of, 58, 59t
types of, 5758
Chronic kidney disease, 11411149
clinical manifestations of, 1166t, 11421145, 1143f
cardiovascular, 11421143, 1144
hematologic, 11431144
integumentary, 1145
metabolic, 1142
neurologic, 1144
psychologic, 1145
reproductive, 1145
respiratory, 1144
urologic, 1171
24
th

definition of, 11701171
for anemia, 11471148
for CKDmineral and bone disorder, 1147
for hyperkalemia, 1147
for hypertension, 1147
drug-related, 1148
end-stage renal disease and, 11411142
nutritional therapy for, 11481149, 1148t1149t
prevention of, 1146t
race/ethnicity and, 1146t
renal transplant for, 11601163
risk factors for, 1146t
stages of, 1142t
uremia in, 1142
vs. acute kidney injury, 1136t
Chronic kidney diseasemineral and bone disorder, 1144, 1145f,
1147
Chronic lymphocytic leukemia, 669670, 669t, 672t. See also
Leukemia.
Chronic myelogenous leukemia, 670, 669t, 672t. See also Leukemia.
Chronic obstructive pulmonary disease (COPD), 584602
acute respiratory failure in, 590
airway clearance techniques for, 598599, 608609
alpha1-antitrypsin deficiency in, 585586, 586b
anxiety in, 590591
body mass index in, 591
breathing retraining for, 597598
case study of, 612b
chest physiotherapy for, 598, 598f
cor pulmonale and, 589591, 589f
coughing in, 565
effective, 598, 598t
depression in, 590
dyspnea in, 591, 605
end-of-life care in, 606, 606b
etiology of, 585587
exacerbations of, 590
exercise in, 604
gender differences in, 585, 585b
lung volume reduction surgery for, 548t
nutrition in, 599602
patient teaching for, 581t, 597t, 603t

planning in, 602
psychosocial considerations in, 605
Chronic obstructive pulmonary disease (COPD) (Continued)
pulmonary rehabilitation for, 604
respiratory failure in, 590, 1703, 1705
sexuality and, 605
sleep problems in, 605606
smoking and, 585, 585t, 592
stages of, 588f
surgery for, 597
vs. asthma, 568t
Chronic painless thyroiditis, 1234
Chronic pancreatitis, 1064t, 10651066
Chronic pelvic pain
in females, 13271328
in males, 1361
Chronic prostatitis/chronic pelvic pain syndrome, 1361
Chronic pyelonephritis, 1101
Chronic stable angina, 7748754, 749t. See also Angina.
collaborative care for, 750754, 751f, 750t, 771b
Chronic venous insufficiency, 862, 869870
Chvosteks sign, 298, 298f
Chylomicrons, 708
Chylothorax, 544
Chyme, 880
Cialis (tadalafil)
for erectile dysfunction, 1368
nitrates and, 784
Ciclesonide (Alvesco, Omnaris)
Cigarette smoking. See Smoking.
Cilia, 476
Ciliary body, 364366
Cimetidine (Tagamet)
Cimzia. See Certolizumab (Cimzia).
Cinacalcet (Sensipar), for hyperparathyroidism, 1246
Cingulate herniation, 1394f, 1396
Ciprofloxacin (Cipro)
Circadian rhythms, 101102
disturbances of, 107
in nurses, 111112
in hormone secretion, 1174, 1174f
Circle of Willis, 1378, 1425, 1425f
Circulating nurse, 332
Circulation
bronchial, 473
cardiac, 691f
cerebral, 13781379, 1425, 1425f
collateral, 1425
collateral, 738, 740f, 755
cerebral, 1425
in coronary artery disease, 738, 740f, 755
coronary, 691, 791f
in emergency assessment, 17221723, 1722t
portal, 881
pulmonary, 472
25
th
renal, 10761077
Circulatory assist devices, 781, 783, 791, 16521654
Circumcision, 1362
Circumduction, 1538
Cirrhosis
cardiac, 1046
hepatic, 10461054
ascites in, 1047, 1047f1048f, 1048t, 1049
case study of, 1073b1074b
drug therapy for, 1052t
edema in, 1047
esophageal/gastric varices in, 1047, 1050, 1058
etiology of, 1046
hepatic encephalopathy in, 1048, 1048t1049t
hepatorenal syndrome in, 1049
in nonalcoholic steatosis, 10451046
liver cancer and, 1060
portal hypertension in, 10461047
primary biliary, 1044
Citrucel (methylcellulose), for constipation, 989t
CKDmineral and bone disorder, 1144, 1145f, 1147
Clarinex (desloratadine), for allergic rhinitis, 496t497t
Clarithromycin (Biaxin), for H. pylori infection, 963t
Claritin (loratidine), for allergic rhinitis, 496t497t
Clark level, 428429
Classification systems, 8
Claw toe, 1594t, 1595f
Clean-catch urine specimen, 1086t1090t, 1096
Clemastine (Tavist), for allergic rhinitis, 496t497t
Cleocin. See Clindamycin.
Clevidipine (Cleviprex), for hypertension, 724t727t
Clindamycin (Clindesse), for bacterial vaginosis, 1326t
Clinical decision making, 45
Clinical nurse leader, 4
Clinical (critical) pathways, 1718
Clitoris, 1261f, 1261
Clodronate (Bonefos), for osteoporosis, 1596
Clomiphene (Clomid, Serophene), 1316t, 1332
Clonal disorders, 667
Clonic seizures, 1456
Clonidine (Catapres, Duraclon), 735b
for pain, 126t, 127
for smoking cessation, 155156, 156t
Clopidogrel (Plavix)
for intermittent claudication, 853
for pain, 126t, 127
Clopidogrel (Plavix)
for intermittent claudication, 853for peripheral arterial disease, 853
Closed pneumothorax, 542
Closed suction technique, 1658, 1658f
Clostridial diarrhea, 982984
Clostridial food poisoning, 979t, 983t

Clostridium botulinum, 1507
Clostridium tetani, 1507
Clot retraction time, 630t
Clotting, 619621
clot lysis in, 621, 621f
complementary and alternative therapies and, 864b
extrinsic pathway in, 620, 620f
intrinsic pathway in, 620, 620fplatelet plug formation in, 620
steps in, 620f
vascular response in, 619620
Clotting disorders
hemophilia, 657, 657659, 657t, 657b, 658f, 659t
in cirrhosis, 1047
Von Willebrands disease, 657659, 657t
Clotting factors, 620, 620f, 621t
for hemophilia, 659, 659t
inhibitors of, 659
Clotting studies, 629, 630t,
Clubbing, digital, 481, 484t485t, 699t700t
Cluster breathing, 1400f
Cluster headaches, 1450t, 14491450, 1453t, 1451. See also
Headaches.
Coagulation. See Clotting.
Coal workers pneumoconiosis, 535t, 534
Cobalamin. See Vitamin B12.
Cocaine, 153t154t, 160, 161t
Coccidioidomycosis, 433, 433t
Cochlea, 374, 375f
Cochlear implants, 410, 410f
Cochrane, Archie, 67
Codeine, 124t
abuse of, 154t, 161162
Coenzyme Q10, 86t
Cognitive changes
after stroke, 14301431
hormone replacement therapy for, 1324b
in dementia. See Dementia.
Cognitive-behavioral therapy
for insomnia, 102
for narcolepsy, 107
for pain, 132
Cognitive-perceptual pattern, 37t, 38
Cogwheel rigidity, in Parkinsons disease, 1471
Coiling, for aneurysms, 1435, 1435f
Colace (docusate), for constipation, 989t
Colchicine, for gout, 1621
Cold sores, 432t, 945t, 1307, 1307f
Cold therapy. See Cryotherapy.
Colds, 495496
Colectomy, 884t
in proctocolectomy
with continent ileostomy, 1003
with permanent ileostomy, 1003
total, with ileoanal reservoir, 1003, 10161017with ileoanal
reservoir, 1003, 1003f, 10161017
Colera, 31t
Colesevelam (WelChol), 747t
Colestipol (Colestid), 747t
26
th
Colic
biliary, 1068
renal, 1078
in nephrolithiasis, 1110
Collaborative problems, 13
Collateral circulation, 738, 749f, 755756
cerebral, 1424
in coronary artery disease, 737, 740f, 754755
Collecting ducts, 1078t
College students, alcohol use by, 1046b
Colles fracture, 1565
Colloidal oncotic pressure, 285
Colloids, 307
Colon. See also Bowel.
cancer of. See Colorectal cancer.
obstruction of, 10051009, 1008t
polyps of, 10101011, 1010f, 1010t
x-ray studies of, 891892, 891f, 891t894t
Colonic J-pouch, 1003f, 1014
Colonoscopy, 891t894, 892, 986987, 10101013
bowel cleansing for, 1015
virtual, 891t894t, 892
Colony-stimulating factors, 197t, 199t
for cancer, 271272, 271t
Coloplasty, 1014
Color vision, testing of, 370t, 373
Colorectal cancer, 10111014
biologic and targeted therapy for, 1014
clinical manifestations of, 10111012, 1012fcollaborative care in,
1012t, 10131014
etiology of, 1011
hereditary nonpolyposis, 1011, 1011b
risk factors for, 1011, 1011t
screening for, 891t894t, 892
surgery for, 10131014. See also Colostomy.
Color-flow imaging, cardiac, 709
Colostomy, 884t, 10141015. See also Ostomy.
ascending, 1016f
care of, 10181021
definition of, 1015
descending, 1016
double-barreled, 1016, 1016f
end, 1004, 1016
indications for, 884t
irrigation of, 1016t, 10181021
loop, 1004, 1016, 1017f
nursing care plan for, 1019b1020bpouches for, 1018, 1021
sigmoid, 1016f
single-barrel, 1016f
types of, 1016f
vs. ileostomy, 1016t
Colporrhaphy, 1341
Colposcopy, 1272t1275t, 1333
Colyte (polyethylene glycol), for constipation, 891t
Coma
definition of, 1393
diabetic. See Diabetic ketoacidosis.

screening for, 891t894t, 892, 986987, 10101013
surgery for, 10131014. See also Colostomy.
Color-flow imaging, cardiac, 709
Colostomy, 884t, 10141015, 1016t. See also Ostomy.
ascending, 1016f
care of, 10181021
definition of, 1015
descending, 1016f
end, 1004, 1016
irrigation of, 1016t, 10181021
loop, 1004, 1016, 1017f
pouches for, 1018, 1021
sigmoid, 1016f
single-barrel, 1016f
types of, 1016f
vs. ileostomy, 1016t
Colporrhaphy, 1341
Colposcopy, 12721275, 1333
Colyte (polyethylene glycol), for constipation, 989t
Coma
definition of, 1393
diabetic. See Diabetic ketoacidosis.
myxedema, 1241
respiration in, 1400f
Combigan (timolol/brimonidine), for glaucoma, 399t400t
Combivent (ipratropium/albuterol), for asthma, 573t574t, 572
Combunox. See Oxycodone.
Comedo, 421t
Commissurotomy, 834
Common carotid artery, 1379f
Common cold, 495497
Communication. See also Speech.
active listening in, 47
cultural factors in, 23, 2627, 3033, 31t32t
empathy in, 47
in end-of-life care, 147
in hearing loss, 407
in stroke patients, 1430, 1444, 1447
nonverbal, 26, 4748
SBAR model for, 5, 6t
silence and, 26, 30
stroke and, 1443, 1446
with foreign language speakers, 30, 30t31t
with tracheostomy, 503t504t, 507509, 509f510f
Community emergency response teams, 17341735
Community-acquired pneumonia, 521, 522t. See also Pneumonia.
Community-based long-term care, 76t. See also Long-term care.
Community-based nursing, 73
ambulatory care in, 75, 75t
consumerism and, 74
continuum of care in, 7475
demographic trends and, 74
health care reform and, 74
demographic trends and, 81
health promotion and prevention and, 74
home health care in, 7577. See also Home health care.
long-term care in, 75, 76t. See also Long-term care.
27
th
nursing roles in, 75

overview of, 73
practice settings in, 7476, 75t76t, 78t
socioeconomic factors and, 74
technology in, 74
vs. public health nursing, 73
Comparative genomic hybridization, 632t, 633
Compartment syndrome, 1725
abdominal, 994, 1679
in musculoskeletal injuries, 1564, 1564f
Competence, 792b
guardianship and, 953b
Complement, total hemolytic, 1540t1541t
Complement system
in hypersensitivity reactions, 202t
in inflammation, 172
Complementary and alternative therapies, 81
assessment of, 87
biologic-based, 82t, 8384
biomedical vs. integrative health care models and, 8182
clotting and, 864b
cultural aspects of, 30, 25, 28
definition of, 82
dietary supplements, 84, 86t
energy therapies, 82t, 86
ethical aspects of, 86, 1244b
for Alzheimers disease, 1490, 1490b
for back pain, 1590b1591b
for benign prostatic hyperplasia, 13491350, 1349b
for breast cancer, 1295b
for colds, 498b499b
for constipation, 988
for depression, 98b
for diabetes mellitus, 1211b
for dysmenorrhea, 1319
for headaches, 1452
for heart failure, 782b
for hepatitis, 1038b
for hyperlipidemia, 746b
for hypertension, 721b
for insomnia, 83, 105b, 106
for menopausal symptoms, 1324, 1325b
for nausea and vomiting, 942943, 943b
for osteoarthritis, 1608, 1603
for sleep problems, 86t, 104, 104b, 1315
for stress, 96b, 97b
for urinary incontinence, 1121b
herbal supplements, 8384, 84t85t
holistic nursing and, 82
in folk medicine, 25, 28
in health history, 36
in nurses self-care, 8788, 87t
incorporating into practice, 87, 87t
integrative health care model and, 8182, 82t
manipulative and body-based, 82t, 8486
massage, 8486, 85t
mind-body interventions, 82t, 83
music therapy, 335
overview of, 82
patient teaching for, 86

popularity of, 82
preoperative assessment for, 317, 318b
safety and effectiveness of, 82, 86
terminology of, 82
traditional Chinese medicine and, 8283, 83t
vs. Western biomedical model, 81, 82t
whole medical systems and, 8283
Complete blood count, 628631, 629t
Complete heart block, 802t, 806f, 807
Complex regional pain syndrome, 118
Compliance (physiologic)
intracranial pressure and, 1393, 1393f
pulmonary, 473
Compliance (therapeutic), ethical aspects of, 834b
Complicated grief, 142
Composite urine collection, 1086t1090t
Comprehensive assessment, 40, 41t
Comprehensive database, 34
Compression bandages
for amputation stump, 15731574, 1574f
Compression fractures, vertebral, 1570
Compression stockings, 863
Computed tomography (CT)
abdominal, 891t894t
calcium-scoring, 703t707t
cardiac, 703t707t, 710, 710f
cerebral, 1386, 1388f, 1388t1389t
chest, 487t488t
for endocrine tumors, 1184t1187t
musculoskeletal, 1540t1542
pelvic, 1272t1275t, 1275
renal, 1086t1090t
single-photon emission, 703t707t
spiral (helical), for pulmonary embolism, 554
Computed tomography angiography, 703t707t
for stroke, 1430
Computers. See Technology.
Comtan (entacapone), for Parkinsons disease, 1472
Concentration technique, 94
Concentration test, 1086t1090t
Concept maps, 17, 16f
Concussions, 1405. See also Head injury.
Condoms, 232, 1300, 1310
Conduction system. See Cardiac conduction system.
Conductive hearing loss, 374, 406407. See also Hearing loss.
Conductive keratoplasty, 383
Condyloid joints, 1533f
Condylomata acuminata, 13081309, 1309f
Condylox (podofilox), for genital warts, 1309
Confidentiality, 1312b
Confusion Assessment Method, 1498t
Congenital syphilis, 1303
Congestive heart failure. See Heart failure.
Conization, 1272t1275t
for cervical cancer, 13321333
Conjunctiva, 364, 367t
disorders of, 371t
examination of, 372
Conjunctivitis, 371t, 387388
Connective tissue disorders, 1601
mixed (overlapping), 1631
race/ethnicity in, 1610b
Consciousness, changes in, in increased intracranial pressure, 1394
Consent. See Informed consent.
28
th
Constipation, 881, 988990, 990t, 991t

after stroke, 1430, 1441, 1444, 1445
fecal impaction and, 985986
fractures and, 15581560
in cancer, 262t263t
in multiple sclerosis, 1464, 1465
opioid-related, 125
Constraint-induced movement therapy, 1445
Constulose. See Lactulose (Constulose, Cephulac).
Contact dermatitis, 204, 204f
allergic, 425, 433, 435f
irritant, 425
latex, 207, 208, 208t
Contact lenses, 383, 384t
Contact precautions, 222
Contemporary nursing practice. See Nursing practice.
Continence, urinary, 10801081
Continuing care retirement communities, 77t. See also Long-term
care.
Continuous ambulatory peritoneal dialysis, 1154. See also Peritoneal
dialysis.
Continuous venovenous hemodialysis, 11591160, 1159t
Continuous venovenous hemofiltration, 1159, 1159t
Continuous venovenous ultrafiltration, 11591160
Continuous cardiac output method, 16491650
Continuous lateral rotation therapy, 1716, 1716f
Continuous passive motion, 1553
Continuous positive airway pressure (CPAP), 1663
for sleep apnea, 108, 108f, 109b
Continuous renal replacement therapy, 11591160, 1159t,
1159fContinuous venovenous hemodialysis, 11591160, 1159t,
1159f
Continuous venovenous hemofiltration, 11591160, 1159t, 1159f
Continuous venovenous ultrafiltration, 11591160, 1159f
Contraceptives, 1268
barrier, 232, 1300, 1310
oral. See Oral contraceptives.
sexually transmitted diseases and, 1301
Contractility, 16421643
Contractures, 179t, 1539t, 1562t
burn, 465, 466f
flexion, after amputation, 1573
Volkmanns ischemic, 1564, 1564f
wound, 179t
Contrast media
for abdominal imaging, 889
implanted infusion ports for, 309310
metformin and, 12091210
nephrotoxicity of, 1140
Contusions, brain, 1406, 1406f
Conus medullaris syndrome, 1510
Coombs test, 631t
Cooper-Rand artificial larynx, 516
Coordinated walking, 604
COPD. See Chronic obstructive pulmonary disease (COPD).
Copegus (ribavirin), for hepatitis C, 1039, 1039b
Coping, 93
emotion-focused, 93
problem-focused, 93
Coping flexibility, 94Coping resources, 93
Coping strategies, 94, 94t. See also Stress management.
Coping-stress tolerance pattern, 37t, 39, 97, 97t
Cor pulmonale, 556f, 558, 558t

in COPD, 587590, 589f
Cordarone (amiodarone), for dysrhythmias, 809t
Cordectomy, 511, 511f
Cordotomies, 130, 131f
Coreg. See Carvedilol (Coreg).
Corgard. See Nadolol (Corgard).
Corlopam (fenoldopam), for hypertension, 724t727t
Cornea, 365f, 366
abrasion of, 371t
examination of, 372
in older adults, 367t, 368f
scarring of, 389390transplantation of, 389390, 411f
ulcers of, 388, 388f
Corns, 1594t
Coronary angiography, 703t707t, 710
in acute coronary syndrome, 758
Coronary arteries, 690, 691f
calcification of, 738
stents for, 753, 753f
emergent placement of, 758759
Coronary artery bypass grafting, 737, 753f, 760, 760f
emergent, 737, 753, 758759
minimally invasive direct, 760
off-pump, 761
robot-assisted, 761
Coronary artery disease, 737743
activity and exercise and, 742, 744745
acute coronary syndrome and, 754755, 754f
angina in, 748750, 754f, 755. See also Angina.
balloon angioplasty for, 753, 754f
cardiac catheterization for, 753
collaborative care for, 743748, 750754, 751f, 750t
collateral circulation in, 738, 740f, 755
complicated lesions in, 738, 739f
diabetes mellitus and, 745
diagnosis of, 751f
drug therapy for
ACE inhibitors in, 750t, 753
antiplatelet agents in 747, 762t
aspirin in, 751t, 747
beta-adrenergic blockers in, 752t, 753
calcium channel blockers in, 752t, 753
lipid-lowering drugs in, 745748, 746b, 747t
nitrates in, 752t, 750753sodium current inhibitors in, 745t, 753
etiology of, 737738
exercise and, 742, 744745
family history of, 739
fatty streaks in, 738, 739fgender differences in, 740, 740b, 754,
754b
health disparities in, 740b
homocysteine and, 743
hyperlipidemia and, 738, 739b
hypertension and, 718, 741
metabolic syndrome and, 743
myocardial infarction and, 738, 753f, 754756
nutrition and, 745, 745t
obesity and, 742743
29
th

plaque in, 738, 739f
psychosocial factors in, 743
race/ethnicity and, 740, 740b
risk management for, 744risk reduction for, 744t, 750
risk screening for, 743silent ischemia in, 749
smoking and, 742
stages of, 738, 739f
stents for, 753, 753f
stress and, 743
substance abuse and, 743
sudden cardiac death and, 770
Coronary circulation, 690, 691f
Coronary microvascular disease, 749, 749t
Coronary revascularization
bypass grafting in, 753, 753f, 754, 754f. See also Coronary artery
bypass grafting.
transmyocardial laser, 761
Corrective lenses, 383
Correctol (phenolphthalein), for constipation, 989t
Cortical bone, 1530
Corticosteroids
definition of, 1177, 1247
endogenous, 1172t, 1177
Cushing syndrome and, 12471248
types of, 1247
exogenous, 12531254
Cushing syndrome and, 12471248
for Addisons disease, 12521253
for adrenalectomy, 12501251
for asthma, 569570, 573t574tfor Bells palsy, 1504
for COPD, 594
for immune thrombocytopenic purpura, 665666
for myasthenia gravis, 14761477
for nephrotic syndrome, 1105
for pain, 114
for polymyositis/dermatomyositis, 1631
for rheumatoid arthritis, 1614
for sinusitis, 496t497t
for skin disorders, 439
for spinal cord injury, 1515
for transplantation, 214t, 1165
gastritis and, 962
intralesional, 439
intravenous, 1709
osteoporosis from, 1254, 1596patient teaching for, 1254t
physiologic effects of, 1253
side effects of, 439, 1165, 12531254, 1254t, 16181619
stress response and, 91
topical, 439
Corticotropin-releasing hormone, 1177
in stress response, 91
Cortisol, 1177
deficiency of, 1229
excess of, in Cushing syndrome, 12471249
in fluid and electrolyte balance, 287, 287f
secretion of, 1174f
Corvert (ibutilide), for dysrhythmias, 809t
Coryza, acute, 497498
Cosmetic procedures, 441t, 442443
face-lift, 442443, 444flaser surgery, 442
liposuction, 443
nonsurgical, 441t
rhinoplasty, 494
Cosopt (timolol maleate/dorzolamide), for glaucoma, 399t400t
Costovertebral angle, 1084, 1084f
pain at, in urinary tract infections, 1100
Cotazym (pancrelipase), for chronic pancreatitis, 10651066
Cough(ing)
assisted (augmented), 1519, 17071708, 1708f
huff, 598, 598t, 1707
in acute bronchitis, 521
in asthma, 565
in COPD, 587, 598, 598tin lung cancer, 538
in pertussis, 521
postoperative, 350, 350f
staged, 1708
whooping, 220t, 521
Cough reflex, 476
Coumadin. See Warfarin (Coumadin).
Counterpulsation, 781, 783, 16521654, 1652t1653
Counterregulatory hormones, 1190
Couplets, 807
Covera-HS (verapamil), for hypertension, 724t726t
Cowpers glands, 1259f
COX inhibitors, 117, 122, 123f, 123t
Coxibs, 122123, 123t
Cozaar. See Losartan (Cozaar).
CPAP (continuous positive airway pressure), 1663
for sleep apnea, 108f, 109b, 110
Crackles, 484, 484t485t
Cramps
heat, 17261727
Cranberry, for urinary tract infections, 10951097
Cranial nerves, 13761377, 1377f, 1377t
disorders of, 1501
examination of, 1382, 1386t
in neurologic assessment, 13991400
Cranial radiation, prophylactic, in lung cancer, 539
Cranial surgery, 14141415
for seizures, 14591460, 1460t
indications for, 1413t, 1414
types of, 1413t, 14141415
Craniometry, 1413t, 1414
Craving, 153t
cue-induced, 155
C-reactive protein, 1540t1542t
coronary artery disease and, 737
in cardiac assessment, 702, 728t732t
Creams, 441
Creatine kinase
30
th
in muscle disorders, 15401542t

Creatinine, 1086t1090t, 1092
serum, vs. glomerular filtration rate, 1146, 1146t
Creatinine clearance, 1086t1090t, 1092
Crepitation, 1539t
in osteoarthritis, 1602
CREST signs, 16281629
Crestor (rosuvastatin), 747t
Cretinism, 1240
Cricoid pressure, in rapid-sequence intubation, 1721, 1721f
Critical care nursing, 1638
agitation in, 1429, 1438
anxiety in, 1640
artificial airways in, 16551657
caregiver needs in, 16411642
circulatory assist devices in, 16951698
common problems in, 16401641
cultural aspects of, 16421652
delirium in, 1641, 1666
endotracheal intubation in, 16551657
hemodynamic monitoring in, 1642
impaired communication in, 1641
nurses responsibilities in, 16391640
patient characteristics in, 16401641
sedation in, 1403, 1404
sensory overload in, 1641
sleep problems in, 106, 1641
Critical care units, 16381639
electronic (virtual), 1638
Critical limb ischemia, 853
Critical (clinical) pathways, 1718
Critical thinking, 4
Crohns disease, 9981004, 1000f. See also Inflammatory bowel
disease.
vs. ulcerative colitis, 999t
Cromolyn (Intal, Nasalcrom)
Crossing over, 205
Crossmatching, 213
Crush injuries, 1725
Crutches, 1563
Crutchfield tongs, 1516, 1519fCryoablation
for breast fibroadenomas, 1280
for liver cancer, 1059
Cryoplasty, for peripheral arterial disease, 854
Cryoprecipitate
for hemophilia, 649, 661, 660
Cryosurgery, 440
gynecologic, 1266t
Cryotherapy
for inflammation, 175
for pain, 132, 132t
Cryptococcosis, 533, 533t
Cryptorchidism, 1364
Cryptosporidiosis, 983t
CT. See Computed tomography.
C-type natriuretic peptide, 702, 703t707t
Cue-induced craving, 155
Culdocentesis, 1272t1275t
Culdoscopy, 1272t1275t
Culdotomy, 1272t1275t
Cullens sign, 995, 10621063
Cultural assessment, 24, 2931, 30t
for surgical patient, 354
Cultural competence, 24, 25t. See also Culturally competent care.
components of, 24, 30t
Cultural diversity, in health care workplace, 2425, 3031
Cultural imposition, 24
Culturally competent care, 4, 36
advocacy in, 31, 31t
assessment in, 36
communication in, 24, 2931, 30t, 31t
family issues in, 27
for diabetes mellitus, 1206
health history in, 36
health history in, 36
in home health care, 77
nurses self-assessment in, 2829
patient assessment in, 24, 2932, 30t
preeoperative, 327
standardized guidelines for, 30
Culture, 2223
acculturation and, 23, 2627
assimilation and, 23
auditory problems and, 383b
basic characteristics of, 23t
biculturalism and, 23
cancer and, 242, 242b
of breast, 1290, 1290b
of female reproductive tract, 1332b
of lung, 536b
communication and, 24, 2627, 3033, 31t
critical care and, 16421652
definition of, 22diabetes mellitus and, 1206
diet and, 27, 879880, 901
end-of-life care and, 1642
ethnicity and, 23, 23t . See also Race/ethnicity.
family roles and relationships and, 27
folk healers and, 25, 2829
health beliefs and practices and, 2528, 25t26t
health care and, 2123, 2533, 30t. See also Culturally competent
care; Health disparities.
health disparities and, 2122, 2425, 2932, 30t. See also Health
disparities.
health literacy and, 50
immigration and, 2728
menopause and, 1323
obesity and, 923t
patient teaching and, 50
personal space and, 27
preoperative care and, 327
psychosomatic disease and, 27, 29
31
th
race and, 2223, 23t

religion and spirituality and, 25, 26t
stereotyping and, 23
subcultures and, 22
touch and, 27
transcultural nursing and, 23
tuberculosis and, 528b
vision problems and, 383b
Culture-bound syndromes, 28, 29, 29t
Cultured epithelial autografts, 463, 463f
Cultures
blood, 222b
cervical, 1272t1275t, 1275
skin, 423t
stool, 891t894t, 1275
urethral, 1272t1275t, 1275
urine, 1086t1091t, 1096
sensitivity testing and, 1096
vaginal, 1272t1275t, 1275
wound, 183
Cumulative trauma disorders, 1547
Cuprimine (penicillamine), for arthritis/connective tissue disease,
1605t1607t
Curanderos, 25
Curettage, 440, 440f
Curlings ulcer, 459t, 462
Cushing disease, 1247
Cushing syndrome, 12471249, 1247t1249t, 1248f1249f
Cushings triad, 1395
Cutaneous T-cell lymphoma, 428t, 438
Cutaneous ureterostomy, 1128t
Cyanide poisoning, 1731t
Cyanocobalamin, for pernicious anemia, 644
Cyanosis, 416, 419t, 421t, 481, 484t485t, 627t628t, 669t700t
in dark-skinned patients, 419t, 421422
Cyclogyl (cyclopentolate), for pupillary dilation, 392t
Cyclooxygenase (COX) inhibitors, 122123, 123f, 123t
Cyclopentolate (AK-Pentolate, Cyclogyl, Ocu-Pentolate, Pentolair), for
pupillary dilation, 392t
Cyclophosphamide (Cytoxan, Neosar)
for aplastic anemia, 646
for systemic lupus erythematosus, 1605t1607t, 1612, 1623
for transfusions, 214t
Cycloplegics, 391, 392t
Cyclosporine (Sandimmune, Neoral, Gengraf)
for transplantation, 213214, 214t
Cyklokapron (tranexamic acid), for hemophilia, 650, 660t
Cypionate (Depo-Testosterone), for andropausal symptoms, 1369
Cyst(s), 421t
breast, 1279t, 1280
chocolate, 1329
ganglion, 1539t
ovarian, 1331, 1331f
pilonidal, 890t
Cystectomy, with urinary diversion, 11291131. See also Ileostomy.
Cystic fibrosis, 606609
assessment in, 610t
diagnosis of, 608
etiology of, 606607
genetic aspects of, 606607, 606b

planning in, 610
Cystine stones, 1109t. See also Urinary calculi.
Cystitis, 1094, 1094f
chemical, 1085t
hemorrhagic, in cancer, 262t263t
interstitial, 11021103
Cystocele, 1266t, 1340, 1340f
Cystogram, 1086t1090tCystometrogram, 1086t1090t
Cystoscopy, 1086t1090t, 1089f
Cystotomy, 1111
Cytadren (aminoglutethimide), for breast cancer, 1289t, 1290
Cytokines, 9293, 197198
clinical uses of, 197198, 199t
in fever, 173, 173f
in inflammation, 172, 172t, 197
types and functions of, 198t
Cytomegalovirus infection, 523
after renal transplant, 1164
retinal, 400401
Cytoprotectants, for peptic ulcers, 969
Cytotec (misoprostol), 967969
for induced abortion, 1317, 1317t
Cytotoxic cerebral edema, 1393
Cytotoxic T cells, 196, 248, 248f
Cytoxan. See Cyclophosphamide (Cytoxan, Neosar).
D
Daclizumab (Zenapax), for transplantation, 214t, 215
Dacogen (decitabine), for myelodysplastic syndrome, 668669
Dalteparin (Fragmin)
for venous thromboembolism, 863t, 854
Danazol (Danocrine), for immune thrombocytopenic purpura, 656
Daranide (dichlorphenamide), for glaucoma, 399t
Darbepoetin (Aranesp), for cancer, 271272, 271t
Dark-field microscopy, 1274t1275t
Darvon (propoxyphene), 125
Dasatinib (Sprycel), for cancer, 269t270t
DASH eating plan, 721722, 720t
Data collection, 11, 3436. See also Assessment; Health history
Database, 3436
comprehensive, 34
Dawn phenomenon, 1199
Day care, adult, 65
D&C. See Dilation and curettage (D&C)
DDAVP (desmopressin acetate). See Desmopressin acetate (DDAVP)
D-dimer test, 555, 630t, 663
DDP-4 inhibitor, for diabetes mellitus, 1200t, 1201
Deafness. See Hearing loss.
Death, 141. See also End-of-life care.
brain, 141
definition of, 141
determination of, 141
Death rattle, 141
Debridement, 177-178, 182t, 1575
of burns, 457, 458f, 462
of open fractures, 1563-1564
Decerebrate posturing, 1395, 1395f, 1403
Decibel levels, 407, 408t
Decitabine (Dacogen), for myelodysplastic syndrome, 668669
Deconditioning, in older adults, 68
32
th
Decongestants
for allergic rhinitis, 495, 496t-497t
Decorticate posturing, 1395, 1395f, 1403
Decortication, 548t, 552
Decubitus ulcers, 183185, 184t
Deep brain stimulation, for Parkinsons disease, 1473
Deep breathing, postoperative, 350
Deep inferior epigastric artery perforator (DIEP) flap, 1317t, 1297
Deep tendon reflexes, 1387t
Deep vein thrombosis, 552, 859. See also Venous thromboembolism.
after stroke, 1438
prevention of, 555
Defecation, 880. See also under Elimination; Fecal; Stool.
position for, 990
Valsalva maneuver in, 988
Defibrillation, 810811, 810f
safety concerns for, 811b
Defining characteristics, 1213
Degarelix, for prostate cancer, 1359t, 1369
Degenerative disk disease (DDD), 15891592
Deglutition. See Swallowing.
Dehiscence, 179f, 179t, 347
Dehydration, 289
Delatest (enanthate), for andropausal symptoms, 1369
Delayed emergence, from anesthesia, 353
Delegation, 1415, 15t, 15b
in Alzheimers disease, 1497b
in assessment, 43b
in bladder irrigation, 1359b
in cardiac catheterization, 770b
in cast/traction care, 1578b
in diabetes mellitus, 1223b
in enteral nutrition, 913b
in fluid therapy, 307b
in health history, 43b
in implementation, 1415, 15t, 15b
in mechanical ventilation, 1664b
in neutropenia, 665b
in ostomy care, 1020b
in oxygen therapy, 595b
in pain management, 133b
in percutaneous coronary intervention, 770b
in physical examination, 43b
in seizures, 1464b
in stroke, 1435b
in tracheostomy care, 517b
in transfusion, 682b
Delirium, 1381, 14961497
alcohol withdrawal, 160161, 160t
postoperative, 353
diagnosis of, 1496t
emergence, 352353
in bacterial meningitis, 1417
in burn injury, 461
in critical care, 1640, 1666
vs. dementia, 1483t, 1497
vs. depression, 1483t
Delta virus, 1035
Demadex (torsemide), for hypertension, 724t727t
Demand analgesia, 130

Dementia, 14821485
Alzheimers. See Alzheimers disease.
etiology of, 1482 1483f, 1484t
falls in, 1494b
frontotemporal, 14951496
Lewy body, 1495
memory loss in, 14831484
nursing management of, 1484, 14971499
patient management in, 1496t
restraints in, 7071
severity of, 1483, 1484tt
vascular, 1483
vs. delirium, 1483t, 1497
vs. depression, 1483t, 1484
Dementia paralytica, 1508
Demerol (meperidine), 125
abuse of, 154t, 161162
Demyelination, in multiple sclerosis, 1464, 1465f
Dendrites, 1372, 1373f
Dendritic cells, 196
Dengue fever, 220t
Dental procedures, antibiotic prophylaxis for, 821, 821t, 821b
Depakote (valproic acid), for migraine prevention, 1453
Depen (penicillamine), for arthritis/connective tissue disease, 1605t
1607t
Dependence, substance, 152, 153t
on opioids, 133
physical, 153t
psychologic, 153t
Depolarization, 692
Depo-Provera. See Medroxyprogesterone (Depo-Provera, Provera).
Depo-Testosterone (cypionate), for andropausal symptoms, 1369
Depressants, abuse of, 161
Depression
after laryngectomy, 517
after stroke, 1430, 14461447
in COPD, 591
in dying patient, 146
in older adults, 70
vs. dementia, 1519t, 1520
Dermatitis. See also Skin disorders.
atopic, 203, 203f, 435t
contact, 204, 204f
allergic, 425, 435t
irritant, 425
radiation recall, 265266
venous, 869870
Dermatomes, 116
Dermatomyositis, 16301631, 1632f
Dermatoscopy, 422
Dermatosis papulosa nigra, 421422
Dermis, 414, 414f, 448
Desaturation test, 491492
Descartes, Rene, 81
Descemets stripping endothelial keratoplasty (DSEK), 390
Descending tracts, 1374
Desflurane (Suprane), 340t
33
th
Desirudin (Iprivask), for venous thromboembolism, 863

Desloratadine (Clarinex), for allergic rhinitis, 496t497t
Desmopressin acetate (DDAVP)
for diabetes insipidus, 1232
for hemophilia, 653
for von Willebrand disease, 653
Desoxyn (methamphetamine), abuse of, 154t
Destination therapy, 783, 838
Desyrel (trazodone), 104
Detemir (Levemir), 11961197
Determinants of health, 1920, 20f
Detrol (tolterodine), for overactive bladder, 1124b
Detrusor muscles, 1080
in obstructive uropathies, 1106
in urinary retention, 1119
Deviated septum, 493
DEXA scan, 1540t1542t
in bone density measurement, 1595
Dexamethasone (Decadron), for nausea and vomiting,
942Dexamethasone suppression test, 1185t1187t
Dexchlorpheniramine (Polaramine), for allergic rhinitis, 496t497t
Dexlansoprazole (Dexilant)
for peptic ulcers, 968t
Dexmedetomidine (Precedex), for increased intracranial pressure, 1403
Dextran, 307
Dextroamphetamine (Dexedrine), abuse of, 154t
DiaBeta (glyburide), for diabetes mellitus, 1200, 1200t
Diabetes insipidus, 287, 12311232, 1231f, 1231t
after hypophysectomy, 1228
hypernatremia and, 291292
increased intracranial pressure and, 14021403
Diabetes mellitus, 1189
associated systemic diseases and, 1190
chronic kidney disease and, 11421143
complications of
acute, 1213
angiopathy, 12181219
cardiovascular, 12181219, 1219t
chronic, 1218, 1218f, 1219t
diabetic ketoacidosis, 1192, 12131216, 1214f, 1720t
erectile dysfunction, 1221
foot ulcers, 1219, 1220f1221f, 12211222, 1222t
gastroparesis, 1221
hemoglobin A1C and, 1194b
hyperglycemia, 1193, 1213, 1213t, 12161217
hyperosmolar hyperglycemic syndrome, 12161217, 1216t, 1217f
hypertension, 12181221
hypoglycemia, 1213, 1213t, 12171218, 1217t
infections, 1222
integumentary, 1222
lipodystrophy, 1197, 1199
macrovascular, 12181219
microvascular, 1220
necrobiosis lipoidica diabeticorum, 1222, 1222f
neuropathy, 1219t, 12201222, 1220f1221f
peripheral arterial disease, 855, 1221
prevention of, 1218
psychiatric, 12231224
renal, 11151116, 1219t, 1220
retinal, 394395, 394f, 12191220, 1219
culturally competent care for, 1206

drug therapy for, 1195t, 1200t
assessment for, 1199t
insulin in, 11941199. See also Insulin, exogenous.
oral agents in, 1200, 1200t, 12101211
drug-related, 1193
eating disorders and, 1223
exercise in, 1204, 1204t
gestational, 1193
glucose monitoring in, 12041206, 1205f, 1205t
health promotion for, 1206, 1209b
home health care in, 12101213
hyperglycemia in, 1213t
hypoglycemia in, 1213t
idiopathic, 1191
in acute illness, 12061209
medical alert aids for, 1211, 1211f
nursing care plan for, 1208b1209
nutritional therapy for, 12011203, 1202t
pancreas transplant for, 1206
patient teaching for, 1204, 12101213, 1212t
perioperative management of, 12071210
planning in, 1206
prediabetes and, 1192
psychosocial aspects of, 1212
screening for, 1207, 1207t
stroke and, 1425
tight glucose control in, 1218
travel and, 1211
type1, 11891191, 1190t
diet in, 1202
etiology of, 1191
onset of, 11911192
type2, 1190t, 11911192
diet in, 12021203
genetic factors in, 1192
onset of, 1192
pathophysiology of, 1220f, 11921193
Diabetic dermopathy, 1219
Diabetic diet, 12011203, 1202t
Diabetic ketoacidosis, 1221, 12131216
Diabetic nephropathy, 11161117, 1219t, 1220
Diabetic neuropathy, 1210t, 12201223, 1220f1221f
Diabetic retinopathy, 394395, 394f, 12191220, 1219t
case study of, 411b
Diagnosis. See Nursing diagnoses.
Dialysis, 11511152
definition of, 1151
diffusion in, 1152
34
th
hemodialysis, 11381139, 11561157. See also Hemodialysis.

osmosis in, 1152
peritoneal, 1140, 11521154. See also Peritoneal dialysis.
principles of, 1152
ultrafiltration in, 1152
Diamox (acetazolamide), for glaucoma, 399t400t
Diaphragm, 473
paralysis of, 473
Diaphragmatic breathing, 597
Diaphragmatic (hiatal) hernia, 952, 953f
Diaphyses, 1531, 1531f
Diarrhea, 982984
definition of, 982
diagnosis of, 983
in cancer, 262t263t, 264265
in Crohns disease, 1001
in inflammatory bowel disease, 1000, 1005
in short bowel syndrome, 1026
in ulcerative colitis, 1001
infectious, 982984, 983t
noninfectious, 982
Diarthrodial joints, 1531, 1531f1532f
Diastole, 690, 692Diastolic blood pressure, 694. See also Blood
pressure.
Diastolic heart failure, 775
Diazepam (Valium), abuse of, 154t, 162
Dichlorphenamide (Daranide), for glaucoma, 399t400t
Diclofenac K (Cataflam), 123t
Dicyclomine (Bentyl), for irritable bowel syndrome, 994
Didronel (etidronate)
Diencephalon, 1376, 1376f
DIEP flap, 1297
Diet. See also Feeding; Food; Nutrition.
aging and, 61
antiaging effects of, 61
caffeine in, 106t
carbohydrates in, 898
DASH, 721722, 720t
diabetic, 12011204, 1202t
diverticular disease and, 10221023
fad, 929
fat in, 899890
fecal incontinence and, 986
gluten-free, 1026t
high-calorie, high-protein, 907t
high-fiber, 989990, 990t
incomplete, 903
ketogenic, 1461
low-calorie, 928929, 928t
low-fat, 745, 745t
low-sodium. See Low-sodium diet.
minerals and trace elements in, 898902, 902t
preoperative, 323, 324t, 325b

protein in, 900
recommended intakes in, 903, 903t
therapeutic lifestyle changes, 745, 745t
vegan, 901
vegetarian, 901
vitamins in, 900. See also Vitamin(s).
Dietary Reference Intakes, 903, 903t
Dietary supplements, 84, 86t
Diffuse axonal injury, 1405
Diffuse parenchymal lung disease, 553
Diffusion, 283, 283f, 1152t
oxygencarbon dioxide, 473474, 474f
Diflucan (fluconazole), for vaginal candidiasis, 1326t
Digestion, 878879
physiology of, 879, 879t
Digital rectal examination, 1347
Digitalis
Digoxin (Lanoxin)
for myocarditis, 827
Dihydrotachysterol (Hytakerol), for hypoparathyroidism, 1247
1,25-Dihydroxycholecalciferol (calcitriol), for hypoparathyroidism,
1247
Dilacor XR (diltiazem), for hypertension, 724t727t
Dilantin. See Phenytoin (Dilantin).
Dilated cardiomyopathy, 775, 837838, 838f
Dilation and curettage (D&C), 1266t
for menorrhagia, 1321
for spontaneous abortion, 1316
Dilation and evacuation, 1317t
Dilaudid (hydromorphone), 124t
abuse of, 154t
Diltiazem (Cardizem)
Dimetane (brompheniramine), for allergic rhinitis, 496t497t
Dimethyl sulfoxide (DMSO), for interstitial cystitis, 1103
Dinoprostone (Cervidil, Prostin E2), for induced abortion, 1317t
Diovan (valsartan), for hypertension, 724t727t
Dipeptidyl peptidase-4 inhibitor, for diabetes mellitus, 1200t, 1201
Diphenhydramine (Benadryl)
for insomnia, 104
Diphenoyxlate-atropine (Lomotil), for diarrhea, 984t
Diphtheria, 220t, 502
Dipivefrin (Propine), 399t-400t
Diplopia, 371t, 1387t
in stroke, 1444
Diprivan (propofol), in general anesthesia, 340t
Dipyridamole (Persantine), for stroke, 1432, 1434
Dipyridamole stress test, 703t707t
Direct immunofluorescence, 422, 423t
Directives to physicians, 144, 145t
Disability, in emergency assessment, 1722t, 1723
Disaster medical assistance teams, 1735
Discharge
from ambulatory surgery, 359360
from postanesthesia care unit, 359, 359t
Discharge planning, for older adults, 67
Discoid lupus, 1622
Disconjugate gaze, 1383
Discrimination, 22
35
th
Disease-modifying antirheumatic drugs, 1605t1607t, 1613

Diskectomy, 1590
Diskograms, 1540t1542t
Dislocations, 1539t, 1547
Disopyramide (Norpace), for dysrhythmias, 809t
Disseminated gonococcal infection, 1302, 1302f
Disseminated intravascular coagulation (DIC), 661663
in systemic inflammatory response syndrome, 1682t, 1696
thrombocytopenia in, 655, 655t
Dissociative anesthesia, 339, 340t
Distal convoluted tubules, 1077f, 1078, 1078
Distal intestinal obstruction syndrome, 607, 609
Distal splenorenal shunt, 1052, 1052f
Distraction, for pain, 132
Distributive shock, 16751677. See also Shock.
pathophysiology of, 1677f1679f
Diuretics
for heart failure, 781, 782t, 783t
for stroke, 1433
loop, 724t727t
potassium-sparing, 724t727t
side effects of, 724t727t, 729
thiazide, 724t727t
Diuril. See Chlorothiazide (Diuril).
Diverticula
epiphrenic, 956, 956f
esophageal, 956
intestinal, 10221023, 1023f, 1023t
urethral, 11021103
Zenkers, 956, 956f
Diverticular disease, 10221023, 1022f1023f, 1023t
Dixidan (docusate), for constipation, 989t
Dizziness, 375
DMSO (dimethyl sulfoxide), for interstitial cystitis, 1103
DNA, 190
Do not resuscitate (DNR) orders, 144145, 145t
Dobutamine (Dobutrex)
in dilated cardiomyopathy, 838
for shock, 1686t1687t
Dobutamine stress test, 703t707t
Docetaxel (Taxotere), for prostate cancer, 1359
Doctorate of nursing practice, 3
Documentation, 1618
electronic health records and, 910
of pain, 121
of physical examination, 40
Docusate, for constipation, 989t
Dofetilide (Tikosyn), for dysrhythmias, 809t
Dog bites, 1730
Dolasetron (Anzemet), for nausea and vomiting, 942
Dolls eye reflex, 1401
Dolophine (methadone), 154t, 123124
Domestic violencem, 1733
Donepezil (Aricept), for Alzheimers disease, 1488
Donnagel-PG, for diarrhea, 984t
Do-not-resuscitate (DNR) orders, 144145, 144t
Dopamine, endogenous, 1177, 1347t
Dopamine (Intropin)
for cardiogenic shock, 1731t1732t
for heart failure, 782784, 782t, 782b
Doppler imaging. See also Ultrasonography.
cardiac, 709
duplex venous, 1540t1542
in stroke, 1430
transcranial, 1388t1389t
Dorsal horn processing, in pain, 116117
Dorsiflexion, 1538t
Dorzolamide (Trusopt), for glaucoma, 399t400t
Double vision, 371t, 1387t
in stroke, 1444
Double voiding, 11241125
Double-barreled stoma, 1016, 1016f
Dowagers hump, 1539t, 1595
Down syndrome, ocular disorders in, 402t
Doxazosin (Cardura), for hypertension, 724t727t, 728b
Doxorubicin (Adriamycin), cardiotoxicity of, 1289t
Doxycycline (Vibramycin)
for chlamydial infections, 1305, 1305t, 1326t
for gonorrhea, 13011303, 1302t, 1302f
for Lyme disease, 1620
for reactive arthritis, 1619
for syphilis, 1301t
Drainage
of cerebrospinal fluid, 1392f, 1397f1398f, 1398
pleural, 545547, 546f, 548t. See also Chest tubes.
postural, 598
wound, 177, 177f, 357358, 358t
Drains, 177, 178f
Dressings, 177178, 178t
for burns, 446, 457458, 458f, 460b
for central venous access devices, 310
for chest tubes, 547t
for skin grafts, 463, 463f
for venous leg ulcers, 869
wet, 441
Dressler syndrome, 757, 824
Dribbling, postvoid, 1096t
Dristan (oxymetazoline), for allergic rhinitis, 496t497t
Dronabinol (Marinol), 127128
for nausea and vomiting, 942
Drop arm test, 1549
Droplet precautions, 222
Drotrecogin alfa (Xigris)
for septic shock, 1686t1687t, 16881689
Drowning, 17281729, 1729t
Drug abuse. See Substance abuse.
Drug allergy, preoperative assessment for, 318
Drug history, 36
Drug reactions, cutaneous, 435t
Drug therapy. See also specific drugs and disorders.
adherence to, ethical aspects of, 531b
alcohol use and, 157
cancer due to, 224
cardiotoxicity in, 721t
drug-resistant organisms and, 220221, 221t, 548, 525
effects on blood glucose levels, 1202t
effects on laboratory values, 623t
empiric, 1096
first pass effect in, 128
food interactions in, 904
36
th
for older adults, 6970, 69f, 70t

goitrogenic, 1233
hematologic effects of, 623t
hemolytic reactions in, 650
hepatotoxic, 262t263t, 884, 884t, 1043
nephrotoxic, 262t263t, 1081t, 1135, 1140
ototoxic, 408
overdose in, 1731t. See also Poisoning.
over-the-counter drugs in, safety concerns with, 578
pegylated drugs in, 1037
photosensitivity in, 425, 425t
polypharmacy and, 70
race/ethnicity and, 2829, 28t
topical, 438440, 442
application of, 442
common bases for, 438t
urinary dysfunction in, 1119t
Drusen, 396
Dry drowning, 17281729
Dry eye, 371, 389, 1631
Dry mouth
in Sjgrens syndrome, 1631
radiation therapy and, 262t263t, 265, 513
Dry powder inhalers, 576, 577f, 577t
Dual energy x-ray absorptiometry (DEXA), 1540t1542t
Duchenne muscular dystrophy, 15861587, 1587t, 1587t
Ductal carcinoma in situ, 1283
Ductal ectasia, 1277, 1279t
Ductus deferens, 1258, 1259f
Duetact (pioglitazone/glimepiride), 1200t
Dukes staging system, for colorectal cancer, 1013t
Dulcolax (bisacodyl), 988989, 989t
Dumping syndrome, 933937, 973974, 974t
Duodenal ulcers. See Peptic ulcer disease.
Duodenum, 877f, 879
DuoNeb (ipratropium/albuterol), for asthma, 573t574t, 575
Duplex ultrasonography, cardiac, 709
Duplex venous Doppler, 1540t1542t
Dura mater, 1379
Durable power of attorney for health care, 145, 145t, 584b
Duraclon. See Clonidine (Catapres, Duraclon).
Duragesic. See Fentanyl.
Dutasteride (Avodart), for benign prostatic hyperplasia, 1349, 1349b
DynaCirc CR (isradipine), for hypertension, 724t727t
Dynamic response test, 1644, 1645f
Dyrenium. See Triamterene (Dyrenium).
Dysarthria, 1387t
in stroke, 1429
Dysfunctional uterine bleeding, 1320
Dysgeusia, in cancer, 262t263t, 265, 274
Dysgraphia, in Alzheimers disease, 1488
Dyskinesia, 1387t
Dysmenorrhea, 1319
in endometriosis, 1329
Dysmetabolic syndrome, 936937
Dyspareunia, menopause and, 1323
Dyspepsia, 890t, 948
in peptic ulcer disease, 966
Dysphagia, 890t, 1387t
in oral cancer, 946
Dysphasia, 1387t. See also Aphasia.
in stroke, 1429
Dysplastic nevi, 428t, 429f, 430431
Dyspnea, 473
in asthma, 565
in COPD, 588589, 592, 605
in dying patient, 147, 148t149t
paroxysmal nocturnal, 696, 779
Dysrhythmias, 795817
after coronary revascularization, 760, 766
after myocardial infarction, 756757, 760, 762
case study of, 816b
defibrillation for, 810811, 810f
diagnosis of, 692. See also Electrocardiogram (ECG).
during suctioning, 1658
electrophysiology of, 799800
emergency management of, 800, 801t
evaluation of, 800801, 801t
hyperkalemia and, 294t 295, 296f
hypokalemia and, 294t, 295, 296f
in acute coronary syndrome, 814815, 814t
in hyperkalemia, 1137
in pulmonary artery catheterization, 1651
in syncope, 816817
mechanisms of, 799800
pacemakers for, 811814, 812f
postoperative, 351352, 760, 766
reperfusion, 759
sudden cardiac death and, 770
synchronized cardioversion for, 810
types of, 801809, 802t
Dyssomnias, 101t. See also Sleep problems.
Dystonia, 1384
Dysuria, 1085t, 1096t
E
Ear. See also Auditory system; Hearing.
burns of, 450, 459
disorders of, cultural factors in, 383b
external
examination of, 378379, 378f379f, 379t
foreign bodies in, 403
impacted cerumen in, 363381, 376t, 403
injuries of, 402
inner
disorders of, 405
middle
disorders of, 403
painful, 387
ringing in, 375
skin cancer of, 403
surgery of, 404, 404t
swimmers, 402
Eardrops, administration of, 402403
Eardrum, 374375, 375f
Earwax, impacted, 379t, 403
37
th
Eating. See also Feeding; Food.

after stroke, 1443, 1444, 1445f
regulation of, 924925, 924t
Eating disorders, 918919
anorexia nervosa, 918
bulimia nervosa, 918
Ebola virus infection, 219
Ecchymoses, 419t, 421t, 626t627t, 627
in hemophilia, 660f
in nasal fractures, 494
periorbital, 1404, 1405f
postauricular, 1404, 1405f
Eccrine sweat glands, 414f, 415
Echinacea, 85t
for colds, 498b
Echocardiography, 703t707t, 709
dobutamine/dipyridamole, 703t707t
motion-mode, 709
real-time 3D, 709, 709f
stress, 703t707t, 709
transesophageal, 703t707t, 709
intraoperative, 343
2D, 709, 709f
Economic status. See Socioeconomic status.
Ectocervix, 1261
Ectopic pregnancy, 13211322, 1322f
pelvic inflammatory disease and, 13271328
Ectropion, 371t
Edecrin (ethacrynic acid), for hypertension, 724t727t
Edema, 286
cerebral, 13931395. See also Cerebral edema.
heat, 1726
in ARDS, 1711f, 17121713
in burn injury, 453, 454f
in cirrhosis, 1047
in nephrotic syndrome, 1105
in urinary disorders, 1083t
laryngeal, postoperative, 348t
optic disc, 394, 1387t, 1395
pitting, 698, 699t700t
pulmonary. See Pulmonary edema.
Efavirenz (Sustiva), 229b
Effient (prasugrel), for angina/acute coronary syndrome, 750
Effleurage, 85
Effusion
exudative, 551
in otitis media, 403
pericardial
pericardiocentesis for, 825, 825f
pleural, 473, 550552, 552t
tubercular, 529
transudative, 551
Egophony, 483, 484t485t
Ejaculate, 1259
Ejaculation, 1264
retrograde, after transurethral resection of prostate, 1355
Ejaculatory duct, 1259
Ejection fraction, 709
Elastic cartilage, 1532
Elastic recoil, 473
Elavil (amitriptyline), for interstitial cystitis, 11021103

Elbow, tennis, 1539t
Elbow arthroplasty, 1577
Eldepryl (selegiline), for Parkinsons disease, 1472
Elder mistreatment/abuse, 6364, 64t
Elderly. See Older adults.
Elective surgery, 314
Electrical burns, 448, 448f, 452t. See also Burns.
Electrical stimulation, for fractures, 1553
Electrocardiogram (ECG), 692, 692f, 703t707t, 708709, 796798
ambulatory, 703t707t, 708, 800801
artifacts on, 798, 798f
cardiac cycle and, 701f
dysrhythmias on, 800801. See also Dysrhythmias.
event monitor and, 703t707t, 708
event recorders and, 708709, 801
heart rate calculation for, 798, 798f
heart sounds and, 701f
in acute coronary syndrome, 757, 814815, 814t
in electrophysiologic study, 703t707t, 711, 800
in myocardial infarction, 757
in myocardial ischemia, 814815, 815f
in stress testing, 703t707t, 705, 709, 801. See also Stress testing.
interpretation of, 798799
lead placement for, 796797, 796f797f
loop recorder for, 703t707t, 708
normal sinus rhythm on, 797f, 799, 799f
paper for, 798
refractory periods and, 799800, 800f
rhythm assessment for, 799
signal-averaged, 703t707t, 801
skin preparation for, 798
telemetry monitoring for, 798
time and voltage on, 798, 798f
waveforms and intervals on 799f, 799t
Electrocoagulation, 440
Electrocochleography, 380t
Electrodessication, 440
Electroencephalography, 13851388, 1387t1388t
in epilepsy, 14581459
Electrohydraulic lithotripsy, 1110
Electrolarynx, 516, 516f
Electrolytes. See also under Fluid and electrolyte, 283
in fluid compartments, 283, 284f
measurement of, 283
normal values for, 288t289t, 291, 305306
Electromyography, 1387t1388t, 13881389, 1540t1542t
in myasthenia gravis, 1476
in tension headaches, 14491450
Electronic health record, 910
Electronic pacemakers. See Pacemakers (electronic).
Electronystagmography, 380tElectrophoresis
hemoglobin, 631t
serum protein, 631t
Electrophysiologic study, 703t707t, 711, 800
Elidel (Pimecrolimus), 439
Elimination, See also under Defecation; Fecal; Stool; Urinary.
Elimination pattern, 37t, 38, 955956
Elmiron (pentosan), for interstitial cystitis, 11021103
Eltrombopag (Promacta), for immune thrombocytopenic purpura, 656
Embolic stroke, 1427f, 1428
Embolism. See also Venous thromboembolism.
air
in pulmonary artery catheterization, 1651, 1651b
arterial, 857858
fat, 1565
38
th

pulmonary. See Pulmonary embolism.
Embolization, uterine artery, for leiomyomas, 1331
Embryonic stem cells, 193194
Emend (aprepitant), for nausea and vomiting, 942
Emergence delirium, 352353
Emergency nursing, 17191726
ABCs of, 1719
assessment in, 43, 43t, 17241725
of abdomen and flanks, 1725
of chest, 1725
of extremities, 1725
of head, neck and face, 1725
of pelvis and perineum, 1725
of posterior surfaces, 1725
comfort measures in, 1724
death in emergency department and, 1726
emergency preparedness and, 17341736
evaluation in, 17251726
family involvement in, 17231724
for environmental emergencies 1727, 1728, 1727t, 1729t
for older adults, 1726history taking in, 17241725
in mass casualty incidents, 17341736
informed consent and, 325
intervention in, 17251726
monitoring in, 17251726
neurologic examination in, 1723
organ donation and, 1726
primary survey in, 17211723, 1722t1723t
secondary survey in, 17231725, 1724
severity classification in, 1720t
therapeutic hypothermia in, 1726
triage in, 1721
Emergency response plans, 1732
Emergency Severity Index, 1720t, 1721
Triage Algorithm for, 1720f
Emergency surgery, 314
consent for, 325
Emerging infections, 217, 220, 218t
EMLA cream, 126t, 129
Emmetropia, 365
Emotion-focused coping, 94, 94t
Empacho, 29t
Empathy, 48
Emphysema, 584. See also Chronic obstructive pulmonary disease
(COPD).
surgery for, 597
lung volume reduction, 548t
Empiric therapy, 1096
Empowerment approach, in patient teaching, 12111213
Empyema, 473, 551552
fibrothorax and, 544f, 551552
treatment of, 552
Enalapril (Vasotec)
Enanthate (Delatest), for andropausal symptoms, 1369
Enbrel (etanercept)
for ankylosing spondylitis, 1605t1607t, 1619
Encephalitis, 1416t, 1420
rabies, 14211422
Encephalopathy, hypertensive, 720, 734
Enchondroma, 1585t
End ileostomy, 1004, 1016
Endarterectomy, for peripheral arterial disease, 854
Endocarditis
infective, 818822
rheumatic, 827828
Endocardium, 690, 818, 819f
Endocervix, 1261
Endocet. See Oxycodone.
Endocrine disorders, 1226
clinical manifestations of, 1179, 1182t1183t
gender differences in, 1226bin cirrhosis, 1046
Endocrine system, 1076
common abnormalities in, 1182t1183t
diagnostic studies in, 11831878, 1184t, 1187t
focused, 1182, 1182b
preoperative, 319320
glands of, 11701171
in blood pressure regulation, 7 716
in stress response, 91f92f, 92
regulation of, 1173
feedback in, 11731174, 1173f1174f
neural, 1174
End-of-life, definition of, 141
End-of-life care, 139, 141144
advance directives and, 145, 145t
analgesics for hastening death in, 135
assessment in, 146
bereavement and grief and, 142143, 142t, 150
brain death and, 141
caregiver support in, 150
communication in, 150
cultural aspects of, 144, 1642
death/brain death in, 141
definition of, 141
ethical issues in, 66, 135, 144145, 147b, 277b, 605b, 1165b
hospice care in, 77
in emergency department, 1618
in HIV infection, 237
integrated model of, 140f
legal issues in, 66, 144145, 145t
nurses needs in, 150
nursing diagnoses for, 146, 146t
organ donation and, 144
palliative care in, 139140, 140t
physical care in, 146t, 147148, 148t149t
planning in, 145146
postmortem care in, 148
psychosocial care in, 146, 146t
psychosocial manifestations of, 141, 142t, 146, 146t
resuscitation in, 144145, 145t
signs of impending death in, 141142, 142t, 146t, 147148, 148t149t
spiritual needs and, 143144, 143t
treatment withdrawal/withholding in, 145, 1165b
Endolymph, 375
Endolymphatic fluid, 375
39
th
Endolymphatic hydrops, 405, 406t

Endometrial ablation, for menorrhagia, 1321
Endometrial biopsy, 1272t1275t, 1333
Endometrial cancer, 13331334. See also Reproductive cancers,
female.
Endometriosis, 13291330, 1329f, 1329t
dysmenorrhea and, 1319
Endomyocardial biopsy, 826
Endomysium, 1532
Endophthalmitis, 401402
Endorphins, 1374t
Endoscopic pneumatic dilation, for achalasia, 957, 957f
Endoscopic retrograde cholangiopancreatography, 891t894t, 892895
for acute pancreatitis, 1064
for cholelithiasis, 1070, 1070f
for chronic pancreatitis, 1067
Endoscopic sclerotherapy, for bleeding varices, 1050
Endoscopic therapy, for upper gastrointestinal bleeding, 959
Endoscopic ultrasonography, 891t894t
Endoscopy, 892895
capsule, 891t894t, 895, 895f
Endothelin, 715
Endothelin receptor blockers, for pulmonary hypertension, 556
Endothelium, vascular
in coronary artery disease, 738, 739f
Endotracheal intubation, 16541656
Ambu bag for, 1656
aspiration in, 1659
contraindications to, 1656
cuff inflation in, 1657
end-tidal CO2 detector in, 1656
in anesthesia, 338339
in burn injury, 457
nasal, 16551656
oral, 16551656
oral care in, 1658
oxygenation monitoring in, 1657
procedure for, 1656
rapid-sequence, 1656, 1721, 1723f
skin care in, 1658
suctioning in, 16561659, 1657t
tube dislodgment in, 1657, 16581660, 1659b, 16671669
tube for, 1655f
tube patency in, 16561659
tube placement in, 16561657
maintenance of, 1657
tube taping in, 1656f
ventilation monitoring in, 1657
vs. tracheostomy, 504
Endotracheal tubes, 1655f
Endoureterotomy, 1113
Endovascular grafts
for aortic aneurysms, 846847, 847f
for aortic dissection, 850
postoperative care for, 847849
Endovascular repair, for aortic dissection, 850
End-stage renal disease, 11411142
End-tidal CO2 detector, 16561657
Enduron (methyclothiazide), for hypertension, 724t727t

Enemas, 989
Energy therapies, 82t, 87
Enkephalins, 1374t
Enoxaparin (Lovenox)
for venous thromboembolism, 863t, 864
Entacapone (Comtan), for Parkinsons disease, 1472
Entamoeba histolytica diarrhea, 983t
Entecavir (Baraclude), for hepatitis, 10381039, 1039b
Enteral nutrition, 909913. See also Nutritional therapy.
aspiration in, 911, 912t
common problems in, 912t
constipation in, 912t
dehydration in, 912t
delegation in, 913b
diarrhea in, 912t
drug administration via, 912
formula for, 911912
gastrostomy tubes in, 910, 910f911f
in home care, 918
jejunostomy tubes in, 910, 910f911f
nasogastric/nasointestinal intubation in, 910, 910f
procedures for, 911
routes for, 910, 910f911f
skin care in, 913, 913b, 1010
vomiting in, 912t
Enteral nutrition misconnection, 914, 913t
Enteric nervous system, 877
Enterococci, vancomycin-resistant, 220221, 220t
Enterohepatic circulation, 882
Entropion, 371t
Enucleation, 401
Enuresis, 1085t, 1096t. See also Urinary incontinence.
Environmental emergencies, 17261727
Environmental lung disease, 534535, 535t
chemical pneumonitis, 534
hypersensitivity pneumonitis, 534
idiopathic pulmonary fibrosis, 553
interstitial, 553
pneumoconiosis, 534
Environmental tobacco smoke, 585
Enzymatic debridement, of burns, 462
Eosinophils, 617f, 618619, 618t
Ependymal cells, 1373
Ephedrine, regulation of, 578579
Epicardial pacing, 812
Epicardium, 690
Epicondylitis
lateral, 1539t
medial, 1539t
Epidemic keratoconjunctivitis, 388
Epidemics, 498499
Epidermal growth factor receptor inhibitors, for cancer, 268, 270
Epidermis, 413, 414f, 448, 449f
Epididymis, 1259, 1259f
Epididymitis, 1363, 1363f
chlamydial, 13051306, 1306f
Epidural analgesia, 129130, 129f
postoperative, 354
Epidural block, 342, 342f
40
th
Epidural hematomas, 1406, 1406f. See also Head injury.

Epidural space, 129f
Epifrin (epinephrine), for glaucoma, 399t400t
Epiglottis, 471, 471f
Epilepsy, .14551459 See also Seizure(s).
driving restrictions and, 1464
drug therapy for, 14591460, 1460t. See also Antiseizure drugs.
evaluation in, 1464
ketogenic diet for, 1461
mortality in, 1458
planning in, 1463
psychosocial aspects of, 1458, 1464
safety concerns in, 1463b
seizure types in, 14551457
status epilepticus in, 1457, 1459
surgery for, 14601461
vagal nerve stimulation for, 1461
Epimorph. See Morphine.
Epimysium, 15321533
Epinal (epinephrine), for glaucoma, 399t400t
Epinephrine (Adrenalin)
for asthma, 571
for upper gastrointestinal bleeding, 959, 960t
Epiphrenic diverticula, 956, 956f
Epiphyseal plate, 1531, 1531f
Epiphyses, 1531, 1531f
Epispadias, 1362
Epistaxis, 494, 494f, 626t627t
Epitrate (epinephrine), for glaucoma, 399t400t
Epitympanum, 374375, 375f
Epivir (lamivudine), for hepatitis, 10381039
Eplerenone (Inspra)
for heart failure, 784
Eply maneuver, 406
Epoetin (Epogen, Procrit), for cancer, 271272, 271t
Epoprostenol (Flolan), for pulmonary hypertension, 557
Eppy (epinephrine), for glaucoma, 399t400t
Eprosartan (Teveten), for hypertension, 724t727t
Epsilon-aminocaproic acid (EACA, Amicar), for hemophilia, 659660,
660t
Eptifibatide (Integrilin), for angina/acute coronary syndrome, 752t
Equianalgesic dose, 128
Equine tetanus antitoxin, 1508
Erb muscular dystrophy, 1587t
Erbitux (cetuximab), for cancer, 269t270t
Erbs point, 699, 700f
Erectile dysfunction, 1367, 1369, 1367t, 1368t
after radical prostatectomy, 1358

antihypertensive-related, 728729
drug therapy for, nitrates and, 784
Erection, persistent, 1363
Ergamisol (levamisole), for cancer, 269t270t
Erlotinib (Tarceva), for cancer, 269t270t
Eructation, 890t
Erysipelas, 430t, 431
Erythema, 419t, 421t
Erythema marginatum, in rheumatic fever, 829
Erythrocyte(s), 617618, 617f
agglutination of, 629630
assessment of, 628
destruction of, 618
causes of, 650651
in urine, 1091t
macrocytic, 643
morphology of, 628, 629t
production of. See Erythropoiesis.
sickled, 648, 648f
Erythrocyte count, 628, 629t
Erythrocyte indices, 628, 629t
Erythrocyte sedimentation rate, 1540t1542t
Erythrocyte transfusions, 307308
Erythroleukemia, 643
Erythromelalgia, in polycythemia, 652
Erythroplakia, 511
Erythropoiesis, 616, 617f, 618
decreased, anemia and, 637t, 639640
nutrients for, 640t
Erythropoietin, 198t, 618
clinical uses of, 199t
for anemia, in chronic kidney disease, 1148
for cancer, 271, 272, 271t
Escape rhythms, 799
junctional, 802t, 805, 805f
Eschar, 450
Escharotomy, 454455, 456f, 462
Escherichia coli infection
diarrhea in, 983, 984, 983t
urinary tract, 1093
Escherichia coli O157:H7 poisoning, 977980, 983t
Esidrix (hydrochlorothiazide), for hypertension, 724727t
Esmolol (Brevibloc)
Esomeprazole (Nexium)
Esophageal achalasia, 957, 957f
Esophageal cancer, 954955
Esophageal diverticula, 956
Esophageal (hiatal) hernia, 950, 953f
Esophageal speech, 517
Esophageal sphincters, 877878
Esophageal strictures, 956957
Esophageal surgery, 954956
Esophageal varices, 955, 1048, 1051, 1056
41
th
management of, 1051, 1051f1052f, 1056

Esophagectomy, 954955
Esophagitis
drug-induced, 953
in cancer treatment, 262t263t, 265
in GERD, 948949
Esophagoenterostomy, 954955
Esophagogastroduodenoscopy, 891t894t
Esophagogastrostomy, 884t, 954955
Esophagus
Barretts, 949
Mallory-Weiss tears of, 941
structures and functions of, 877f, 877
Esotropia, 390
Estimated blood glucose, 1194
Estradiol, measurement of, 1272t1275t
Estrogen, 1172t
endogenous, 1262f, 1263, 1263t
deficiency of, 1323t
in menstrual cycle, 1263, 1263f
menopausal decrease in, 13221325, 1323t
exogenous
breast cancer and, 1282, 1285, 1289t
endometrial overgrowth and, 1320
for hypopituitarism, 1229
for prostate cancer, 1359t, 1360
in hormone replacement therapy. See Hormone replacement
therapy.
Eszopiclone (Lunesta), 104
Etanercept (Enbrel)
for ankylosing spondylitis, 1605t1607t, 1619
Ethacrynic acid (Edecrin), for hypertension, 724t727t
Ethambutol (Myambutol), for tuberculosis, 530532, 530t531t
Ethical issues
abortion, 1318b
advance directives, 605b
affecting older adults, 66
analgesics for hastening death, 135
assisted suicide, 135
brain death, 1410b
competence, 792b
confidentiality, 1312b
durable power of attorney for health care, 585b
euthanasia, 145
failure to disclose information, 1639b
guardianship, 953b
health care disparities, 20b
health care rationing, 1057b, 1063b
in complementary and alternative therapy, 86, 1244b
in end-of-life care, 66, 144145, 147b, 277b, 605b
in genetic testing, 192b, 193
in HIV infection, 229b
in preoperative care, 324, 324b
in sterilization, 1336b
in treatment adherence, 531b
informed consent, 792b
medical futility, 277b
payment for organ donors, 1160b
placebos, 135
religious objections to transfusion, 680b
treatment refusal, 680b, 1509b
treatment withholding, 1165b, 1417b, 1566b

Ethnicity. See also Race/ethnicity.
definition of, 2324
Ethnocentrism, 24
Ethnogeriatrics, 62
Ethylene glycol poisoning, 1731t
Etidronate (Didronel)
Etomidate (Amidate), in general anesthesia, 340t
Eulexin (flutamide), for prostate cancer, 1359t, 1360
Eustachian tube, 374, 375f
Euthanasia, 145
Evaluation, 16
Evening primrose, 85t
Event recorders (monitors), 708709, 801
Everolimus (Afinitor), for cancer, 269t270t
Eversion, 1538t
Evidence-based practice, 68
acupuncture for headaches, 1452b
acyclovir for postherpetic neuralgia prevention, 432b
adherence to antihypertensive therapy, 728b
alcohol use by college students, 1046b
antibiotic prophylaxis for dental procedures, 821b
antibiotic prophylaxis for PEG tubes, 916b
anticoagulants for atrial fibrillation, 805b
asthma and allergic rhinitis, 500b
bariatric surgery, 933b
blood cultures, 222b
caregiver/patient support in stroke, 1436b
clinical questions in, 8t
cognitive function and hormone replacement therapy, 1324b
complementary and alternative therapies for back pain, 1590b1591b
counseling for STD prevention, 1312b
definition of, 6
falls in dementia, 1494b
femoral artery stent for intermittent claudication, 851b
green tea and cancer risk, 246b
hemoglobin A1C and diabetic complications, 1194b
heparin flushes, 308b
implementation of, 8
inflammatory bowel disease and osteoporosis, 100b
lifestyle modifications for GERD, 950b
low-protein diet for chronic kidney disease, 1149b
NPO status after gastrointestinal surgery, 993b
nutritional counseling in heart failure, 785
pelvic floor exercises, 785b
PICOT question format for, 7, 7t
preoperative fasting, 325b
prone positioning in mechanical ventilation, 1705b, 17151716
recurrent breast cancer after radiation therapy, 1284b
resistance training in older adults, 68b
silver sulfadiazine for burns, 460b
smoking cessation, 155b
steps in, 78, 7f, 7t
types and sources of evidence in, 8t
varicocele-related infertility, 1364b
ventilator weaning, 1660b
Evil eye, 27
Evisceration, 179t
Evista (raloxifene)
Evoked potentials, 1338t1339t, 1340
Ewings sarcoma, 1585t
Excision and grafting, for burns, 459, 459t, 462464, 463f
42
th
Excoriation, 419t
Exelon (rivastigmine), for Alzheimers disease, 1489
Exemestane (Aromasin), for breast cancer, 1289t, 1290
Exenatide (Byetta), 1200t
Exercise. See Activity and exercise.
Exercise testing, 491492, 703t707t, 709, 801
nuclear imaging in, 703t707t
6-minute walk test in, 491492, 703t707t
Exercise-induced asthma, 563
Exercises
after stroke, 1442
in mechanical ventilation, 1667
neck, 1592t
pelvic floor, 1121b, 1123, 1122t1123t
for cystocele/rectocele, 13401341
for uterine prolapse, 1341
postoperative, in breast cancer, 12911294, 1294f
range of motion, 15601562
Ex-Lax (phenolphthalein), for constipation, 989t
Exna (benzthiazide), for hypertension, 724t727t
Exocrine glands, 11701171
Exophthalmos, 371t, 1183t1184t
exposure keratitis and, 388
in Graves disease, 1233f, 12351236
Exotropia, 390, 390f
Expiration, 473
Expiratory reserve volume, 489490, 490t
Explosives, in terrorism, 1734
Exposure keratitis, 389
in Guillain-Barr syndrome, 1507
Extension, 1538t
Extensor plantar response, 1387t
External fixation, 1555, 1556f
External otitis, 402
External rotation, 1538t
Extracellular fluid, 282, 283f, 286. See also Fluid.
electrolytes in, 283, 284f
imbalances of, 289
Extracorporeal membrane oxygenation (ECMO), 1664
for ARDS, 1715
Extracorporeal shock wave lithotripsy, 1110
for gallstones, 10701071
Extracranial-intracranial bypass, 1432
Extraocular muscles, 365
assessment of, 365, 1383
disorders of, 371t
Extrapyramidal side effects, 1498
Extravasation, of vesicants, 256257, 257f
Extremities, examination of, 41t42t
Extrinsic allergic alveolitis, 534, 535t
Exubera (inhaled insulin), 1197
Exudate, 172, 173t
Eye. See also under Visual.
in head injury, 1411
in stroke, 1430, 14431444
in systemic disease, 401402, 402t
surgery for, 393t
terminology for, 372
traumatic, 386, 386t

in facial fractures, 1570
dry, 371t
examination of, 370373, 370t
in older adults, 367, 367t, 386
infections of, 400401
inflammation of, 400401
injuries of, 386, 386t
irrigation of, 1731
raccoon, 493, 1405, 1405f
removal of, 401
surgery of, patient teaching for, 393t
tumors of, 401, 401f
Eyebrows, 366, 367t, 373
Eyedrops, 368
compliance with, 389b
cycloplegic, 391, 391t, 392
mydriatic, 388, 391t, 392
Eyeglasses, corrective, 383
Eyelashes, 367, 367t
examination of, 373
Eyelid
examination of, 373
inflammation of, 388390
Eyelid-lift, 443444
Ezetimibe (Zetia), 747t
F
Face
burns of, 432, 454f, 457
moon, in Cushing syndrome, 1248f
skin grafts for, 463
Face-lifts, 443444 444f
Facial fractures, 1570, 1570t
Facial nerve, 374375, 375f, 1382t
paralysis of, 15041505
Facilitated diffusion, 283
Facioscapulohumeral muscular dystrophy, 1587t
Factor Xa inhibitors, for venous thromboembolism, 863t, 864
Fad diets, 929
Fainting, 816
Falling out, 29t
Fallopian tubes
ectopic pregnancy in, 13211322, 1322f
patency assessment for, 1315
Falls, in dementia, 1518b
False aneurysm, 844, 844f
Falx cerebri, 1379, 1394f, 1395
Famciclovir (Famvir), for genital herpes, 1307, 1308t
Familial adenomatous polyposis, 1010, 1010b
Familial Alzheimers disease, 1486
Familial hypercholesterolemia, 739, 741b
Family
culturally competent care and, 2829
presence during resuscitation, 16891690
43
th
Family and intimate partner violencem, 1732

Family caregivers, 7778. See also under Caregiver.
Family pedigrees, 190, 191f, 192
Family presence, 1723
Famipridine (Ampyra), for multiple sclerosis, 1467
Famotidine (Pepcid)
Fareston (toremifene), for breast cancer, 1289t, 1290
Farmers lung, 535, 536t
Farsightedness. See Hyperopia.
Fascia, 1534
Fasciculations, 1181
Fasciitis, plantar, 1539t
Fasciotomy, for compartment syndrome, 1564, 1564f
Faslodex (fulvestrant), for breast cancer, 1289t, 1290
FAST (focused abdominal sonography for trauma), 1725
Fasting, preoperative, 323, 324t, 325b
Fasting blood glucose, 1184t1187t
impaired, 11921194
Fasting plasma glucose, 1193
Fast-tracking, 345
Fast-twitch fibers, 1533
Fat, body
abdominal vs. visceral, 922, 923f, 923t
distribution of, 922, 923f, 923t
measurement of, 905
Fat embolism, 1565
Fat emulsion, in parenteral nutrition, 917
Fat necrosis, of breast, 1279t
Fatigue
chronic, 1634, 1634t
vs. fibromyalgia syndrome, 1634t
Fats, 898900. See also Lipids/lipoproteins.
dietary restriction of, 745, 745t, 923
in stool, 890t, 1024
in chronic pancreatitis, 1065
Fatty liver disease, nonalcoholic, 10441045
Fears
of dying patient, 147
Febrile neutropenia, 665666
Febuxostat (Uloric), for gout, 1620
Fecal analysis, 891t894t
Fecal impaction, 985986
Fecal incontinence, 985986, 987t
in cauda equina syndrome, 1510, 15891590
Fecal management systems, 988
Fecaliths, 996
Feces, 880. See also Stool.
Feedback, in hormone secretion, 11711172, 1173f1174f
Feeding. See also Eating; Food; Nutrition.
after stroke, 1445, 1445f
oral, 908
tube. See Enteral nutrition.
Feeding tubes. See Enteral nutrition.
Feen-a-mint (phenolphthalein), for constipation, 989t
Felbamate (Felbatol), for seizures, 1460
Felodipine (Plendil)
Felty syndrome, 1611
Female condoms, 232
Female reproductive system. See Reproductive system.
Femara (letrozole), for breast cancer, 1289t, 1290
Femoral artery stents, for peripheral arterial disease, 851b, 854
Femoral head prosthesis, 1568, 1568t
Femoral hernias, 1023, 1023f
Femoral vein cannulation, for hemodialysis, 1155
Femur, fractures of
location of, 1567f
of neck, 1567. See Hip, fractures of.
of shaft, 1569
Fenofibrate (TriCor), 747t
Fenoldopam (Corlopam), for hypertension, 747t
Fentanyl, 124t
abuse of, 154t, 161162
onsolis and, 276
transdermal, 128
transmucosal, 128
Ferritin, 631, 631t
in anemia, 641t
Ferrous gluconate, 641, 641t
Ferrous sulfate, 641
Fertility studies, 1272t1275t, 1315. See also Infertility.
Fertilization, 1264
in vitro, 13151316
Fertinex (urofollitropin), for infertility, 1316t
Festinating gait, 1539t
Fetal hemoglobin, 650
FEV1/FVC ratio, 490t
in restrictive vs. obstructive lung disease, 550t
Fever, 172, 173f
in neutropenia, 664665
management of, 173
metabolic effects of, 903
Feverfew, 85t
Fexofenadine (Allegra), for allergic rhinitis, 496t497t
Fiber, dietary, 989990, 990t
Fiberall (psyllium), for constipation, 989t
Fiberoptic catheters, in intracranial pressure monitoring, 1396
Fibric acid derivatives, 746, 747t
Fibrin degradation products, 621, 630t, 663
Fibrin sealant, 177
Fibrin split products, 621, 630t, 663
Fibrinogen, 630t
Fibrinolysis, 620, 621f
Fibrinolytics
for angina, 752t
indications/contraindications for, 759, 759t
Fibroadenoma, of breast, 1279t, 12801281, 1281f
Fibroblasts, 176, 176t, 414
Fibrocystic breast tissue, 1279t, 1280, 1280f
Fibroid tumors. See Leiomyomas.
Fibromyalgia syndrome, 16321633, 1633f
vs. chronic fatigue syndrome, 1632t
vs. myofascial pain, 1632t
Fibrothorax, 543f, 551552
Fibrous cartilage, 1532
44
th
Fight-or-flight response, 91, 92f, 1377

Filgrastim (Neupogen)
Film dressings, 180, 181t
Filters
carotid artery, 14321433
vena cava, 865
Filtration, HEPA, 667
Filtration surgery, for glaucoma, 398
Fimbriae, 1260
Finasteride (Proscar)
for benign prostatic hyperplasia, 1349, 1349b, 1350t
for prostate cancer prevention, 1355
Fine-needle aspiration biopsy. See also Biopsy.
of breast, 1279
Finger
clubbing of, 481, 484t485t, 699t700t
osteoarthritis of. See Osteoarthritis.
Finger joint arthroplasty, 1577
Finger-to-nose test, 1384
Fire ant bites, 1730
First pass effect, 128
First spacing, 286
First-degree atrioventricular block, 802t, 806, 806f
Fish oil, 84b, 721b
Fissures, 419t
anal, 890t, 1028
Fistulas, 179t
anal, 1028, 1028f
arteriovenous, in hemodialysis, 1155, 1155f
definition of, 1342
vaginal, 1341f, 1342
FITT formula, 744745, 769t
Fitz-HughCurtis syndrome, 1328
Five As/Five Rs, for smoking cessation, 157, 157t
5% dextrose in water, 307
5-HT3 antagonists, for nausea and vomiting, 942
FK506 (tacrolimus), for transplantation, 213215
Flagyl. See Metronidazole (Flagyl).
Flail chest, 543t, 544, 544f
Flapping tremor, 1049
Flaps
deep inferior epigastric artery perforator, 1288t, 1297
musculocutaneous
in breast reconstruction, 1288t, 12951297, 1297f
transverse rectus abdominis, 1288t, 1296, 1297f
skin, 444445
in amputation, 1572
Flatfoot, 1539t, 1594t
Flatulence
postoperative, 356
Flecainide (Tambocor), for dysrhythmias, 809t
Fleet enema, for constipation, 989t
Flexion, 1538t
Flexion contractures, after amputation, 1573
Floaters, 371t
Flolan (epoprostenol), for pulmonary hypertension, 556
Flonase (fluticasone), for allergic rhinitis, 496t497t
Flovent (fluticasone), for asthma, 571, 573t574t
Fluconazole (Diflucan), for vaginal candidiasis, 1326t
Fluid
extracellular, 282, 284f
functions of, 282
intracellular, 282, 283f

transcellular, 282
Fluid and electrolyte balance, 282
active transport in, 283284
diffusion in, 284, 284f
osmosis in, 284, 285f
preoperative assessment of, 320
regulation of, 283288, 10781079
renal system in, 10771078
Fluid and electrolyte imbalances, 288
case study of, 311b
extracellular fluid volume, 289
fluid deficit. See Fluid volume deficit.
fluid excess. See Fluid volume excess.
in burn injury, 453454, 453f454f, 461
in increased intracranial pressure, 14011404
of calcium, 296297, 297t
of magnesium, 299300, 300t
of phosphate, 298299, 299t
of potassium, 294295, 294t
of sodium, 291293, 292f, 293t
stress and, 287, 287f
Fluid and electrolyte movement, 283286
between capillaries and tissue, 285, 286f
between intracellular and extracellular fluid, 284f, 286
Fluid chemistry, terminology of, 283t
Fluid compartments, 282
Fluid deficit. See Fluid volume deficit.
Fluid distribution, 282, 283f
Fluid excess. See Fluid volume excess.
Fluid gain, calculation of, 282
Fluid intake and output
measurement of, 289
Fluid loss
calculation of, 282
insensible, 288
Fluid shifts, 286, 286f
Fluid spaces, 282
Fluid spacing, 286
Fluid therapy, 306308. See also Transfusion(s).
Brooke formula for, 457, 457t
central venous access devices for, 17221723
delegation in, 307b
emergency, 17221723
for acute kidney injury, 11391141
for ARDS, 1716
for ascites, 1049
for burns, 456t457t, 457
for diabetic ketoacidosis, 12141215
for hemorrhage, 645646
45
th
for hypernatremia, 292293

for hyperosmolar hyperglycemic syndrome, 1216
for hypervolemia, 289290
for hypovolemia, 289290
for kidney stones, 11111112
for renal transplant, 11631164
for shock, 16841686, 1685t
for stroke, 1433
for syndrome of inappropriate antidiuretic hormone, 1231
for upper gastrointestinal bleeding, 959, 961
for urinary tract infections, 10971099
intravenous, 306308
oral, 306
Parkland (Baxter) formula for, 457, 457t
perioperative, 320
plasma expanders in, 307308
postoperative, for ileostomy, 1021
solutions in
additives to, 307
colloid, 307, 1705b
hypertonic, 285, 285f, 306308, 306t
hypotonic, 285, 285f, 306308, 306t
isotonic, 285, 285f, 306308, 306t
parenteral, 916917
Fluid volume deficit, 285, 289291, 289t. See also Fluid and electrolyte
imbalances; Hypovolemic shock.
postoperative, 351
Fluid volume excess, 285, 289291, 289t. See also Fluid and electrolyte
imbalances.
in polycythemia, 651653, 652f
postoperative, 351
Flumazenil (Romazicon), for benzodiazepine overdose, 162
Flunisolide (Nasalide), for allergic rhinitis, 496t497t
Fluorescein angiography, ocular, 374t
Fluorescent in situ hybridization (FISH), 633
Fluorescent treponemal antibody (FTA-Abs) test, 1272, 1272t1275t,
13041305
Fluoroquinolones
Fluorouracil, topical, 439
Fluothane (halothane), 340t
Flushing, 626t627t
niacin-related, 746, 746b
Flutamide (Eulexin), for prostate cancer, 1359t, 1360
Fluticasone (Flonase, Flovent)
Fluticasone furoate (Veramyst), for allergic rhinitis, 496t497t
Fluticasone/salmeterol (Advair)
for COPD, 594
Flutter device, 599, 599f
Flutter (Heimlich) valve, 546, 546f
Fluvastatin (Lescol), 747t
Foam dressings, 181t
Focused abdominal sonography for trauma (FAST), 1725
Focused assessment, 4243, 43t
Folate (folic acid), 631t
endogenous, deficiency of, anemia and, 641t, 643645, 963, 965
exogenous
for alcohol intoxication, 159
for methotrexate GI toxicity, 1625b
with sulfasalazine, 1004
Folex. See Methotrexate (Folex, Rheumatrex).

Folk healers, 25, 2829. See also Complementary and alternative
therapies.
Follicle-stimulating hormone, 1172t, 1175, 1184t1187t, 12621263,
1262f
deficiency of, 1229
in menopause, 1323
Follicle-stimulating hormone agonists, for infertility, 1316t
Folliculitis, 430t, 431
Follitropin (Gonal-f, Follistim), for infertility, 1316t
Fondaparinux (Arixtra), for venous thromboembolism, 863t, 864
Food. See also Diet; Feeding; Nutrition.
safe storage and handling of, 15071508
Food additives, asthma and, 563
Food allergies, 208
Food security/insecurity, 903
Foodborne illness, 978981, 979t, 983t
Food-drug interactions, 904
Food-induced headaches, 1451, 1455. See also Headaches.
Foot
Charcot, 1222
disorders of, 1592, 1594t
flat, 1539t, 1594t
Foot care
in diabetes mellitus, 1211, 1222
in peripheral arterial disease, 857, 857t
Foot ulcers, diabetic, 1219t, 1220f1221f, 12211222, 1222t
Footdrop, 1562t
Foradil (formoterol)
for COPD, 594
Forane (isoflurane), 340t
Forced expiratory volume, 489490, 490t
Forced midexpiratory flow rate, 489490, 490t
Forced vital capacity, 489490, 490t
Foreign bodies
in ear, 403
in eye, 386t
nasal, 501
Foreign language speakers, communication with, 31, 31t
Forgetfulness. See also Memory loss.
normal, vs. Alzheimers disease, 1485t
Formoterol (Foradil, Perforomist)
for COPD, 594
Formula, enteral nutrition, 911912
Forteo (teriparatide), for osteoporosis, 1596
Fosamax (alendronate), for osteoporosis, 1596
Fosinopril (Monopril), for hypertension, 724t727t
4 x 4 technique, 94t
Four-point gait, 1563
Fovea centralis, 365
Fractional flow reserve, 703t707t, 711
Fracture(s), 15511557
acute intervention for, 1558
ambulation and, 1563
neurovascular, 1557, 1562, 1564
avulsion, 1545
callus formation in, 1551, 1551f
casts for, 1554. See also Casts (fracture).
closed, 1551, 1551f
46
th

Colles, 1565
comminuted, 1551
compartment syndrome and, 1564, 1564f
complete vs. incomplete, 1551
complications of, 1562t, 15631565
counseling and referrals for, 1563
definition of, 1551
delayed union of, 1553, 1553t
displaced, 1551
electrical stimulation for, 1552
evaluation in, 1563
external fixation for, 1555, 1556f
fat embolism and, 1565
greenstick, 1551, 1551f
healing of, 15511553, 1552f
complications of, 1553t
immobilization of, 15541556
in multiple myeloma, 678
internal fixation of, 1553, 1555, 1555f, 1567f
malunion of, 1553t
nondisplaced, 1551
nonunion of, 1553, 1553t
oblique, 1551, 1551f
of facial bones, 15701571, 1570t
of femur
location of, 1567f
of neck, 1566. See also Hip, fractures of.
of shaft, 1569
of frontal bone, 15701571, 1570t
of hip. See Hip, fractures of.
of humerus, 15651566, 1566f
of mandible, 15701571, 1570t, 1571f
of maxilla, 15701571, 1570t
of neck, 15671568
of nose, 493494, 15701571, 1570t
of orbit, 14041405, 1405t, 15701571, 1570t
of pelvis, 1566
of rib, 544545, 551t
in flail chest, 544, 544f
of skull, 14041405, 1405f, 1404t. See also Head injury.
of temporal bone, 14041405, 1405t
of tibia, 1556f, 1569
of vertebrae, 15691570
pathologic, 1583, 1539t, 15961597
spinal cord injury in, 15081516 See also Spinal cord injury.
of wrist, 1565
of zygomatic arch, 15701571, 1570t
open, 1551, 1551f, 1556
infection of, 15631564
pathologic, 1551f
in osteoporosis, 1539t, 15961598
planning in, 1558
radiologic union of, 1552
reduction of, 15531554
skull, 14041405, 1405f, 1405t. See also Head injury.

spiral, 1551, 1551f
stress, 1551f
surgery for
traction for, 1553, 1560
transverse, 1551, 1551f
types of, 1565
venous thromboembolism and, 15641565
Fracture hematoma, 1552, 1552f
Fragmin. See Dalteparin (Fragmin).
Frail elderly, 60, 63
Frank-Starling law, 775776, 1642
Fraxiparin (nadroparin), for venous thromboembolism, 863t
Fremitus, 482, 484t485t
Fresh frozen plasma, 681t
Friction rub
pericardial, 699t700t, 701
pleural, 484, 484t485t, 552
Frontal bone, fractures of, 15701571, 1570t
Frontal lobe, 1375, 1375f, 1376t
Frontotemporal dementia, 14951496
FTA-Abs test, 1271, 1272t1275
Full code, 145
Full-thickness burns, 447f, 449, 449t
Fulminant hepatic failure, 10581059
Fulminant viral hepatitis, 1035
Fulvestrant (Faslodex), for breast cancer, 1289t, 1290
Functional health patterns, 3638
in assessment, 37t
of auditory system, 376378, 377t
of cardiovascular system, 695698
of endocrine system, 11801181
of gastrointestinal system, 884, 885t
of hematologic system, 623625, 624t
of integumentary system, 417418, 417t
of musculoskeletal system, 1535
of nervous system, 1380
of reproductive system, 1265
of respiratory system, 477480, 478t
of urinary system, 10811084
of visual system, 367370, 369t
in health history, 37t
nursing diagnoses and, 14
Functional hearing loss, 407
Functional incontinence, 1120t1121t
Functional residual capacity, 489490, 490t
Fundus, gastric, 878f, 879
Fungal infections, 217, 218t
cutaneous, 433, 433f, 433t
in burns, 460
pulmonary, 534, 533t
Fungizone (amphotericin B), for infective endocarditis, 822t
Furadantin (nitrofurantoin), for urinary tract infections, 10961097,
1097b
Furosemide (Lasix)
Furuncles, 430t, 431
Furunculosis, 430t, 431
Fusiform aneurysm, 845, 845f
47
th
GABA (-aminobutyric acid), 1374t

Gag reflex, assessment of, 1383, 1443
Gait
antalgic, 1539t
ataxic, 1539t
festinating, 1577t
four-point, 1563
short-leg, 1539t
spastic, 1539t
steppage, 1539t
swing-through, 1563
swing-to, 1563
two-point, 1563
with assistive devices, 1563
Gait analysis, 1383
Galactorrhea, 1270t, 1281
Galantamine (Razadyne), for Alzheimers disease, 1488
Gallbladder, 877f, 881f, 882
cancer of, 10731074
surgery of, 1070t
Gallbladder disease, 10681069
Gallstones, 10681069, 1068f, 1069t1070t, 1072t
Gamete intrafallopian transfer (GIFT), 13151316
Gamma knife surgery, 260
Gamma-aminobutyric acid (GABA), 1374t
Gamma-glutamyl transpeptidase, 896t
Ganglion cysts, 1539t
Ganglionic blockers, for hypertension, 724t727t
Ganirelix (Antagon), for infertility, 1316t
Garamycin (gentamicin), for osteomyelitis, 1583
Gardasil, 1309, 13331334, 1335
Garlic, 85t
Gas, abdominal, 355356
Gastrectomy, 884t, 977f
bile reflux gastritis and, 974
dumping syndrome and, 933934, 973974, 974t
partial, for peptic ulcers, 975
postoperative care and, 975
postprandial hypoglycemia and, 973974
preoperative care for, 975976
total, for cancer, 896t, 977f
vertical sleeve, 931t, 932f, 933
Gastric banding, 931t, 932933, 932f
Gastric bypass, roux-en-Y, 931t, 932f, 932
Gastric cancer, 976978, 977f, 976t, 977f
pernicious anemia and, 644645
Gastric disorders, 890t, 962
Gastric distention
Gastric empyting studies, 891t894
Gastric inhibitory peptide, 880t
Gastric lavage, for poisoning, 1731
Gastric outlet obstruction, in peptic ulcer disease, 967968, 970, 972
Gastric residual, in enteral nutrition, 911
Gastric secretions, 879880, 880t
hormonal regulation of, 880t
phases of, 880t
Gastric ulcers. See Peptic ulcer disease.
Gastric varices
in cirrhosis, 1048, 1051, 1057
management of, 1051, 1051f
Gastrin, 880t
serum, 891t894t
Gastrinoma, 967
Gastritis, 962963, 962t, 963t
autoimmune, 963
bile reflux, 974
Gastroduodenostomy, for peptic ulcers, 973, 974f
Gastroenteritis, 998
in foodborne illness, 978981
Gastroepiploic artery, in coronary artery bypass grafting, 760
Gastroesophageal reflux disease (GERD), 948951
asthma and, 563
collaborative care for, 949t, 950, 951
endoscopic therapy for, 951
etiology of, 948
hiatal hernia and, 953954
lifestyle modifications for, 950, 950b
nursing management of, 951, 952, 952t
surgery for, 951, 951f
Gastrografin, 889
Gastrointestinal bleeding, 640
anemia from, 641t, 645646
FAST imaging in, 1725
scintigraphy of, 891t894t
upper, 958961
diagnosis of, 959
emergency management of, 959
endoscopic therapy for, 959
esophageal, 959
gastroduodenal, 959
in stress-related mucosal disease, 959
surgery for, 959
types of, 958t
Gastrointestinal disorders
postoperative, 356
upper tract, 940
Gastrointestinal surgery, 884t
NPO status after, 993b
Gastrointestinal system, 876896
common abnormalities on, 890t
focused, 889, 889b
functional health patterns and, 884
48
th
normal findings on, 889t

functions of, 876878
digestion and absorption, 879880
ingestion and propulsion of food, 878879
in older adults, 882883, 883t, 888889
structures of, 877882, 877f
Gastrojejunostomy, for peptic ulcers, 973
Gastroparesis, 1180
Gastropexy, 953
Gastroplasty, vertical banded, 931t, 932, 932f
Gastrostomy tubes, 884t, 910, 910f. See also Enteral nutrition.
drainage from, 358t
infection prevention for, 916b
Gaucon (epinephrine), for glaucoma, 399t400t
Gaze
cardinal positions of, 372, 372f
disconjugate, 1383
Gefitinib (Iressa), for cancer, 269t270t
Gemfibrozil (Lopid), 747t
Gemtuzumab ozogamicin (Mylotarg), for cancer, 269t270t
Gender differences
culture and, 29
in access to care, 2223
in aging, 6162, 62b
in Alzheimers disease, 1486b
in asthma, 563b
in cancer, 242, 242t
in cardiovascular system, 698b
in cholelithiasis, 1068b
in COPD, 585, 585b
in coronary artery bypass grafting, 760
in coronary artery disease, 740, 740b, 754, 754b
in dementia, 1486b
in endocrine disorders, 1226b
in gout, 1620b
in headaches, 1450
in heart failure, 775b
in hernias, 1024b
in hip fractures, 1567b
in hypertension, 714b
in irritable bowel syndrome, 994b
in lung cancer, 536, 536b
in osteoporosis, 1595, 1596, 1597b
in pain, 115b
in sexually transmitted diseases, 1301
in smoking cessation, 157
in stroke, 1426b
in urinary incontinence, 1119b
in urinary tract infections, 1095
in vascular disorders, 844b
Gene therapy, 192193, 273
for cancer, 273
General adaptation syndrome, 90, 91
General anesthesia, 338, 339, 338t . See also Anesthesia.
General survey, 3942, 41t42t. See also Physical examination.
Generalized seizures, 1456, 1456t. See also Seizure(s).
Genes, 189
Genetic disorders, inheritance patterns in, 190, 190t, 193, 193f
Genetic factors
in Alzheimers disease, 1486b, 1488
in asthma, 562
in breast cancer, 1282, 1283, 1283b
in COPD, 586, 586b
in coronary artery disease, 740.741b
in cystic fibrosis, 605, 606, 606b

in diabetes mellitus
type1, 1212t
type2, 1192, 1212t
in drug therapy, 28
in obesity, 923924
in sickle cell disease, 647b
Genetic testing, 192, 193, 192b, 192t, 193f
Genetics, 189193
principles of, 189191
Genetics Information Nondiscrimination Act (GINA), 193, 194b
Gengraf (cyclosporine), for transplantation, 213214, 214t
Genioglossal advancement and hyoid myotomy, 110
Genital herpes, 1306, 1308, 1307f, 1308t
Genital warts, 1308, 1309, 1309f, 1326, 1328
Genitalia
female
disorders of, 1326, 1328
male
disorders of, 1720t
Genotropin (Somatropin), for hypopituitarism, 1229
Gentamicin (Garamycin), for osteomyelitis, 1583
Geographic tongue, 890t
GERD. See Gastroesophageal reflux disease (GERD).
Geriatric assessment, 67
Gerontologic nursing, 66. See also Older adults.
Gestational diabetes, 1193
GF (chemical weapon), 1734t
Ghost sickness, 29t
Ghrelin, 924925, 924t
Giant cell, 171
Giant cell tumor of bone, 1585t
Giardiasis, 220t, 983, 985, 983t
Giemsas stain, 423t
Gigantism, 1226
Ginger, 85t
for nausea and vomiting, 943b
Gingival hyperplasia, phenytoin-related, 1460
Gingivitis, 890t, 945t
Ginkgo biloba, 85t
for Alzheimers disease, 1490, 1490b
Ginseng, 85t, 96b
Glands
endocrine, 11701171. See also Endocrine system.
exocrine, 11701171
Glans, 12591260
Glargine (Lantus), 11961197
Glasgow Coma Scale, 1396, 1400, 1400t
head injury prognosis and, 14041405
Glasses, corrective, 383
Glaucoma, 366, 397398
case study of, 411
etiology of, 397
49
th
primary angle-closure, 397, 398

primary open-angle, 397, 398
secondary, 397
treatment of, 397, 398, 398t
pharmacologic, 398, 399t400t, 400
surgical, 398
Gleason scale, 1356
Gleevec (imatinib), for cancer, 269t270t
Glial cells, 1372
Gliding joints, 1533f
Glimepiride (Amaryl), for diabetes mellitus, 1200, 1200t
Glioblastoma multiforme. 1412, 1413f. See also Brain tumors.
Gliomas, 1412. See also Brain tumors.
Glipizide (Glucotrol), for diabetes mellitus, 1200, 1200t
Global aphasia, 1430t
Global Initiative for Asthma (GINA), 569
Globe
disorders of, 371t
rupture of, 1570
Globus sensation, 949
Glomerular filtration rate (GFR), 1078, 1146, 1146t
Glomerulonephritis, 11031104
acute, 1104t
poststreptococcal, 1104
chronic, 1105
rapidly progressive, 1105
Glomerulus, 1077, 1077f, 1078t
Glossectomy, 884t, 946947
Glossitis, 890t
in iron-deficiency anemia, 640
Glossopharyngeal nerve, 1378f, 1378t
Gloving, preoperative, 335336
Glucagon, 1172t, 11771178
for hypoglycemia, 1217
Glucocorticoids, 1177, 1247. See also Corticosteroids.
Glucophage (metformin)
contrast media and, 1210
for diabetes mellitus, 1200, 1200t, 12091210
Glucosamine, 86t, 1608b
Glucose
endogenous
drug effects on, 1202t
estimated blood, 1194
in cerebrospinal fluid, 1389t
metabolism of, insulin in, 1178
urinary, measurement of, 1184t1187t
exogenous, for alcohol intoxication, 160
Glucose monitoring, 12041206, 1205f, 1205t
Glucose tolerance, impaired, 11921194
-Glucosidase inhibitors, for diabetes mellitus, 1200t, 1201
Glucosuria, 1091t
Glucotrol (glipizide), for diabetes mellitus, 1200, 1200t
Glucovance (metformin/glyburide), 1200t
Glulisine (Apidra), 1196
Glutamate, 1374t
-Glutamyl transpeptidase, 896t
Gluten-sensitive enteropathy, 10251026, 1036t
Glyburide (Micronase, DiaBeta, Glynase), for diabetes mellitus, 1200,
1200t
Glycemic index (GI), 1203
Glycerin liquid (Ophthalgan, Osmoglyn Oral), for glaucoma, 399t400t
Glycerol rhizotomy, 1502, 1503f
Glycerol test, 405
Glycine, 1374t
Glycolic acid, 441t
Glycoprotein IIb/IIIa inhibitors, for angina/acute coronary syndrome,

738
Glycosylated hemoglobin
Glynase (glyburide), for diabetes mellitus, 1200, 1200t
Glyset (miglitol), for diabetes mellitus, 1200t, 1201
Goiter, 1182t1183t, 1233, 1333t
in Graves disease, 1233f
toxic nodular, 1235
Gold compounds, 1605t1607t
Goldenseal, 517b
Golimimab (Simponi), for rheumatoid arthritis, 1605t1607t, 1605
GoLYTELY (polyethylene glycol), for constipation, 989t
Gonadal hormones, 1172t, 1262, 1262f, 1263t
Gonadotropin-releasing hormone, 1262, 1262f
Gonadotropin-releasing hormone agonists
for endometriosis, 1329
for infertility, 1316t
Gonadotropin-releasing hormone antagonists, for infertility, 1316t
Gonadotropins, measurement of, 1184t1187t
Gonads, 1288. See also Ovary; Testis.
Gonal-F (follitropin), for infertility, 1316t
Goniometer, 15371537f
Gonorrhea, 13011303, 1301f1302f, 1302t
diagnosis of, 1272t1275t, 1302, 1302t
screening for, 1311
Good lung down position, 1708
Goodpasture syndrome, 203, 1105
Gordons functional health patterns. See Functional health patterns.
Goserelin (Zoladex), for prostate cancer, 13581359, 1359t
Gout, 1116, 16201622, 1620t1621t, 1620f
Gowning, preoperative, 335336
Graduated compression stockings, 862
Graft(s), 458, 458t
arteriovenous, in hemodialysis, 1156, 1156f
coronary artery. See Coronary artery bypass grafting.
endovascular
for peripheral arterial disease, 854, 854f, 857t
skin. See Skin grafts.
Graft rejection, in renal transplant, 1164
Graft-versus-host disease, 215216
Gram stain, for gonorrhea, 1272t1275t
Grand mal seizures, 14561457
Granisetron (Kytril), for nausea and vomiting, 942
Granulation tissue, 176, 177f, 179t
Granulocyte, 617f, 618619, 620t
Granulocyte colony-stimulating factor, 198t199t
Granulocyte-macrophage colony-stimulating factor, 198t199t
Granulocytopenia, 664
Granuloma annulare, in diabetes mellitus, 1222
Granulomatous thyroiditis, 1234
Graphesthesia, 1385
Graves disease, 1234. See also Hyperthyroidism.
Gray matter, 1375
Grey Turners sign, 845, 995, 10611062
50
th
Grief
Groshong catheters, 309. See also Central venous access devices.
Grottons papules, 16311632, 1632f
Grottons sign, 16311632
Growth hormone (GH), 1172t, 1175
endogenous
deficiency of, 1229
excess of, in acromegaly, 12281229
exogenous, for hypopituitarism, 1229
Growth hormone stimulation, measurement of, 1184t1187t
Guanabenz (Wytensin), for hypertension, 724t727t
Guanadrel sulfate (Hylorel), for hypertension, 724t727t
Guanethidine (Ismelin), for hypertension, 724t727t
Guanfacine (Tenex), for hypertension, 724t727t
Guardianship, 953b
Guglielmi detachable coils, 1435, 1435f
Guided imagery, 95
Guided meditation, 95
Guillain-Barr syndrome, 15051506
Guillotine amputation, 1572
Gummas, syphilitic, 1303, 1304t, 1305f
Gynecomastia, 1281
in cirrhosis, 1057
senescent, 1281
Gynoid obesity, 922923, 923f, 923t
H
H1N1 infection, 218
H1N1 influenza, 498
H2-receptor blockers
for cirrhosis, 1052
for GERD, 951
for upper GI bleeding, 959, 960t
Hair, 414
assessment of, . See also Integumentary system, assessment of.416
422
in endocrine disorders, 1182t1183t
inspection of 420
Hair care, 426
Hair cells, 374
Hair loss. See Alopecia.
Hallux rigidus, 1594t
Hallux valgus, 1593f, 1594t
in rheumatoid arthritis, 16111612, 1612f
Halo sign, 14041405, 1405f
Halo vest, 1519, 1519f, 1520t, 1570
Haloperidol (Haldol), for delirium, 14981499
Halothane (Fluothane), 340t
Hamartomas, of lung, 541
Hammer toe, 1594t, 1593f
Hamwi formula, 912t
Hand, burns of, 450, 459
Hand antisepsis, surgical, 335336
Hand massage, 85
Hand-foot syndrome, in chemotherapy, 266267
Hantavirus pulmonary syndrome, 535, 535t
Haplotypes, 211
Hartmanns pouch, 1016, 1016f
Hashimotos thyroiditis, 1234, 1234f
Hashish, 154t, 152

Haustral churning, 880
Haversian systems, 1530, 1531f
Hawthorn, 85t, 782b
Hay fever, 201
Head and neck, examination of, 41t, 42t
Head and neck cancer, 510519, 945947
airway management in, 516519
diagnosis of, 510
nutrition in, 512513
planning in, 513
radiation therapy for, 510, 513
surgery for, See also Laryngectomy.510516, 511f512f
swallowing problems in, 262t263t, 265, 511
Head blocks, 1721
Head injury, 14041408
case history of, 1422b
diagnosis of, 1407
emergency management of, 1407, 1408t, 1408
evaluation in, 1414
family concerns in, 1410
increased intracranial pressure in, . See also Increased intracranial
pressure.1411
planning in, 14081409
respiratory complications of, 551t
scalp lacerations, 1404
skull fractures, 14041405, 1405f, 1405t
traumatic brain injury in, 1404, 14051406
types of, 14041405
Head lice, 433434, 434t
Headaches, 14491450
acupuncture for, 1452b
brain tumorrelated, 1412
caffeine withdrawal, 320
cluster, 1450t, 14511452, 1453
complementary and alternative therapies for, 1452
diagnosis of, 14511454, 1451t, 1453t
etiology of, 1456
food-induced, 1451, 1454
51
th

medication overuse, 1454
migraine, 450t, 14501451
pain location in, 1450f
primary, 1449, 1450t
ruptured aneurysm and, 1429b
secondary, 1449, 1451
tension-type, 14501452, 1450t
Head-up tilt-test, 816
Healing. See Wound healing.
Healing Touch, 86
Health, determinants of, 19-20, 20f
Health beliefs and practices, cultural factors in, 2530, 26t27t
Health care informatics, 910
Health care personnel, hepatitis in, 1042
Health care rationing, 1057b, 1161
Health care reform, 6, 2224
community-based nursing and, 73
Health care system, factors for change in, . See also Health care
reform.7273
Health careassociated infections, 221
pneumonia, . See also Pneumonia.521522, 521t
urinary tract, 1095
Health disparities, 2022, 22b
age and, 21
case study of, 32b
contributing factors to, 2022, 20t
cultural factors in, . See also Culture.2021, 21f, 2534, 31t
definition of, 20
gender and, 2122, 6162, 62b
geographic location and, 21, 63
health care reform and, 2225
heart failure and, 775b, 784
hypertension and, 714b
impact on health, 22
in asthma, 562b
in brain tumors, 1410b
in chronic kidney disease, 1142b
in coronary artery disease, 740, 740b
in diabetes mellitus, 1206b
in female reproductive cancers, 1332b
in gallbladder disease, 1033b
in hematologic disorders, 636b
in liver disease, 1033b
in lung cancer, 532b
in osteoporosis, 1595b
in pancreatic disease, 1033b
in prostate cancer, 1355b
in sexually transmitted diseases, 1301b
in stroke, 1426b, 1427
in testicular cancer, 1358b
in tuberculosis, 528b
in urologic disorders, 1096b
nursing management and, 21
provider attitudes and, 22
socioeconomic status and, 21
Health history, 3436
data collection for, 3436
data organization for, 36, 37t
delegation for, 43b
functional health patterns in, 36, 37, 38t, 3940
important health information in, 3637
in culturally competent care, 36
medical focus in, 3435, 35t

in preoperative assessment, 319320
nursing focus in, 34
objective data in, . See also Physical examination.35, 3942
past, 36
patient interview in, 3536
sexual history in, 1268, 1268t
subjective data in, . See also Health history.3539
symptom investigation for, 35, 35t
Health insurance
for home health care, 76
for immigrants, 22
health care reform and, 6, 20
Medicare/Medicaid, 22, 6566, 76, 140141
Health Insurance Portability and Accountability Act (HIPAA), 34
Health literacy, 21, 50
Health maintenance organizations (HMOs), 73
Health perceptionhealth management pattern, 36t, 37
Health promotion. See also Healthy People initiative.
in community-based nursing, 73
models for, 4647, 47t
teaching in. See Patient and caregiver teaching.
Health Promotion Model, 46
Health status, 19
Healthy People initiative, 45, 5t, 19
access to health services and, 45, 5t , 19, 19b
Hearing
decibel levels and, 407, 408t
mechanics of, 375
Hearing aids, 408409, 409t
Hearing loss, 406407
assistive devices/techniques for, 408410
causes of, 407f
central, 373, 407
conductive, 373, 406407
cultural factors in, 383
delegation in, 517b
functional, 407
in congenital rubella, 408
in Mnires disease, 405
in older adults, 372, 373t, 410412, 410t
in otosclerosis, 404405
mixed, 407
sensorineural, 370, 407
Hearing tests, 379380, 379t
Heart. See also under Cardiac; Cardiovascular.
adverse drug effects on, 695t
anatomic orientation of, 699f
artificial, 1654
assessment of, . See also Cardiovascular system, assessment of.694
701
blood flow through, 690f
imaging studies of, 702t706t
mechanical system of, 692
52
th

structures and functions of, 690692, 690f, 820
Heart block
Mobitz I (Wenckebach), 802t, 806, 806f
Mobitz II, 825t, 829, 829f802t, 806, 806f
third-degree (complete), 802t, 806f, 807f
Heart disease
atherosclerotic. See Coronary artery disease.
biomarkers in, 702, 703t707t
diagnosis of, 702712, 703t707t
health promotion for, 743744, 743b
hypertensive, 718719, 718f, 718t
inflammatory, 820
rheumatic, 827828, 827f
stroke and, 1426
valvular. See Valvular heart disease.
Heart failure, 774785
acute decompensated, 778779, 779t, 780782
after myocardial infarction, 757
ambulatory and home care for, 789, 789t
cardiac transplantation for, 791794, 791t
case study of, 792b
chronic, 778779, 778t, 783785
circulatory assist devices for, 781
clinical manifestations of
in chronic failure, 778779
in decompensated failure, 778, 778t
in right- vs. left-sided failure, 779t
collaborative care for
for acute decompensated failure, 780783, 781t
for chronic failure, 781t, 783785
compensatory mechanisms in, 775776
counterregulatory mechanisms in, 777
definition of, 703
diastolic, 775
dilation in, 775776, 775f
drug therapy for
for acute decompensated failure, 781, 782t
for chronic failure, 782t, 783
hypertrophy in, 776
in cardiomyopathy, 836
left-sided, 777, 777f
mixed systolic-diastolic, 775
neurohormonal response in, 775
nutritional therapy for, 785, 785b
palliative and end-of-life care in, 790
planning in, 789
race/ethnicity and, 776b, 784

right-sided, 778779, 778f
sympathetic nervous system in, 775
systolic, 775
ultrafiltration for, 781
Heart murmurs. See Murmurs.
Heart rate, 693
cardiac output and, 693
during exercise, 768
measurement of, 698
on electrocardiogram, 798
Heart sounds
auscultation of, 699, 699t700t, 700f, 701
electrocardiogram and, 701f
Heart transplantation, 791794, 791t
Heart valves. See Cardiac valves.
Heartburn, 890t, 948949
Heat application, for osteoarthritis, 1604
Heat cramps, 1727
Heat edema, 1727
Heat exhaustion, 17271728
Heat rash, 1726
Heat syncope, 1727
Heat therapy
for inflammation, 175
for pain, 131132, 132t
Heat-related emergencies, 17261727, 1727t, 1729t
Heatstroke, 1727t, 1728
Heaves, 699701Heberdens nodes, 1602
Heel pain, 1594t
Heel-to-shin test, 1384
Height, measurement of, 906
Heimlich valve, 546, 546f
Helical CT scan, for pulmonary embolism, 554
Helicobacter pylori infection
diagnosis of, 967
gastritis and, 962963
peptic ulcers and, 966967
stomach cancer and, 976977
Heliotrope rash, in polymyositis/dermatomyositis, 16301631
Heller myotomy, for achalasia, 957
Helper T cells, 197f, 197
Hemabate (carboprost), for induced abortion, 1317t
Hemangioblastomas, 1412t
Hemarthrosis, 625, 1545
Hematemesis, 479, 623, 890t
Hematinics, for inflammatory bowel disease, 1002t
Hematocrit, 487t488t
Hematologic disorders, 635
health care disparities in, 636b
hemostatic, 678
in cirrhosis, 1047
race/ethnicity and, 636bskin manifestations of, 437t
Hematologic system, 616
biopsy in, 631633, 631t, 632t, 633f
focused, 628, 628b
53
th
functional health patterns in, 623625, 624t

medication history in, 622623, 623t
physical examination in, 625628, 626t, 627t
radiologic studies in, 631, 632t
blood in, 616618
bone marrow in, 616617
clotting in, 619621
hemoglobin in, 619
iron metabolism and, 619
liver in, 621
lymph system in, 621622
spleen in, 621
Hematology, 616
Hematomas, 421t, 626t626t
epidural, 1406, 1406f
fracture, 1551, 1552f
intracerebral, 1407
of ear, 402
subarachnoid, 1406f
subdural, 14061407, 1406f, 1406t
Hematopoiesis, 616, 617f
spleen in, 621
Hematopoietic growth factors, for cancer, 271272, 271t
Hematopoietic stem cells, 616617
injection of, for urinary incontinence, 11221123transplantation
of, 272273, 272f, 272t
cell collection for, 209, 273
for leukemia, 672
for sickle cell disease, 650
Hematuria, 1085t
Hemianopsia, 1383
homonymous, 1387t
in stroke, 1430, 14421443
Hemicolectomy, 10131014
Hemiglossectomy, 884t, 946947
Hemi-Kock pouch, 1129
Hemilaryngectomy, 511
Hemiparesis, in increased intracranial pressure, 1395
Hemiplegia, 1387t
Hemochromatosis, 651, 651b
Hemodialysis, 11391140, 11551159. See also Dialysis; Renal
replacement therapy.
advantages and disadvantages of, 1153t
arteriovenous fistulas and grafts in, 1156, 1156fcatheters for,
1156, 1157f
continuous arteriovenous, 11591160, 1159t
continuous venovenous, 11591160, 1159f, 1159f
dialyzers for, 1157
effectiveness of, 1158
in continuous renal replacement therapy, 11591160, 1164f
in home care, 1158, 1158f
procedure for, 11571158
schedules for, 1158
settings for, 1158
system components in, 11571158, 1158f
vascular access in, 1153, 1156f1157f
temporary, 1156
vs. peritoneal dialysis, 1153t
Hemodynamic monitoring, 703t707t, 711, 1642
afterload in, 1642

cardiac index in, 16421643complications of, 1644, 16511652
contractility in, 16421643
definition of, 1642
impedance cardiography in, 1650
in ARDS, 1716
in shock, 17001702, 1701t
invasive, 16431650
equipment for, 1644f
noninvasive, 1650, 1652
of arterial blood pressure, 16441645of cardiac output, 1462
1463, 16491650
of central venous pressure, 1648
of pulmonary artery pressure, 1647
of right atrial pressure, 1648
of venous oxygen saturation, 16501651phlebostatic axis in,
1643, 1645f
preload in, 1642
pulmonary artery catheterization in, 475, 16451651, 1646t. See also
Hemodynamic monitoring.
complications in, 16511652
pulse oximetry in, 1651
referencing in, 1643
steps in, 16441645, 1646t
terminology of, 16421644
types of, 16441650
vascular resistance in, 1642
zeroing in, 1643
Hemofiltration
continuous arteriovenous, 11591160, 1159t
continuous venovenous, 11591160, 1159t, 1160f
Hemoglobin, 473474
assessment of, 485, 487t
fetal, 650
glycosylated, 1194
Hemoglobin A1C, diabetic complications and, 1194b
Hemoglobin A1C test, 1192, 1194
Hemoglobin electrophoresis, 631t
Hemoglobin F, 650
Hemoglobin S, 647, 648f
Hemolysis, 618
causes of, 650651
Hemolytic anemia, 641t. See also Anemia.
acquired, 650651
Hemolytic jaundice, 1032, 1032t
Hemolytic transfusion reactions, 203, 682, 683t
Hemolytic-uremic syndrome
Escherichia coli O157:H7 poisoning and, 979983
thrombotic thrombocytopenic purpura and, 654
Hemophilia, 657659, 659b, 659t, 658, 658f, 660t
Hemopneumothorax, 542
Hemoptysis, 479
Hemorrhage. See also Bleeding.
anemia from, 641t, 646647
54
th

in thrombocytopenia, 645, 656657
intracerebral, 1427t, 14281429
splinter, 699t700t, 820
subarachnoid, 1427t, 1428
subconjunctival, 371t
Hemorrhagic cystitis, in cancer, 262t263t
Hemorrhagic fever, in terrorism, 17321734, 1733t1734t
Hemorrhagic stroke, 1427, 14281429
Hemorrhoidectomy, 1027
Hemorrhoids, 891t, 988, 1026, 1026f, 1028f
Hemostatic disorders, 653
disseminated intravascular coagulation, 661662
hemophilia, 661663
thrombocytopenia, 653657
von Willebrand disease, 661663Hemothorax,

543, 543
Hemovac, 358t
HEPA filtration, 667
Heparin
bleeding due to, 866
for burns, 460
for stroke, 1433
for venous thromboembolism, 863, 863t
low-molecular-weight, 863, 863t
thrombocytopenia due to, 654, 655t656t, 656657. See also
Thrombocytopenia.
unfractionated, 863, 863t
Heparin flush, 308b, 311Hepatic disorders. See Liver, disorders of.
Hepatic ducts, 891f, 892
Hepatic encephalopathy, 1048, 148t1049t, 1056
Hepatic failure
fulminant (acute), 10561057
with renal failure, 1057
Hepatic steatosis, 10441045
Hepatitis, 10321033
ambulatory and home care in, 1043
anicteric, 1036
autoimmune, 1044
chronic, 1036
cirrhosis and, 1044
drug therapy for, 1037, 1038
drug-induced, 1043, 1061
evaluation in, 1043
fulminant hepatic failure and, 10581059
fulminant viral, 1036
health promotion for, 1039, 1040t
hemodialysis-related, 1158
icteric, 1035. See also Jaundice.
immunization for
for hepatitis A, 1039

for hepatitis B, 1042
in health care personnel, 1043
in liver transplant recipients, 1060
jaundice in, 1042
rest in, 1043
toxic, 1043
transmission of, 10331034
Hepatitis A, 10321034, 1034f
prevention of, 1040
transmission of, 10331034, 1034t, 1043
Hepatitis A virus, 10331034, 1034t
Hepatitis B, 10321034, 1034t
chronic, 1035, 1038
immune globulin for, 1045, 1060
prevention of, 1045
transmission of, 1033t, 1034, 1043
Hepatitis B virus, 1033t, 1034
Hepatitis C, 10321034, 1036
chronic, 1039
HIV infection and, 1032, 1038
prevention of, 1045transmission of, 1033t, 1034, 1060
Hepatitis C virus, 1033t, 1034
Hepatitis D, 1033t, 1034
Hepatitis E, 1033t, 1034
Hepatitis G, 1034
Hepatobiliary scintigraphy, 891t894t
Hepatocellular carcinoma, 10581059
Hepatocellular jaundice, 1032, 1032t
Hepatocytes, 881882, 882f
Hepatomegaly, 626t627t, 627, 890t
Hepatorenal syndrome, 1049
Hepatotoxicity, 884, 884t, 1043
of chemotherapy, 262t263t
Hepcidin, 621
Hepsera (adefovir), for hepatitis, 10381039
HER-2, in breast cancer, 1284, 1285
Herbal therapy, 8283, 84t85t. See also Complementary and
alternative therapies.
Herceptin (trastuzumab)
cardiotoxicity of, 267
Hereditary nonpolyposis colorectal cancer, 1011, 1011b
Hering-Breuer reflex, 476
Hernias, 890t, 1024
femoral, 1024, 1024f
gender differences in, 1024hiatal, 949t, 952953, 954f
incisional, 1024
inguinal, 1024, 1024f
umbilical, 1024, 1024f
ventral, 1024
Herniation
55
th
cerebral
cingulate, 1394f, 1395
infratentorial, 1379
tentorial, 1394f, 1395
uncal, 1394f, 1395
intervertebral disk, 1589
Hernioplasty, 1024
Herniorrhaphy, 884, 884t, 1024, 1266t
Herniotomy, 953
Heroin, 154t, 161162
Herpes simplex virus infection
in pregnancy, 1307of eye, 387388, 1306
of genitals, 13061308, 1308t, 13251327
of lip, 431, 431f, 432t, 13071308, 1307
of oral cavity, 890t, 945t
of skin, 431, 431f, 432t
Herpes simplex virus keratitis, 388389, 1307
Herpes zoster, 431, 431f, 432t
postherpetic neuralgia and, 432b
Herpes zoster ophthalmicus, 388389
Hetastarch (Hespan), 307Hiatal hernia, 949t, 852953, 954f
Hiccups, postoperative, 355
Hickman catheters, 309. See also Central venous access devices.
High-density lipoproteins, 703t707t, 708, 738. See also
Hyperlipidemia; Lipids/lipoproteins.
High-fiber diet, 990991High-frequency ventilation, 1664
Hilus, 471
Hindus, health beliefs and practices of, 26t
Hinge joints, 1533f
Hip
dislocation of, 1547, 1547f
fractures of, 15661567, 1567f
subluxation of, 1547, 1548f
Hip arthroplasty, 1576, 1576f
Hip resurfacing, 1577
Hip spica casts, 1554, 1555f
Hippocampus, stress effects on, 93
Hirsutism, 421t
Hirudin derivatives, for venous thromboembolism, 863t, 863
Hispanics/Latinos. See also Race/ethnicity.
Histoplasmosis, 532, 533t
History taking. See Health history.
HIV infection. See Human immunodeficiency virus infection.
Hives, 203, 435t
HLA system, 211, 211f, 1540t1541t
in diabetes, 1190
HLA typing, 212
HMG-CoA reductase inhibitors, 746, 747t
HMOs (health maintenance organizations), 74
Hodgkins lymphoma, 210, 674675, 674f675f, 674t
Holding area, 331
Holistic nursing, 82
Holter monitoring, 703t707t, 708, 800801
Homans sign, 861

Homatropine hydrobromide (AK-Homatropine, Isopto Homatropine),
for pupillary dilation, 392t
Home health aides, 79t
Home health care, 7577. See also Community-based nursing.
blood pressure measurement in, 731732
caregiver needs in, 8081
common assessed needs in, 76, 77t
definition of, 75
family caregivers in, 76, 7980. See also under Caregiver.
for acute abdominal pain, 993
for acute pancreatitis, 1065
for adrenalectomy, 1251
for amputation, 1574
for asthma, 581582
for bariatric surgery, 936
for benign prostatic hyperplasia, 1355
for cataracts, 393
for chronic stable angina, 762
for cirrhosis, 1057
for COPD, 596597, 602606
for cranial surgery, 1415
for epilepsy, 1463
for esophageal cancer, 956
for glaucoma, 400
for head and neck cancer, 517518
for head injury, 1409
for hemophilia, 661
for hepatitis, 1043
for HIV infection, 233t
for hypothyroidism, 12421244
for infective endocarditis, 823
for laryngectomy, 517518
for leukemia, 673
for malnutrition, 907
for peptic ulcer disease, 972973, 973t
for pneumonia, 528
for pressure ulcers, 186, 187t
for rheumatic fever, 829
for sexually transmitted diseases, 1358
for shock, 1694
for skin disorders, 441442
for stomach cancer, 978
for stroke, 1444
for systemic lupus erythematosus, 1625
for thrombocytopenia, 657658
for thyroidectomy, 1240
for tracheostomy, 506, 506f
56
th
for urinary tract infections, 1099

hemodialysis in, 1158, 1158f
hospice care and, 77
insurance coverage for, 77
nursing diagnoses for, 78t, 80
oxygen therapy in, 595596, 596t597t
peritoneal dialysis in, 1154
scope of care in, 7577, 77t
spirometry in, 491
substance abuse and, 166
teaching in, 76
team approach in, 77, 79t
technology in, 7677
Home Health Care Classification, 8
Homelessness, among older adults, 6263
Homeopathy, 83t
Homeostasis, 281
Homocysteine, 631t
in cardiac assessment, 702, 703t707t
Homonymous hemianopsia, 1387t
in stroke, 1409, 14221423
Hopelessness, in dying patient, 146
Hordeolum, 371t, 387, 387f
Hormonal therapy
of breast, 12891290, 1289t
for endometrial cancer, 13331334
for prostate cancer, 13571359, 1358t
Hormone(s), 11701173
anabolic, 1178
counterregulatory, 1190
definition of, 1170
digestive, 879, 879t
functions of, 1701
in weight regulation, 924925, 924t
inhibiting, 1174
lipid-soluble, 1171
releasing, 1174
secretion of, 1173
complex feedback in, 1173f1174f, 1174
neural regulation of, 1174
rhythms of, 1174
simple feedback in, 1173, 1173f1174f
sex (gonadal), 1172t, 12611262, 1261f, 1263t
in older adults, 1178t, 1265
stress, 91
target tissues of, 1170, 1171f, 1172t
transport of, 1171
tropic, 1176
water-soluble, 1170
Hormone receptors, 1171
protein, 1171, 1173f
steroid, 11701172, 1173f
Hormone replacement therapy, 1324
for andropausal symptoms, 1368
osteoporosis and, 1596
risks and benefits of, 1324
Hornet stings, 1730
Hospice care,. See also End-of-life care.77, 139140

Hospital-acquired pneumonia,. See also Pneumonia.521522, 521t
Hospitalization
infection transmission in, 221
of older adults, 6771, 67t
sleep disturbances and, 105
smoking cessation and, 158t
Hot flashes, 1323
Hougans, 25
Housing, for older adults, 65
Huber-point needle, 309, 309f
Huff coughing, 598, 598t, 1708
Huhner test, 1275t1278t
Humalog (lispro), 1196
Human bites, 1730
Human chorionic gonadotropin
endogenous
in ectopic pregnancy, 1322
in pregnancy testing, 12701271, 1271t1274t
exogenous, for infertility, 1320t
Human epidermal growth factor receptor 2 (HER-2), in breast cancer,
1283, 1284
Human Genome Project, 191192
Human immunodeficiency virus, 224, 224f
antibody tests for, 226, 226t
ocular disorders in, 402t
Human immunodeficiency virus infection, 224231
acute, 224225, 224f
acute exacerbations in, 235236
case studies of, 237b
chronic, 225f, 226
clinical manifestations of, 224225, 224f, 226t
need to report, 235t
diagnosis of, 226t, 227, 227t, 232b, 234
drug therapy for,. See also Antiretroviral therapy.227228, 228t229t,
234, 236237
end-of-life care in, 236
ethical issues in, 228b
health promotion in, 232
hepatitis C and, 1033, 1039
impact of, 222
implementation in, 232, 233t
in IV drug users, 161
laboratory findings in, 226
occupational exposure to, 233
opportunistic diseases in, 224226, 227t, 229230
planning in, 232
postexposure, 233
progression of, 224225, 224f, 227
delaying interventions for, 235239
seroconversion in, 224225
stigma of, 236
syphilis and, 1303
transmission of
by blood and blood products, 222224, 232233
perinatal, 224, 233
tuberculosis in, 529
viral load in, 222224, 222f
57
th
Human leukocyte antigens (HLAs), 211212, 212f, 1540t1542t

in diabetes, 1191
Human papillomavirus infection
cervical cancer and, 13321333
genital warts and, 13081309, 1309f
immunization for, 1341
Humatrope (Somatropin), for hypopituitarism, 12291230
Humegon, 1316t
Humerus, fractures of, 15651566, 1566f
Humidification
for COPD, 595
in respiratory therapy, 1708
Humira (adalimumab)
Humoral immunity, 197f, 199200, 200t
Huntingtons disease, 14791481, 1479b
Hwa-byung, 29t
Hyaline cartilage, 1531
Hyaluronic acid
Hydralazine (Apresoline)
Hydration, in respiratory therapy, 1708
Hydrocele, 1364, 1364f
Hydrocephalus, 1395
brain tumorrelated, 1412
normal pressure, 1496
Hydrochloric acid, gastric, 879
Hydrochlorothiazide, for hypertension, 724t727t
Hydrocil (psyllium), for constipation, 989t
Hydrocodone (Lortab, Vicodin, Zydonel), 124t
Hydrocolloid dressings, 180, 181t
Hydrocortisone (Solu-Cortef)
for Addisons disease, 1252
HydroDIURIL (hydrochlorothiazide), for hypertension, 724t727t
Hydrogel dressings, 181t
Hydrogen ion concentration, pH and, 300, 301f
Hydromorphone (Dilaudid), 124t
abuse of, 154t, 162163
Hydronephrosis, 1107, 1107f, 11361138
Hydrostatic pressure, 285
Hydrothorax, 551
Hydroureter, 1107
Hydroxocobalamin, for pernicious anemia, 644
Hydroxychloroquine (Plaquenil)
for systemic lupus erythematosus, 16051607, 16241625
Hydroxyurea (Hydrea), for sickle cell disease, 650
Hygiene. See Oral care; Skin care.
Hygiene hypothesis, 563
Hygroton (chlorthalidone), for hypertension, 724t727t
Hylalgan (hyaluronic acid), for osteoarthritis, 1608
Hylorel (guanadrel sulfate), for hypertension, 724t727t
Hymen, 1261, 1261f
Hymenoptera stings, 1730
Hyperaldosteronism, 1254
Hyperalgesia, opioid-induced, 127
Hyperbaric oxygen, 181182
Hypercalcemia, 297, 297t
in cancer, 274275, 297

in hyperparathyroidism, 1246
Hypercapnia, 1699, 1704t
permissive, 1714
Hypercapnic respiratory failure, 1699, 1699t, 1702, 1703t
Hypercholesterolemia. See also Hyperlipidemia.
familial, 740, 741b
Hypercoagulability, venous thromboembolism and, 861, 860t
Hyperextension, 1538t
Hyperglycemia
etiology of, 1213t
in burn injury, 462
in diabetes mellitus, 1193, 1213, 1213t, 12151216, 1215t
in parenteral nutrition, 917
management of, 1213t
vs. hypoglycemia, 1213t
Hyperinsulinemia, hypertension and, 718Hyperkalemia, 294295,
294t
digitalis-related, 784785
drug therapy for, 1139t
dysrhythmias and, 1138
in burn injury, 454, 454f, 461
Hyperlipidemia, 707
coronary artery disease and, 739, 741b
diagnosis of, 702, 703t707t, 742t
in familial hypercholesterolemia, 740, 741b
in nephrotic syndrome, 1105, 1106
peripheral arterial disease and, 852853
risk classification for, 742t
treatment of, 742t
Hypermagnesemia, 299300, 301t
Hypermetabolism
Hypernatremia, 291293, 292f, 293t
Hyperopia, 366, 382
correction of
surgical, 382383
Hyperosmolality, 286
hypernatremia and, 291292
Hyperosmolar agents, for glaucoma, 399t400t
Hyperosmolar hyperglycemic syndrome (HHS), 12151216, 1215t,
1216f
Hyperparathyroidism, 12731275, 1274t
Hyperphosphatemia, 318319, 319t
Hyperpigmentation, 1182t1183t
in Addisons disease, 1251, 1251f
Hypersensitivity pneumonitis, 535
Hypersensitivity reactions, 200204. See also Allergic
disorders/reactions.
anaphylactic, 201204, 202f, 202t
58
th
atopic, 201203
chemical mediators of, 200201, 202t
microbial, 204
type I (IgE-mediated), 201204, 200f, 201t
type II (cytotoxic/cytolytic reactions), 201t, 204
type III (immune-complex reactions), 201t, 204
type IV (delayed), 201t, 204205
Hypersplenism, 679680, 680t
Hypertension, 716729
alcohol use and, 722
aortic dissection and, 849850
assessment in, 729t
case study of, 735b
cerebrovascular disease and, 718t, 719
complementary and alternative therapy for, 721b
definition of, 716
adherence to, 728b, 732
agents for, 723, 724t727t
combination therapy in, 728t
follow-up in, 727
for hypertensive crisis, 733735
goals of, 723
in older adults, 732733mechanism of action of, 723, 723f, 724t
727t
nursing management of, 724t727t
side effects of, 724t727t, 727729
exercise for, 722
health disparities in, 714b
heart disease and, 718719, 718f, 718t
home care for, 731732
nephropathy and, 1220
in hyperaldosteronism, 12541255
insulin resistance and, 718
intracerebral hemorrhage and, 1428, 1428f
isolated systolic, 716
lifestyle modifications for, 717, 720722, 728
nursing diagnoses for, 730t
ocular involvement in, 404t
peripheral vascular disease and, 718t, 719, 853
pheochromocytoma and, 1255
planning in, 728
portal, in cirrhosis, 10741075
poststroke, 14331435
prehypertension and, 716, 716t
primary (essential), 716
fluid and sodium retention in, 717

renin-angiotensin-aldosterone system in, 715717
pseudohypertension and, 716
psychosocial risk factors for, 722723
pulmonary. See Pulmonary hypertension.
resistant, 729
retinopathy and, 394
salt restriction for, 721
screening for, 722
secondary, 717, 717t
smoking and, 722
stages of, 716t
stress and, 718
stroke and, 1425
subtypes of, 716
target organ disease in, 718719, 718t
weight loss for, 721
white coat, 720
Hypertensive crisis, 732733, 733t
Hypertensive emergency, 732733
Hypertensive encephalopathy, 733
Hypertensive urgency, 732733
Hyperthermia
in head injury, 1409
in stroke, 1433
malignant, 343
Hyperthyroidism, 12341237
nursing care plan for, 1239bnursing management of, 12381239,
1238t
Hypertonia, 1384, 1387t
Hypertonic solutions, 285, 285f, 306t, 307
Hypertrophic cardiomyopathy, 839, 837t, 839840, 839f
Hypertrophic scars, 179f, 179f, 419t, 420421, 422f
Hypertropia, 390
Hyperuricemia, 1620t1621t
from chemotherapy, 262t263t
in gout, 16201622
Hyperventilation
central neurogenic, 1400f
Hyperviscosity, in polycythemia, 651652, 652f
Hypervolemia, 285, 289, 289t. See also Fluid and electrolyte
imbalances.
in polycythemia, 651652, 652f
postoperative, 351
Hyphema, 368
Hypnosis, for pain, 132
Hypnotics, for insomnia, 100101
Hypocalcemia, 297t, 298
hyperparathyroidism and, 1246
hypoparathyroidism and, 1246
tetany and, 1182t1183t, 1246
59
th
Hypoglossal nerve, 1378f, 1378t

Hypoglycemia
etiology of, 1213t
herbal remedies for, 1211b
in diabetes mellitus, 1213, 1213t, 12161217, 1217t
management of, 1213t
postprandial, 974
vs. hyperglycemia, 1213t
Hypoglycemic unawareness, 12161217
Hypokalemia, 294t, 295
postoperative, 351
Hypomagnesemia, 300, 300t
Hyponatremia, 293, 293t
in syndrome of inappropriate antidiuretic hormone, 12291230
Hypoparathyroidism, 1245t, 1246
Hypophosphatemia, 299, 299t
Hypophyseal stalk, 1174
Hypophysectomy, for acromegaly, 12261228, 1227f
Hypopigmentation, 421t
Hypopituitarism, 1229
Hypopnea, 108
in sleep apnea, 108
Hypospadias, 1362
Hypotension
in shock, 1679
orthostatic, 695, 730731
antihypertensive-related, 728, 732
nitrate-related, 751
postprandial, 695
Hypothalamic hormones, 1174, 1174t
Hypothalamic-pituitary-adrenal axis, 9091, 91f
Hypothalamic-pituitary-gonadal axis, 12611262, 1262f
Hypothalamus, 11731174, 1376t
in fluid balance, 286287
in stress response, 9091, 91f
pituitary gland and, 11731174, 1174f
structures and functions of, 11731174, 1376
Hypothalamus-hypophyseal portal system, 1174
induced, in surgery, 342
management of, 355
postoperative, 354355, 355t
therapeutic, 1726
Hypothyroidism, 12401242
clinical manifestations of, 1235t, 12401241
diagnosis of, 1236t, 1241, 1241t
etiology of, 1240

Hypotonia, 1384, 1387t
Hypotonic solutions, 285, 285f, 307308, 306t
Hypotropia, 390
Hypoventilation
Hypovolemia, 285, 289, 290, 289t. See also Fluid and electrolyte
imbalances.
postoperative, 351
Hypovolemic shock, 16741675. See also Shock.
in burn injury, 453454, 453f454f
Hypoxemia, 1699, 1704, 1704t
diagnosis of
arterial blood gas analysis in, 474, 474t
mixed venous blood gas analysis in, 475
pulse oximetry in, 475, 475t
in ARDS, 17021712
delirium and, 353
refractory, 1712
Hypoxemic respiratory failure, 16991703, 1700t1704t
Hypoxia, 1704
Hysterectomy, 1266t, 1336, 1336t
abdominal, 1336, 1336t
for leiomyomas, 1331
for uterine fibroids, 1321
radical, 1336t
subtotal, 1336f, 1336t
total, 1336f, 1336t
vaginal, 13351336, 1336f
laparoscopic-assisted, 1336, 1336t
Hysterosalpingogram, 1272t1275t
Hysteroscopy, 1272t1275t
Hysterotomy, 1317t
Hytakerol (dihydrotachysterol), for hypoparathyroidism, 1247
Hytrin (terazosin), for hypertension, 724t727t
I
Ibandronate (Boniva)
Ibritumomab tiuxetan/yttrium-90 (Zevalin)
Ibuprofen, 122, 123t
Ibutilide (Corvert), for dysrhythmias, 809t
ICU. See also under Critical care.
60
th
Idiopathic pulmonary fibrosis, 553

IgA, 197t
IgD, 197t
IgE, 197
IgE-mediated hypersensitivity reactions, 201203, 200f
IgG, 197t, 200
for hepatitis, 1040t, 1042
IgM, 197t, 199
Ileal conduits, 11281129, 1128t. See also Ostomy; Urinary diversion.
appliances for, 1131t
stoma care for, 1129f, 11291133, 1131f1132f
Ileoanal reservoir, 1003, 1003f, 1017
Ileocecal fold, 895f
Ileocecal junction, 895f
Ileostomy, 884t, 1016f, 1016t, 1021. See also Urinary diversion.
care of, 1021
continent, 986, 1129
definition of, 1015
end, 1004, 1016
loop, 1004, 1016
nursing care plan, 1019b1020b
permanent, 10031004
continent, 10031004
pouches for, 10031004, 1018, 1021
types of, 1016f
vs. colostomy, 1016t
Ileum, 879
Ileus, paralytic, 1007
postoperative, 847
Illness
acute, 57, 58t
chronic. See Chronic illness.
Iloprost (Ventavis), for pulmonary hypertension, 556
Imagery, 95, 95f, 95t, 96t, 1295b
Imatinib (Gleevec), for cancer, 269t270t
Imiquimod (Aldara), 439
Imitrex (sumatriptan), for migraine, 1452, 1453b
Immersion syndrome, 1728, 1729t
Immigrants, 2728
health insurance for, 22
tuberculosis in, 28
Immobilization. See also Casts (fracture); Traction.
cervical, 15151519, 1519f, 1721
Immune complex diseases, 1104
Immune globulin
for hepatitis A, 1040t, 10391042
in liver transplantation, 1060
rabies, 1730
tetanus, 1725t
Immune response, 194200
altered, 200204
antigens in, 195
autoimmune, 650
cells in, 195197, 196f
in allergic disorders, 206207
in autoimmune disorders, 208210

in burn injury, 454
in cancer, 247248, 248f
in hypersensitivity reactions, 200204
in immunodeficiency disorders, 210211
isoimmune, 650
lymphoid organs in, 195, 195f
primary, 199, 199f
secondary, 199, 199f
steps in, 197f
Immune system. See also Immune response.
cells of, 195197
disorders of
renal, 1103
organs of, 195, 195f
respiratory system in, 476
stress and, 91f, 9293, 92f
Immune thrombocytopenic purpura, 653656, 655t656t. See also
Thrombocytopenia.
Immunity, 194
active acquired, 194, 194t
cell-mediated, 196f, 199t, 200
humoral, 197f, 199t, 201
passive acquired, 194195, 194t
Immunization
for hepatitis A, 1039
for influenza, 479, 498t, 499
for pneumococcal pneumonia, 479, 523, 524t
for rabies, 1730
for rubella, 408
for tetanus, 15071508
in burn patients, 460
Immunocompetence, 200
Immunodeficiency, 210
Immunodeficiency disorders, 210211, 210t
infections in. See Opportunistic diseases.
Immunofluorescence, direct, 422, 423t
Immunoglobulins (antibodies), 194195, 197t, 199
Immunologic disorders
renal, 1103
Immunologic surveillance, 248
Immunomodulators, topical, 439
Immunosenescence, 200
Immunosuppressive therapy
for multiple sclerosis, 1467
for transplantation, 213215, 214t, 215f
of liver, 1061
immunodeficiency due to, 210, 210t
Immunotherapy
Imodium (loperamide), for irritable bowel syndrome, 993994
Impaired fasting glucose, 11921194
Impaired glucose tolerance, 11921194
61
th
Impedance cardiography, 1650

Impetigo, 430t, 431, 431f
Impingement syndrome, 1545t
Implantable cardioverter-defibrillator, 811, 811f
Implantable pumps, for analgesia, 130
Implanted infusion ports, 309310, 309f, 310t. See also Central venous
access devices.
Implementation, 1416
assignment in, 15
delegation in, 1415, 15t, 15b
supervision in, 15
Impotence. See Erectile dysfunction.
Imuran (azathioprine)
In vitro fertilization, 13151316
Inamrinone (Inocor), for heart failure, 782t, 783
In-and-out catheterization, 1127
Incision(s)
care of, 357358, 358t. See also Wound(s).
drainage from, 357358, 358t
splinting of, 350, 350f
Incisional hernias, 1024
Incompetence, 792b
guardianship and, 953b
Incontinence. See Fecal incontinence; Urinary incontinence.
Increased intracranial pressure, 13931399
assessment in
neurologic, 14001401
nursing, 1399
cerebral edema and, 13931394
collaborative care in, 1396t, 13981399
diagnostic studies in, 13951396, 1396t
drug therapy for, 13981399, 1403
evaluation in, 1404
fluid and electrolyte balance in, 1403
in stroke, 1433
mechanisms of, 1393
monitoring of, 13961398, 1396f1398f, 1397t
nursing diagnoses in, 1401
patient positioning in, 1403
planning in, 1401
postoperative, 1450
progression of, 1394f
protection from injury in, 1403
psychologic considerations in, 1404
radiation-induced, 281t282t
respiratory function in, 14011403, 1400f
stages of, 1392, 1394f
Incretin, in diabetes mellitus, 1201
Incus, 374, 375f
Inderal. See Propranolol (Inderal).
Infection(s), 217218
antibiotic-resistant, 220221, 220t, 522
bacterial, 217, 218t
case study of, 187b
causes of, 217218, 218t
emerging, 218221, 219t
extent and severity of, 218
fungal, 218, 219t
health careassociated, 221
pneumonia, 521523, 522t. See also Pneumonia.

urinary tract, 1095
of burns, 461
opportunistic
in cancer, 273
in HIV infection, 224226, 227t
prevention and control of, 220222, 221t
prion, 218
protozoal, 218
reemerging, 219220, 220t
transfusion-related, 683t, 684685
viral, 217, 218t
vs. inflammation, 170
Infection precautions, 220222, 221t
Infectious arthritis, 16191620
Infectious diarrhea, 982984, 983t
Infective endocarditis, 818822, 821t
predisposing factors in, 819, 819t
Inferior epigastric artery, in coronary artery bypass grafting, 760761
Inferior vena cava, 693
Infertility
assisted reproduction technology for, 13151316
female, 13141315
chlamydial infections and, 13051306
diagnosis of, 1272t1275t, 13141315, 1315t
endometriosis and, 13291330
etiology of, 1314
in cancer, 262t263t, 267268
in testicular cancer, 1365
male, 13681370
diagnosis of, 1272t1275t
varicocele and, 1364b, 1369
Infestations, 433, 434f, 434t
Inflammatory bowel disease, 9981004
clinical manifestations of, 999t, 1000
colon cancer and, 1001
complications of, 999t, 10001001, 1001t
Crohns disease, 998, 999t, 1000f
diagnosis of, 1001
etiology of, 998999
osteoporosis and, 1000b
pathophysiology of, 998999, 999t, 1000f
surgery for, 10031004, 1003t
ulcerative colitis, 998, 999t, 1000f
62
th
Inflammatory breast cancer, 1283

Inflammatory response, 170173
acute, 173
anemia of, 641t, 643
case study of, 187b
cellular response in, 170, 171f
chemical mediators of, 171172, 172t, 197
chronic, 173
definition of, 170
exudate in, 172, 173t
fever in, 173, 173f
subacute, 173
vascular response in, 170, 171f
vs. infection, 170
Infliximab (Remicade)
Influenza, 498499
H1N1, 218, 499
immunization for, 479, 498t, 525
Information technology. See Technology.
Informed consent, 324, 792b
definition of, 324
for emergency treatment, 324
for surgery, 324, 324b
Infratentorial herniation, 1379
Infundibular stalk, 1175
Infusion ports, 309310, 309f, 310t. See also Central venous access
devices.
Inguinal area, examination of, 1269
Inguinal hernias, 1024, 1024t
Inguinal masses, 1271t
Inhalation agents, anesthetic, 330, 340t
Inhalation injury, 446448, 455, 455t
lower airway, 451453
management of, 453, 452t, 457, 456f, 456t
upper airway, 447
Inhalers
dry powder, 575, 577f, 577t
metered-dose, 572, 572f, 575, 576f. See also Metered-dose inhalers.
spacers for, 575, 575f
Inheritance patterns, in genetic disorders, 190191, 191t, 192193, 193f
Inhibin, 1262
Innohep (tinzaparin), for venous thromboembolism, 863t
Inocor (inamrinone), for heart failure, 782t, 783
Inotropes, 1643
positive, for heart failure, 782, 782t, 784
Insect bites and stings, 433, 434f, 434t, 17301731
Insensible water loss, 288
Insomnia, 102105
acute, 102
case study of, 111b
chronic, 102
definition of, 102
etiology of, 102
primary (idiopathic), 102
rebound, 104
secondary (co-morbid), 102, 103t
treatment of, 82t, 103105, 104t, 105b
Inspection, 35, 39
Inspiration, 473
Inspiratory capacity, 490t
Inspiratory reserve volume, 490t
Inspra (eplerenone)
Institute of Medicine (IOM), 5
Insulin, 924925, 924t
endogenous, 1190t, 1192
functions of, 1189
in obesity, 924, 924t
metabolism of, 1189, 1190f
regulation of, 1178t, 1190f
target tissues for, 1219
exogenous, 11951200
administration of, 11971199, 1198f, 1205f
allergic reaction to, 1199
dawn phenomenon and, 1199
for diabetic ketoacidosis, 1215
for hyperosmolar hyperglycemic syndrome, 1216
home management of, 1197, 1210
hypoglycemia due to, 1213, 12161217
in acute illness, 12071210
in combination therapy, 1197, 1198f
in intensive therapy, 1196
inhalation of, 1197
injection of, 11971198, 1198f
intravenous, 1197
lipodystrophy and, 1199
long-/intermediate-acting, 1195f, 11961197
mealtime (bolus), 1196
mixing of, 1197, 1198f
patient teaching for, 1197t, 1210
pump for, 11981199, 1198f, 1205f
rapid-acting, 1195f, 1196
regimens for, 11951196, 1196t
short-acting, 1195f, 1196
Somogyi effect and, 1199
storage of, 1197
types of, 1195, 1195f, 1195t1196t
Insulin glargine (Lantus), 11961197
Insulin pen, 1198, 1198f
Insulin pumps, 11981199, 1198f, 1205f
Insulin reaction, 1213
Insulin resistance, 936937
Insulin sensitizers, 1201
Insulin tolerance test, 1184t1197t
Insurance. See Health insurance.
Intake and output
measurement of, 290
Intal (cromolyn)
Integrase, 224
Integrase transcriptase inhibitors, 230t
Integrative health care model, 81, 82t. See also Complementary and
alternative therapies.
Integrilin (eptifibatide), for angina/acute coronary syndrome, 752t
Integumentary system, 413. See also Hair; Nails; Skin.
63
th
ABCDE rule for, 426, 429f

diagnostic studies in, 422423, 423f, 423t
focused, 420, 420b
inspection in, 418419
palpation in, 420
Intensive care units. See also under Critical care.
Intensive insulin therapy, 11951196
Interatrial septum, 690, 691f
Intercourse, painful, menopause and, 1323
Interdisciplinary nursing, 3
Interferon(s), 198, 198t, 199f
Interferon- (pegylated), for hepatitis, 1038
Interferon- (Roferon-A, Intron A)
for hepatitis, 1037
Interferon--1a (Avonex, Rebif), for multiple sclerosis, 14661467
Interferon--1b (Betaseron), for multiple sclerosis, 14661467
Interleukin(s), 198t
Interleukin-2 (aldesleukin), for cancer, 269t270t
Interleukin-11 (oprelvekin), for cancer, 271t
Intermaxillary fixation, 1571, 1571f
Intermediate care communities, 76t. See also Long-term care.
Intermediate care units, 1638
Intermittent catheterization, 1127
Intermittent claudication, 719, 851
femoral artery stents for, 851b
Intermittent mandatory ventilation, 1662, 1662t
Internal carotid arteries, 1378, 1379f
Internal fixation, of fractures, 1553, 1555, 1556f, 1567f
Internal jugular vein cannulation, for hemodialysis, 1156
Internal mammary artery, in coronary artery bypass grafting, 760, 760f
Internal pelvic examination, 1269
Internal rotation, 1538t
International normalized ratio (INR), 630t, 863, 864t
Internet resources, for patient/caregiver teaching, 52
Interpreters, 31, 31t
Interspinous process decompression system (X Stop), 1590
Interstitial cellstimulating hormone, 12611262, 1262f
Interstitial cerebral edema, 1394
Interstitial cystitis, 11021103, 1102t
Interstitial laser coagulation, 1350
Interstitial lung disease, 552t, 553
occupational/environmental, 534536, 535t. See also Occupational
lung disease.
Interstitial nephritis, 1101
Intertriginous areas, 417, 420, 420f
Intertrigo, 420f, 421t, 1282
Interventricular septum, 690, 691f
Intervertebral disk disease, 15891591
acute pain in, 1587
chronic pain in, 1589
etiology of, 1589

surgery for, 1590
Interview
motivational, 165166, 166t
patient, 35. See also Health history.
preoperative, 315
Intestinal distention, in mechanical ventilation, 1665
Intestinal infarction, 1008
Intestinal obstruction, 10051009, 1008f, 1008t
Intestinal polyps, 984
Intestinal pseudo-obstruction, 1007
Intestinal strangulation, 1008
Intestinal villi, 879
Intestinal volvulus, 1008
Intoxication. See also Poisoning.
alcohol, 159160
Intraaortic balloon pump (IABP), 781, 783, 16521654, 1652t1653t,
1652f
Intraarterial digital subtraction angiography, in stroke, 1431
Intracellular fluid, 282, 283f, 285. See also Fluid.
electrolytes in, 282, 284f
Intracerebral hematomas, 1407. See also Head injury.
Intracerebral hemorrhage, 1427t, 1428
Intracorneal ring segments, 383
Intracoronary ultrasonography, 703t707t, 710711
Intracranial pressure (ICP), 13911393
cerebral blood flow and, 13921393
compensatory adaptations for, 13911392
compliance and, 1392, 1393f
increased. See Increased intracranial pressure.
measurement of, 13961397
monitoring of, 13961398, 1396f1398f, 1397t, 1403
normal, 13911392
pressure-volume curve and, 1392
Intradermal tests, 205
Intraductal papillomas, 1281
Intraocular lenses
after cataract surgery, 393
corrective, 383
Intraocular pressure
elevated, 366, 397398. See also Glaucoma.
measurement of, 370t, 372, 373f
Intraoperative care, 330
admitting procedure in, 335
advances in, 343344
anaphylaxis and, 343
anesthesia and, 337. See also Anesthesia.
aseptic technique in, 336, 336t
catastrophic events and, 342343
chart review in, 335
cultural assessment in, 334
latex allergy and, 343
malignant hyperthermia and, 343
nursing management in
before surgery, 334335
during surgery, 335337
operating room in, 331
preparation of, 335
outcome criteria for, 337
patient positioning in, 337
physical assessment in, 334335
psychosocial assessment in, 334
64
th

scrubbing, gowning and gloving in, 335336
skin preparation in, 337
surgical team in, 331334. See also Surgical team.
Intrapleural space, 473
Intraprostatic urethral stents, 1350t, 1351
Intraspinal analgesia, 129130, 129f
Intrathecal analgesia, 129130, 129f
Intraurethral devices, for erectile dysfunction, 1399
Intrauterine devices (IUDs), 1368
Intravenous drug users. See also Substance abuse.
HIV infection in, 232233
Intravenous immunoglobulin
for Guillain-Barr syndrome, 1506
Intravenous pyelogram, 1086t1091t
Intravenous therapy. See Fluid therapy.
Intravesical therapy, for bladder cancer, 1118
Intrinsic factor, 643644
gastritis and, 963
Intron-A (interferon-)
for hepatitis, 1037
Intropin (dopamine)
for heart failure, 782783, 782t, 783b
for shock, 16861687
Intubation. See Endotracheal intubation; Nasogastric intubation.
Inversion, 1538t
Involucrum, 1581, 1581f
Iodine
deficiency of
goiter and, 1232
hypothyroidism and, 1240
Ionizing radiation, in terrorism, 1374, 1374t
Ions, 303
Ipratropium bromide (Atrovent)
for COPD, 592594
Ipratropium/albuterol (Combivent, DuoNeb), for asthma, 573t574t, 575
Iprivask (desirudin), for venous thromboembolism, 863t
Irbesartan (Avapro), for hypertension, 724t727t
Iressa (gefitinib), for cancer, 269t270t
Iris, 365f, 366
examination of, 372
Iron
assessment of, 626t627t, 630631
food sources of, 640t, 902t
in hemoglobin, 473, 617, 619, 619f
malabsorption of, 640
metabolism of, 619, 619f
assessment of, 626t627t , 630631
overdose of, 1731t
supplemental, 640641
for inflammatory bowel disease, 1002t, 1004
Iron overload, 651, 651b
liver disease in, 1043
Iron-deficiency anemia, 641642, 641t
Irrigation
bladder
colostomy, 1016t, 10181020
ocular, 1732
whole-bowel, for poisoning, 1732
Irritable bowel syndrome, 993994

Irritant contact dermatitis, 425
Ischemia
acute arterial, 857858
critical limb, 853854
myocardial. See Myocardial ischemia.
silent, 749
Ischemic cascade, 1425
Ischemic strokes, 14261428, 1427f. See also Stroke.
Islet cell transplantation, for diabetes mellitus, 1206
Islets of Langerhans, 1171f, 1177
Ismelin (guanethidine), for hypertension, 724t727t
Ismotic (isosorbide), for glaucoma, 399t400t
Isoflurane (Forane), 340t
Isolated systolic hypertension, 716
Isolation, airborne infection, 532
Isometric contractions, 15321533
Isoniazid
for tuberculosis, 530532, 531t
side effects of, 531t, 530b531b
Isoptin. See Verapamil.
Isopto Atropine (atropine), for pupillary dilation, 392t
Isopto Carbachol, for glaucoma, 399t400t
Isopto Carpine (pilocarpine), for glaucoma, 399t400t
Isopto Homatropine (homatropine hydrobromide), for pupillary dilation,
392t
Isopto Hyoscine (scopolamine), for pupillary dilation, 392t
Isordil (isosorbide dinitrate), for angina/acute coronary syndrome, 752t
Isosorbide (Ismotic), for glaucoma, 399t400t
Isosorbide dinitrate (Isordil, Sorbitrate), for angina/acute coronary
syndrome, 752t
Isotonic contractions, 15321533
Isotonic solutions, 285, 285f, 306t, 307
Isotretinoin (Accutane), 435b
Isradipine (DynaCirc CR), for hypertension, 724t727t
Istalol (timolol maleate), for glaucoma, 399t400t
Itching. See Pruritus.
IV therapy. See Fluid therapy.
J
Jackson-Pratt drain, 180, 180f
Janeways lesions, 820
Janumet (metformin/sitagliptin), 1200t
Januvia (sitagliptin), for diabetes mellitus, 1200t, 1201
Jargon, in patient teaching, 47
Jaundice, 418t, 421t, 626t627t, 1031, 1031f
diagnosis of, 1032t
hemolytic, 1032, 1032t
hepatocellular, 1032, 1302t
in cirrhosis, 1046
in hepatitis, 1040
obstructive, 1032, 1032t
pruritus and, 1053
Jaw fractures, 15701571, 1571f
Jaw-thrust maneuver, 1721, 1721f
Jehovahs Witnesses, health beliefs and practices of, 26t
Jejunostomy tubes, 910, 910f. See also Enteral nutrition
Jejunum, 879
Jet lag disorder, 107
Jews, health beliefs and practices of, 26t
Jock itch, 433, 433t
Joint(s)
amphiarthrotic, 1532f
65
th
aspiration of, 1543

ball and socket, 1533f
bleeding in, 625, 1545
Charcots, 1508
condyloid, 1533f
diarthrodial (synovial), 1513, 1531f1533f
dislocation of, 1547
gliding, 1533f
hinge, 1533f
pivot, 1533f
saddle, 1533f
subluxation of, 1547
synarthrotic, 1532f
Joint aspiration. See also Synovial fluid analysis
in gout, 1620
The Joint Commission
national safety goals of, 4, 4t
patient teaching and, 4849, 49t
Joint contractures, 1539t
flexion, after amputation, 1573
Volkmanns ischemic, 1564, 1564f
Joint pain. See also Arthritis
Joint surgery, 15751578
arthrodesis, 1577
hip arthroplasty, 1576, 1576f
hip resurfacing, 1577
knee arthroplasty, 1577
types of, 1575
Jones criteria, for rheumatic fever, 828t
J-pouch, colonic, 1003f, 1014
Jugular venous bulb catheter, 1398, 1399f
Jugular venous distention, 698, 699t700t
Junctional dysrhythmias, 802t, 805, 805f
K
Kadian. See Morphine.
Kaolin-pectin-opium, for diarrhea, 984t
Kaolin-pectin-paregoric, for diarrhea, 984t
Kaposi sarcoma, 226, 226f, 227t
Karnofsky Functional Performance Scale, 250
Karyotyping, spectral, 632t, 633
Katz Index of Independence in Activities of Daily Living, 250
Kava, 85t, 98b
Kayexalate (sodium polystyrene sulfonate)
for hyperkalemia, 294, 1139t
Kayser-Fleischer rings, 1044
Kegel exercises, 1119b, 1120, 1119t1120t
Keloids, 179f, 179t, 421422, 422f
Kepivance (palifermin), 265
Keratinocytes, 413
Keratitis, 387388
exposure, in Guillain-Barr syndrome, 1506
herpes simplex virus, 388, 1306
Keratoconjunctivitis, 387388
epidemic, 388
Keratoconjunctivitis sicca, 71t, 390, 1631
Keratoconus, 390
Keratometry, 370t
Kerlone (betaxolol), for hypertension, 725t727t
Ketamine (Ketalar), 339, 340t
Ketoacidosis. See Diabetic ketoacidosis.
Ketogenic diet, 1416
Ketones, 1091t
urinary, measurement of, 1184t1186t
Ketorolac (Toradol), 123t
Kidney. See also under Renal.
biopsy of, 10871090t
cancer of, 1116, 1116f1117f, 1117t
examination of, 10841085, 1084f
in acid-base balance, 301, 1076, 1078
in blood pressure regulation, 715716, 715f
in fluid and electrolyte balance, 288
palpation of, 10841085, 1084f
percussion of, 10841085, 1085f
polycystic, 11141115, 1115f, 1125b
surgery of, 1127
Kidney disease, chronic. See Chronic kidney disease.
Kidney failure, acute. See Acute kidney injury.
Kidney punch, 1076, 1084f
Kidney stones. See Urinary calculi.
Kidney-ureter-bladder film, 1087t1091t
Kineret (anakinra), for rheumatoid arthritis, 1605t1606t, 16121613
Kinetic therapy, 17151716, 1716f
Kit chroeun, 29t
Knee
anterior cruciate ligament injury of, 1550, 1550f
arthroscopy of, 15401542, 1542t1543t
meniscus injuries of, 1545t, 15491550, 1550f
structure of, 1549f
Knee arthroplasty, 15771578
Knee immobilizers, 1555, 1555f
Knowles, Malcolm, 46
Kock pouch, 10031004, 1016, 1129, 1129f
KOH test, 423t
Kondremul Plain (mineral oil), for constipation, 989t
Konsyl (psyllium), for constipation, 989t
Korotkoff sounds, 694
Korsakoffs psychosis, 157160
Koucharang, 29t
Kupffer cells, 881882, 882f
Kussmaul respiration, 303, 481, 484t485t
in diabetic ketoacidosis, 1214
Kwashiorkor, 902
Kyphoplasty, 1596
Kyphoscoliosis, respiratory complications of, 551t
Kyphosis, 1539t, 1595
Kytril (granisetron), for nausea and vomiting, 942
66
th
Labetalol (Normodyne, Trandate), 734

Labia majora/minora, 1261, 1261f
Lacerations, scalp, 1040
Lachmans test, 1550
Lacrimal apparatus, 365, 366f
Lactase deficiency, 1004, 1025
diarrhea and, 982
Lactated Ringers solution, 307
Lactation, 1262, 1262f
mastitis in, 12791280, 1279t
Lactic acid, 441t
Lacto-ovo-vegetarians, 901
Lactase intolerance, 1004, 1025
diarrhea and, 982
Lactulose (Constulose, Cephulac)
for hepatic encephalopathy, 1051
Lacunar stroke, 1428
Laminectomy, 1590
Lamivudine (Epivir), for hepatitis, 10381039
Landouzy-Djrine muscular dystrophy, 1587
Langerhans cells, 195
Language deficits, after stroke, 1430, 1443, 1443t, 1447
Lanoxin. See Digoxin (Lanoxin).
Lansoprazole (Prevacid)
Lantus (insulin glargine), 11961197
Laparoscopic cholecystectomy, 10711072
Laparoscopic fundoplication, for GERD, 951, 951f
Laparoscopic nephrectomy, 1128
Laparoscopic-assisted vaginal hysterectomy, 1337, 1336t
Laparoscopy, 891t894t
pelvic, 1272t1275t, 1275t
Lapatinib (Tykerb), for cancer, 269t270t
Lap-Band system, 931t, 934935, 932f
Large intestine. See also Bowel.
polyps of, 1009, 1010f, 1010t
x-ray studies of, 891892, 891f, 891t894t
Laryngeal cancer, 509512, 511f. See also Head and neck cancer.
case study of, 518b
Laryngeal edema, postoperative, 348t
Laryngeal mask airway, 338339
Laryngeal polyps, 509
Laryngeal stridor, 1240
Laryngectomy, 511, 511f
hemilaryngectomy, 511
nursing care plan for, 513516
psychosocial concerns in, 517
radical neck dissection with, 511, 512f
speech after, 541542
stoma care in, 517
supraglottic, 511
Laryngectomy tube, suctioning of, 516
Laryngospasm, postoperative, 348t
Larynx, 470, 471f
artificial, 516517, 517f

Laser lithotripsy, 1110
Laser photocoagulation
for diabetic retinopathy, 12191220
for retinal detachment, 394395
interstitial, 1351
Laser prostatectomy, 1350t, 1351
Laser revascularization, transmyocardial, 761
Laser therapy
bronchoscopic, 539
for benign prostatic hyperplasia, 1350t, 1351
for skin disorders, 438, 438t
for varicose veins, 868
Laser thermal keratoplasty, 383
Laser trabeculoplasty, 398399
Laser-assisted epithelial keratomileusis (LASEK), 383
Laser-assisted in situ keratomileusis (LASIK), 383
Lasix (furosemide). See Furosemide (Lasix).
Latanoprost (Xalatan), for glaucoma, 399t400t
Lateral epicondylitis, 1539t
Latex allergy, 208, 208t, 343
Latex-food syndrome, 208
Latinos. See Hispanics/Latinos.
Lavage
bronchoalveolar, 486487, 489f
for upper GI bleeding, 962
gastric, for poisoning, 1731
nasal, 501
peritoneal, in abdominal trauma, 995
Laxatives, 988
cathartic colon syndrome and, 988
LE cell prep test, 1624
Learning. See also Patient and caregiver teaching.
definition of, 47
Learning needs, 50, 51t
Learning readiness, 50
Learning styles, 50
LEEP (loop electrosurgical excision procedure), 1272t1275t
LEETZ (loop electrosurgical excision of transformation zone), 1272t
1275t
Leflunomide (Arava), for arthritis/connective tissue disease, 1605t
1607t
Left atrial pressure, 1643t
Left ventricular end-diastolic pressure, 1643
Left ventricular hypertrophy, hypertension and, 718719, 718f
Left ventricular thrombosis, 780
Legal blindness, 384, 385t
Legal issues
affecting older adults, 65
in end-of-life care, 66, 144145, 145t
in genetic testing, 192, 192b
in preoperative care, 325, 325b
in sexual assault, 13421343, 1343t
Leininger, Madeleine, 23
Leiomyomas, 1330
menorrhagia and, 13201321
of lung, 540
treatment of, 1321
Lens, 365367, 365f
absence of, 383
disorders of, 371t
opacities in, 390401. See also Cataracts.
Lenses
67
th
contact, 383, 384t

corrective, 383, 384t
intraocular, after cataract surgery, 392
telescopic, 385
Lentigo, 436t437t
Lepirudin (Refludan), for venous thromboembolism, 863, 864
Leptin, 929930, 929t
Lescol (fluvastatin), 747t
Letairis (ambrisentan), for pulmonary hypertension, 557
Letrozole (Femara), for breast cancer, 1289t, 1290
Leukemia, 669672
acute, 669
acute lymphocytic, 669, 669t, 672t
acute myelogenous, 669, 670f, 669t, 672
adult T-cell, 669
age at onset of, 669t
case study of, 685b
chemotherapy for, 671672, 672t
consolidation, 671
induction, 671672
intensification, 671
maintenance, 671
regimens for, 671672, 672t
chronic, 669
chronic lymphocytic, 669670, 669t, 672t
chronic myelogenous, 669, 669t, 672t
clinical manifestations of, 670, 670f, 669t
collaborative care for, 640, 671672
etiology of, 669
hematopoietic stem cell transplant for, 672
remission in, 671
secondary, 245
Leukine (sargramostim)
Leukocytapheresis, 209210
Leukocyte(s), 618t
in urine, 1091t
production of, 616, 617f
Leukocyte count, 628629, 629f
Leukocytosis, 172173
Leukopenia, 629, 664
in cancer, 262t263t
Leukoplakia, 510, 890t, 946
Leukotriene modifiers, for asthma, 572573, 573t574t
Leukotriene receptor antagonists
Leukotrienes
in inflammation, 172, 172f, 172t
Leuprolide (Lupron)
for endometriosis, 13291330, 1329b
for leiomyomas, 1330
for prostate cancer, 13551356, 1356t
Levalbuterol (Xopenex), for asthma, 573t574t, 572
Levamisole (Ergamisol), for cancer, 269t270t
Levatol (penbutolol), for hypertension, 724t727t
Level of consciousness, in increased intracranial pressure, 13941395
Levemir (detemir), 11961197
Levines technique, 182

Levitra (vardenafil), for erectile dysfunction, 1368
Levobunolol (Betagan), for glaucoma, 399t400t
Levocetirizine (Xyzal), for allergic rhinitis, 496t497t
Levodopa, for Parkinsons disease, 1471
Levodopa/carbidopa (Sinemet), for Parkinsons disease, 1471
Levophed (norepinephrine), for shock, 1686t1687t
Levorphanol (Levo-Dromoran), 124t
Levothyroxine (Synthroid), for hypothyroidism, 1241
Levothyroxine-liothyroxine (Liotrix), for hypothyroidism, 1241
Lewy body dementia (LBD), 1495
Lhermittes sign, 14651466
Librium (chlordiazepoxide), abuse of, 154t, 162
Lice, 433434, 434t
Licensed practical/vocational nurse, 14. See also Delegation.
in surgical team, 331332
Lichen sclerosis, 1326
Lichenification, 421t, 435t
LICOX brain tissue oxygenation system, 1398Lidocaine (Xylocaine)
transdermal, 128129
Life expectancy, 6061
Life review, 148
Ligaments, 1534
injuries of
anterior cruciate ligament, 1550, 1550f
sports-related, 1545t
Limb length, measurement of, 15371538
Limb salvage, for osteosarcoma, 16841685
Limb-girdle muscular dystrophy, 1587t
Limbic system, 1376, 1376t
Linear accelerators, 259, 260f
Linton-Nachlas tube, 1051
Lioresal (baclofen), for pain, 126t, 127t
Liothyronine, for hypothyroidism, 1242
Liotrix (levothyroxine-liothyroxine), for hypothyroidism, 1242
Lip
cancer of, 945946, 946t
herpes simplex virus infection of, 431, 431f, 432t
Lip reading, 409
Lipase, serum, 891t984t
in acute pancreatitis, 1062, 1063t
Lipectomy, 933
Lipid profile test, 703t707t, 708
Lipid-lowering drugs
bile acid sequestrants, 747, 747t
cholesterol absorption inhibitors, 747, 748
fibric acid derivatives, 747, 747t
for coronary artery disease, 743746, 747t
HMG-CoA reductase inhibitors, 746, 747t
niacin, 746b747b, 747, 747t
statins, 746, 746t
Lipids/lipoproteins, 702, 703t704t, 739
elevated serum. See Hyperlipidemia.
high-density, 703t704t, 705, 739
low-density, 703t704t, 705, 739, 741t
very low-density, 703t704t, 705
Lipitor (atorvastatin), 747t
Lipodystrophy
in HIV infection, 237, 237f
Lipomas, 436t437t
68
th
Lipoprotein(a), 703t704t, 705

Lipoprotein-associated phospholipase A2, 703t704t, 705
Lipoproteins. See Lipids/lipoproteins.
Liposuction, 443, 934
Liquid nitrogen, 440
Lisinopril (Prinivil, Zestril), for hypertension, 724t727t
Lispro (Humalog), 1196
Listening, active, 47
Literacy, 50
health, 501
Lithotripsy
electrohydraulic, 1110
extracorporeal shock wave, 1110
laser, 1110
percutaneous ultrasonic, 1110
Livalo (pitavastatin), 747t
Liver. See also under Hepatic.
adverse drug effects on, 262t263t, 884, 884t
assessment of
in hematologic assessment, 627
preoperative, 319
biopsy of, 981t894t, 895
cancer of, 10581059, 1059f
autoimmune/metabolic/genetic
enlarged, 626t627t, 627, 890t
functions of, 621
imaging of, 632t
in older adults, 881881, 881t, 1061
nodular, 890t
palpation of, 627, 888889, 888t
percussion of, 890
structures and functions of, 877f, 881882, 881f882f, 882t
transplantation of, 10591060
Liver function tests, 896t
Liver/spleen scan, 632t
Living wills, 144145, 145t
Lobectomy, 548t
Local anesthesia, 338t, 339342. See also Anesthesia.
allergic reactions in, 340
Lockjaw. See Tetanus.
Lomotil (Diphenoyxlate-atropine), for diarrhea, 984t
Long arm casts, 1554, 1555f
Long leg casts, 1554, 1555f
Long-term care, 65, 75. See also Community-based nursing.
elder mistreatment/abuse in, 6364
practice settings for, 75, 75t
relocation stress syndrome and, 65, 75
Loniten (minoxidil), for hypertension, 724t727t
Loop colostomy, 1016, 1017f
Loop diuretics, 724t727t
Loop electrosurgical excision of transformation zone (LEETZ), 1272t
1275t
Loop electrosurgical excision procedure (LEEP), 1272t1275t
Loop ileostomy, 1004, 1016
Loop of Henle, 1077f, 1078, 1078t
Loop recorder, 708709
Loopogram, 1086t1091t
Loperamide (Imodium)
for diarrhea, 984t
for irritable bowel syndrome, 983

Lopid (gemfibrozil), 747t
Lopidine (apraclonidine), for glaucoma, 399t400t
Lopressor. See Metoprolol (Lopressor).
Loratidine (Claritin), for allergic rhinitis, 496t497t
Lordosis, 1539t
Lortab (hydrocodone), 124t
Losartan (Cozaar)
for gout, 16201621
Lotensin (benazepril), for hypertension, 724t727t
Lotions, 441
Lotronex (alosetron), for irritable bowel syndrome, 993, 994b
Lou Gehrigs disease, 1478t1479t
Lovastatin (Mevacor), 747t
Lovenox (enoxaparin), for angina/acute coronary syndrome, 752t
Low back pain. See Back pain, low.
Low-calorie diets, 928929, 928t
Low-density lipoproteins, 703t707t, 708, 738, 740t. See
Hyperlipidemia; Lipids/lipoproteins.
Lower esophageal sphincter, 878879, 949t
in GERD, 948, 948f
Lower extremity amputation, in diabetes mellitus, 1221
Lower gastrointestinal disorders, 982
inflammatory, 996997
traumatic, 993994
Lower gastrointestinal series, 891892, 891t892t
Lower motor neurons (LMNs), 1374
Lower respiratory system, 470473, 472f. See also Respiratory system.
disorders of, 546
Lower urinary tract symptoms (LUTS), 1096t
in acute pyelonephritis, 1100
in interstitial cystitis, 1102
Low-phosphate diet, for chronic kidney disease, 1147, 1149
Low-potassium diet, 1148t
Low-protein diet, for chronic kidney disease, 1148, 1150b
Low-sodium diet
for ascites, 1052
for cirrhosis, 1052
for urinary calculi, 1111
label information and, 786t
sample menus for, 786t
Lubiprostone (Amitiza)
for irritable bowel syndrome, 993
Lubricants, for constipation, 989t
Lucentis (ranibizumab), for macular degeneration, 396
Lumbar puncture, 1385, 1388t1389t
in stroke, 1431
Lumbar spine
intervertebral disk disease in, 15891592. See also Intervertebral disk
disease.
pain in. See Back pain, low.
Lumigan (bimatoprost), for glaucoma, 399t400t
Lumpectomy, 12861287, 1288t
Lund-Browder chart, 450, 450f
Lunesta (eszopiclone), 104
Lung. See also under Pulmonary; Respiratory.
benign tumors of, 541542
69
th
biopsy of, 487t488t, 489, 490f, 538539

bird fanciers, 535, 535t
black, 535, 353t
elastic recoil of, 472
farmers, 535, 535t
gas exchange unit in, 1700f
in acid-base balance, 301
infections of. See Pneumonia.
metastases to, 541
structure of, 470471, 471f
transfusion-related injury of, 683t, 684
trapped, 551
white, 1540, 1540f
Lung abscess, 534
Lung cancer, 536540
airway stenting for, 540
asbestos-related, 535
biologic and targeted therapy for, 540
bronchoscopic laser therapy for, 539
case study of, 559b
cryotherapy for, 538
etiology of, 537
evaluation of, 542
gender differences in, 537
nonsmall cell, 537, 537t
paraneoplastic syndromes in, 538
photodynamic therapy for, 539
planning in, 540
prophylactic cranial, 539
screening for, 539
small cell, 538, 537t, 538
surgery for, 539
syndrome of inappropriate antidiuretic hormone in, 12291230
Lung capacities, 490t
Lung disease
diffuse parenchymal, 553
environmental, 534536, 535t, 553
interstitial, 552t, 553
obstructive, 562
lung volumes in, 550t
occupational, 534535, 535t, 553
restrictive, 550
extrapulmonary causes of, 550, 551t
intrapulmonary causes of, 550, 552t
vascular, 553
Lung sounds, auscultation of, 484, 485t486t, 489f
Lung transplantation, 558560, 558t
for COPD, 597
Lung volume reduction surgery, 548t, 597
Lung volumes, 490t

Lunula, 414415, 415f
Lupron. See Leuprolide (Lupron).
Lupus erythematosus cell prep test, 1624
Lupus nephritis, 1622
Luteinizing hormone, 1172, 1175, 1184t1187t, 1262, 1262f
deficiency of, 1229
in menopause, 1323
Luteinizing hormonereleasing hormone agonists/antagonists, for
prostate cancer, 13581359, 1359t
Lymph fluid, 621
Lymph nodes, 621, 628f
assessment of, 625627, 626t627t, 628f
axillary, 1262, 1287f
in breast cancer, 12831284, 1285
biopsy of, 632t, 633
cervical, radical dissection of, 511, 511f, 947
inguinal, 1269
of breast, 12831284
palpable superficial, 628f
retroperitoneal, in testicular cancer, 1366
sentinel, in breast cancer, 12831284, 1287f
shotty, 481
Lymph system, 621
Lymphadenopathy, 626t627t
in Hodgkins lymphoma, 674, 674f
Lymphatic capillaries, 621
Lymphatic mapping, in breast cancer, 12831284
Lymphedema, in breast cancer, 1286, 1287f, 1294
Lymphocytapheresis, 209210
Lymphocyte(s), 92, 195, 617f, 619. See B cell(s); T cell(s).
Lymphocyte count, 629
Lymphocyte immune globulin (Atgam), for transplantation, 214t, 215
Lymphogranuloma venereum, 1305
Lymphoid organs, 195, 195f
Lymphoma, 674
central nervous system, 1412t
cutaneous T-cell, 428t, 438
Hodgkins, 210, 674, 674f675f, 674t
non-Hodgkins, 676, 676f, 677t
Lynch syndrome, 1011, 1011b
Lyrica (pregabalin), for seizures, 1460
M
M protein, 678
Macrodantin (nitrofurantoin), for urinary tract infections, 1097, 1097b
Macrophage(s), 171172, 195, 196f, 619
alveolar, 476
Macrophage colony-stimulating factor, 198t, 199t
Macugen (pegaptanib), for macular degeneration, 396
Macula, 365
Macular degeneration, 396397
Amsler grid test for, 374t
Macules, 418t
Magnesium, for dysrhythmias, 809t
Magnesium citrate, for constipation, 989t
Magnesium imbalances, 299300, 300t
Magnesium salts, for constipation, 989t
Magnesium sulfate, for cirrhosis, 1053t
Magnetic resonance angiography
in stroke, 1430
renal, 1086t1090t
Magnetic resonance cholangiopancreatography, 891t894t
70
th
Magnetic resonance imaging (MRI)

abdominal, 891t894t
breast, 1278
cardiac, 703t707t, 710, 710f
cerebral, 1386, 1388f, 1388t1389t
chest, 487t488t
endocrine tumor, 1184t1187t
in musculoskeletal disorders, 1540t1542t
pelvic, 1272t1275t, 1275
renal, 1086t1090t
Magnetoencephalography, 1388t1389t
Major histocompatibility antigens, 211212
Mal ojo, 27
Malabsorption syndrome, 903, 10241026
Male reproductive system. See Reproductive system.
Malignant external otitis, 402
Malignant hyperthermia, 343
Malignant melanoma. See Melanoma.
Malignant neoplasms, 244, 244t. See also Cancer.
Malleus, 374375, 375f
Mallory-Weiss tears, 941
Malnutrition, 902906
anthropometric measurements in, 906
etiology of, 903904
health promotion in, 907
history in, 904
in cancer, 273
laboratory studies in, 904
planning in, 907
starvation and, 904
types of, 902
Mammography, 1272t1275t, 1275, 12781279, 1278f
digital, 1278, 1278f
Mammoplasty, 12951297
augmentation, 12971299
reconstructive, 1288t, 12951297, 1296f1297
freduction, 12971298
MammoSite system, 1288, 1289f
Managed care, 4. See also Case Management.
Mandibular fractures, 15701571, 1570t, 1571f
Mandibulectomy, 884t, 946947
Manipulative therapies, 8486
Mannitol (Osmitrol), for glaucomat, 399t400t
Mantoux test, for tuberculosis, 530
Mantras, 95
Marasmus, 902
Marijuana
medical, 163
for pain, 127128
use/abuse of, 153t154t, 162
Marinol (dronabinol), 127128, 163
Mass casualty incident (MCI), 17341737
Massage, 8486, 96
for pain, 131
trigger point, 131

Mastalgia, 1279
Mast-cell stabilizers
Mastectomy, 1266t, 12851287, 1288t, 1296f
breast prosthesis for, 1294
breast reconstruction after, 1288t, 12951297, 1296f1297f
follow-up and survivorship care after, 1287
home health care for, 12941295
lymphedema after, 1286, 1287f, 1294
modified radical, 1287, 1288t
pain after, 1287, 1294
prophylactic, 1283
Mastitis, 1279, 1279t
Mastoiditis, 404405
Mavic (trandolapril), for hypertension, 724t727t
Maxair (pirbuterol), 573t574t, 572
Maxillary fractures, 15701571, 1570t
Maximal voluntary ventilation, 517, 490t
Maze procedure, 805
McBurneys point, 996
McCaffery, Margo, 114
Mean arterial pressure, 694, 1643t
Mean corpuscular hemoglobin, 629t
Mean corpuscular hemoglobin concentration, 629t
Mean corpuscular volume, 629t
Measles, 220
Mechanical receptors, 476
Mechanical ventilation, 16601670
adaptive support, 1663
airway pressure release, 1662, 1663t
alarms in, 1663t, 1667
assist-control, 1661, 1663t
automatic tube compensation in, 1664
barotrauma in, 16651666, 1714
bilevel positive airway pressure in, 1664
chapter cross-references for, 16691671, 1669t
chronic, 16691670
cardiovascular, 1664
neurologic, 1666
pulmonary, 16651666
continuous positive airway pressure, 16631664, 1663t
for sleep apnea, 109b, 109, 109f
endotracheal intubation in, 16551657. See also Endotracheal
intubation.
extubation in, 16691670
accidental, 16591660, 16671668
fluid and electrolyte imbalances in, 1666
high-frequency ventilation in, 1664
in ARDS, 17131716
in home care, 16681670
intermittent mandatory, 16621663, 1663t
modes of, 16611663, 1663t
negative pressure, 1660, 1661f
neuromuscular blockade for, 1667, 17091710
nitric oxide in, 1664
71
th

oral care in, 1658, 1659t
permissive hypercapnia in, 1714
pneumonia in, 521522, 521t, 526, 1665, 17141715
positive end-expiratory pressure, 1663
positive-pressure, 1660
pressure support, 1662, 1663t
pressure-control inverse ratio, 1662, 1663t
prone positioning in, 1664, 1705b, 17151716, 1716f
psychosocial needs in, 1666
sedation in, 1666, 17091710
skin care in, 16581659
spontaneous breathing trial in, 1668
stress ulcers and, 1714
synchronized intermittent mandatory, 16621663, 1663t
types of, 1660
ventilator bundle protocol for, 1, 17141715, 1714t
ventilator disconnection/malfunction in, 1662tt, 1667
ventilator settings for, 1661, 1664t
volume-assured pressure, 1663
volutrauma in, 1664, 1714
weaning from, 1660b, 16671668
Median eminence, 1175
Median nerve compression, in carpal tunnel syndrome, 1548, 1548f
Mediastinoscopy, 487t488t
in lung cancer, 538539
Medical alert aids, for diabetes mellitus, 1211, 1211f
Medical futility, ethical aspects of, 277b
Medical history, 3435. See also Health history.
Medical interpreters, 31, 31t
Medical jargon, in patient teaching, 47
Medical power of attorney, 144, 145t
Medical records, electronic, 910
Medication history, 36
in preoperative assessment, 317
Medication overuse headaches, 1454. See also Headaches
Medications. See also under Drug.
Medicine, primary goals of, 10t
Meditation, 95, 95t
Medrol (methylprednisolone), for asthma, 572, 573t574t
Medroxyprogesterone (Depo-Provera, Provera)
Medullary cystic disease, 1115
Megakaryocytes, 619
Megaloblastic anemia, 643, 643t
classification of, 643t
folic acid deficiency and, 644
vitamin B12 deficiency and, 643645
Meglitinides, for diabetes mellitus, 1200, 1200t
Meiosis, 190
Melanin, 413
Melanocytes, 413414, 414f
Melanocyte-stimulating hormone, 1172t
Melanoma, 427431, 428t
ABCDEs of, 426, 429f
uveal, 401, 401f
Melanonychea striata, 414415, 415f
Melatonin, 101
for insomnia, 86t, 104, 104b
Melatonin-receptor agonists, for insomnia, 104, 104t
Melena, 640, 890t, 958
Memantine (Namenda), for Alzheimers disease, 1489
Memory cells, 196f, 199

Memory loss
age-related, 61, 61t, 1483. See also Dementia.
vs. Alzheimers disease, 1485t
in Alzheimers disease, 1485t, 1489
vs. normal forgetfulness, 1485t
in dementia, 14831484
in mild cognitive impairment, 1485t
Menarche, 1263
Mendel, Gregor, 189190
Mnires disease, 405, 406t
Meninges, 1379
Meningiomas, 1413f, 1412t
Meningitis
bacterial, 1418t, 1419, 1419t
viral, 1418t, 1419
Meningococcal meningitis, 1419
Meniscus injuries, 1549, 1549f
Menometrorrhagia, 1320
Menopause, 1323, 13231326, 1323t
hot flashes in, 1324
osteoporosis and, 13231324
surgical, 1339
Menorrhagia, 1268, 13201321
leiomyomas and, 1330
Menotropins, for infertility, 1316t
Menstrual cycle, 12631264, 1263f
anovulatory, 1320
Menstrual extraction, 1317t
Menstrual history, 1268
Menstruation
abnormalities in, 13181319
absence of, 1264, 1268, 13201321
breakthrough bleeding in, 1320
excessive bleeding in, 1268, 13201321
leiomyomas and, 1330
normal variation in, 1318
painful, 1319
patient teaching for, 1264t, 1321
premenstrual syndrome and, 13181319, 1318t
tampons for, toxic shock syndrome and, 1321
Mental illness. See Psychologic disorders.
Mental status examination, 1383
in dementia, 1483
Mentgen, Janet, 86
Meperidine (Demerol), 125
abuse of, 153t, 162163
6-Mercaptopurine, for inflammatory bowel disease, 1002, 1002t
MERCI retriever, 14341435, 1434f
Mesentery, 977878
Mesothelioma, 541
Metabolic acidosis, 300, 302t, 303
anion gap in, 305306
assessment in, 304306, 305tblood gas values in, 303304, 304t
in diabetes. See Diabetic ketoacidosis.
in mixed acid-base disorders, 303
Metabolic alkalosis
72
th

hypokalemia and, 295296
Metabolic bone disease, 1593
Metabolic equivalent (MET) units, 767, 768t
Metabolic imbalances
in burn injury, 460
Metabolic syndrome, 936937, 937f, 937t
in diabetes, 11921193
Metaglip (metformin/glipizide), 1200t
Metahydrin (trichlormethiazide), for hypertension, 724t727t
Metamorphopsia, 396
Metamucil (psyllium), for constipation, 989t
Metanephrine, measurement of, 1184t1187t
Metaphyses, 1531, 1531f
Metaproterenol (Alupent), for respiratory failure, 1709
Metastases, 246, 246f
bone, 1585
brain, 1412t1413t
hepatic, 1059, 1059f
pulmonary, 541
Metered-dose inhalers, 570, 572f, 575576, 576f
problems with, 576
spacers for, 571, 572f, 575
vs. dry powder inhalers, 577t
Metformin (Glucophage)
contrast media and, 1210
for diabetes mellitus, 1200t, 1201, 1210
Methadone (Dolophine), 124t, 154t, 162
Methamphetamine (Desoxyn), abuse of, 154
Methaqualone (Quaalude), 154
Methazolamide (Neptazane), for glaucoma, 399t
Methicillin-resistant Staphylococcus aureus (MRSA), 220221
Methimazole (Tapazole), for hyperthyroidism, 1237
Methohexital (Brevital), in general anesthesia, 340t
Methotrexate (Folex, Rheumatrex)
for ectopic pregnancy, 1322
for induced abortion, 1317t, 1317
for inflammatory bowel disease, 1002
for rheumatoid arthritis, 1606t, 1613
GI toxicity of, folic acid for, 1625
Methyclothiazide (Enduron), for hypertension, 724t-727t
Methylcellulose (Citrucel), for constipation, 989
Methyldopa (Aldomet), for hypertension, 724t727t
Methylmalonic acid, 631t
Methylnaltrexone (Relistor), for constipation, 989
Methylphenidate (Ritalin), abuse of, 154t
Methylprednisolone, for spinal cord injury, 15151516
Methylprednisolone (Medrol, Solu-Medrol), for asthma, 570, 573t574t
Methylxanthines
for COPD, 591
Metipranolol (OptiPranolol), for glaucoma, 399t400t
Metoclopramide (Reglan), for nausea and vomiting, 942
Metolazone (Zaroxolyn), for hypertension, 724t725t
Metoprolol (Lopressor)
for angina/acute coronary syndrome, 752
Metronidazole (Flagyl)
for bacterial vaginosis, 1326t
for clostridial diarrhea, 984
for H. pylori infection, 963t
for trichomoniasis, 1326t

Metrorrhagia, 1268, 1320
Mevacor (lovastatin), 747t
Mexiletine (Mexitil), 126t
Micardis (telmisartan), for hypertension, 724t727t
Microdermabrasion, 441t
Micronase (glyburide), for diabetes mellitus, 1200, 1200t
Microvascular angina, 749, 750t
Microvascular decompression, for trigeminal neuralgia, 1503
Microvilli, 879
Microzide (hydrochlorothiazide), for hypertension, 724t727t
Micturition. See Urinary elimination.
Midamor. See Amiloride.
Middle cerebral artery, 1378, 1379f
Mifepristone (Mifeprex, RU-486), for induced abortion, 1317, 1317t
Miglitol (Glyset), for diabetes mellitus, 1200 t, 1201
Migraine headaches, 1450f, 1450t, 14501451, 1452. See also
Headaches.
tension-type headaches and, 1450
Mild cognitive impairment, 1484, 1485t
Miliary tuberculosis, 530
Milk of Magnesia, for constipation, 989t
Milk thistle, 5t, 1038
Milliequivalents (mEq), 283
Milrinone (Primacor), for heart failure, 782t, 783
in dilated cardiomyopathy, 838
Mind-body interventions, 83
Mindfulness practices, 95
Mineral oil, for constipation, 989
Mineral oil slides, 423t
Mineralocorticoids, 1172, 1177. See also Corticosteroids.
Minerals, 900901, 902t
Minimal leak technique, 505, 1657
Minimal occluding volume technique, 1657
Minimally invasive surgery, 343
Mini-Mental Status Examination, 1483, 1485t. See also Mental status
examination.
Minipress (prazosin), for hypertension, 724t727t
Mini-tracheostomy, 1708
Minorities. See Culture; Race/ethnicity.
Minoxidil (Loniten), for hypertension, 724t727t
Miotics, for glaucoma, 398
MiraLax (polyethylene glycol), for constipation, 989
Mirapex (pramipexole), for Parkinsons disease, 1472
Miscarriage, 1316
Misoprostol (Cytotec), 968670
for induced abortion, 1317, 1317t
Mithracin (plicamycin), 297
Mitosis, 190
Mitotic inhibitors, 255t256t
Mitral valve prolapse, 831t, 831832, 831f, 832. See also Valvular
heart disease.
Mitral valve regurgitation, 831t, 831. See also Valvular heart disease.
Mitral valve stenosis, 853f, 830831, 831t. See also Valvular heart
disease.
Mitrolan (calcium polycarbophil), for diarrhea, 984t
Mixed (overlapping) connective tissue disease, 1631
Mixed venous blood gases, 475
Mixed venous hemoglobin oxygen saturation, 1643t
Mixed venous oxygen saturation, 1642, 16501651
M-mode echocardiography, 709
Mobitz I heart block, 802t, 806, 806f
Mobitz II heart block, 802t, 806, 806f
Modified Monroe-Kellie doctrine, 1391
Modified neck dissection, 511
Modified radical mastectomy, 1287, 1288t. See also Mastectomy.
73
th
Modulation, of pain, 115f, 116

Moexipril (Univasc), for hypertension, 724t727t
Moles. See Nevi.
Mometasone (Asmanex)
for asthma, 597, 598t599t 571, 573t574t
Moniliasis. See Candidiasis.
Monitored anesthesia care, 337, 338t
Monoclonal antibodies
for cancer, 268271, 269t270t
for transplantation, 214t, 215
side effects of, 269t, 270
Monocytes, 170171, 171f, 617f, 619
Monofilament test, for sensory neuropathy, 1221
Mononuclear phagocytes, 195, 196f
Monopril (fosinopril), for hypertension, 724t727t
Monosaccharides, 899
Monroe-Kellie doctrine, 1391
Mons pubis, 1261, 1261f
Montelukast (Singulair)
for asthma, 571574, 573t574t
Moon face, 1182t1183t
in Cushing syndrome, 1248f
Morbid obesity, 921922, 922t
Mormons, health beliefs and practices of, 26t
Morphine, 124t. See also Opioids.
abuse of, 124t, 161162
for acute coronary syndrome, 752t
for angina, 752t
Mortons neuroma, 1594t
Motion-mode echocardiography, 709
Motivational interview, 166167, 166t
Motor endplates, 1533
Motor system, assessment of, 13841385, 1386t
Motrin. See Ibuprofen.
Mouth. See Oral.
MRI. See Magnetic resonance imaging.
MS Contin. See Morphine.
MSIR. See Morphine.
Mucociliary escalator, 476
Mucositis, in cancer, 262t263t, 264
Mucus, cervical, postcoital test and, 1315
MUGA (multigated acquisition) scan, 706t
Multicultural nursing. See Culturally competent care.
Multidrug-resistant organisms, 220, 220t
Multidrug-resistant tuberculosis, 528
Multigated acquisition (MUGA) scan, 706
Multinucleated giant cells, 171
Multiple chemical sensitivities, 208
Multiple myeloma, 678679
Multiple organ dysfunction syndrome, 1673f, 16941695, 1695t
1696t
in ARDS, 1713
Multiple sclerosis (MS), 14641467
assessment in, 1468t
classification of, 1466t
clinical course of, 1466
demyelination in, 1465, 1465f
etiology of, 1465
N
Nadir, in blood cell count, 261
Nadolol (Corgard)
Naevus of Ota, 421422, 422f
Nafarelin (Synarel)
Nails, 414
assessment of, 416422. See Integumentary system, assessment of.
fungal infections of, 433, 433f, 433t
inspection of420
pigmented lines in, 413414, 414f
splinter hemorrhage under, 699t700t, 820
Naloxone (Narcan), 425, 462
Namenda (memantine), for Alzheimers disease, 14881489
NANDA International
nursing diagnoses of, 11.See also Nursing diagnoses.
standardized terminologies of, 9
NIC-NOC linkages with, 13, 14t, 15f, 14t
Naproxen (Naprosyn, Aleve), 123t
Naqua (trichlormethiazide), for hypertension, 724t727t
Narcan (naloxone), 125162
Narcolepsy, 106107, 107t
Nasacort (triamcinolone), for allergic rhinitis, 496t497t
Nasal anatomy, 478
Nasal bleeding, 493, 494f
Nasal cannula, 594t596t
Nasal cavity, 470
Nasal disorders, 493
Nasal examination, 480
Nasal filtration, 476
Nasal foreign bodies, 501
Nasal fractures, 5493494, 15701571, 1570t
Nasal lavage502
Nasal obstruction, 501
Nasal packing, 493-494, 494f
Nasal polyps, 507
asthma and, 563
Nasal septum, deviated, 493
Nasal surgery, 494
Nasal tampons, 494
Nasal turbinates, 470
Nasalcrom (cromolyn)
Nasalide (flunisolide), for allergic rhinitis, 496t497t
Nasogastric feeding, 910, 910f. See also Enteral nutrition.
Nasogastric intubation
drainage in, 358t
oral hygiene in, 823
postoperative, 992
skin care for, 912, 914b
Nasogastric suction, fluid intake and, 291
Nasointestinal feeding, 910. See also Enteral nutrition.
Nasonex. See Mometasone.
Nasopharyngeal cancer, 509513. See also Head and neck cancer.
Natalizumab (Tysabri)
74
th

Nateglinide (Starlix), for diabetes mellitus, 12001201, 1200t
National Center for Complementary and Alternative Medicine
(NCCAM), 82
National Disaster Medical System, 1735
National Institute for Occupational Safety and Health (NIOSH), 534
National Institutes of Health Stroke Scale, 1437, 1437t
National patient safety goals, 4, 5t
Native Americans. See also Race/ethnicity.
Natrecor (nesiritide), for heart failure, 724t727t, 785
Natriuretic peptides, 288, 702, 703t707t
in heart failure, 777, 780, 781t
Natural death acts, 65, 144
Natural killer cells, 19293, 196f, 197, 247
Naturetin (bendroflumethiazide), for hypertension, 724t727t
Naturopathy, 83t
Nausea and vomiting, 890t, 940943
definition of, 1399
etiology of, 940
in cancer, 262t263t, 264265
in gastric outlet obstruction966967
intestinal obstruction and, 10991100
opioid-related125
postoperative, 345346, 348
projectile, 941
Near-drowning, 941943, 942t
Nearsightedness. See Myopia.
Nebivolol (Bystolic), for hypertension, 724t727t
Nebulizers, 575576
for oxygen therapy, 594
Neck. See also under Cervical.
cancer of. See Head and neck cancer.
examination of, 41t43t, 481
exercises for, 1592
fractures of, 15691570. See also Spinal cord injury.
wry, 1539t
Neck dissection, 510, 511f.
See also Laryngectomy.
modified, 511
nursing care plan for, 526b, 527b
radical, 1336, 1336f
Neck pain, 1592, 1592t
Neck stiffness, in bacterial meningitis, 1416
Neck veins, distended, 698, 698t699t
Necrobiosis lipoidica diabeticorum, 1222, 1222f
Necrotizing ulcerative gingivitis, 945t
nedocromil (Tilled), for allergic disorders, 207
Needle aspiration, transthoracic, 489, 489t
Needles
Huber-point, 309, 309f
insulin, 1198
Needle-stick injuries, HIV transmission via, 224, 232
Negative acute phase proteins, 905906
Negative feedback, in hormone secretion, 1171, 1171f1172f
Negative inotropes, 1643

Negative-pressure therapy, 181
Negative-pressure ventilation, 1660, 1660f
Neglect, elder, 63 64, 63t
Neglect syndrome, 12231224
Neisseria gonorrhoeae, 1301
Neisseria meningitidis, 1416
vaccine for, 1399
Nembutal (pentobarbital), abuse of, 153t, 161
Neoadjuvant chemotherapy, 1289
Neobladder, orthotopic, 11291130
Neocortex, 13741375
Neomycin, for cirrhosis, 1052t
Neonate
gonorrheal eye infections in1302
lupus erythematosus in, 1626
Neoral (cyclosporine), for transplantation, 213214, 214t
Neosar. See Cyclophosphamide (Cytoxan, Neosar).
Neo-Synephrine. See Phenylephrine (Neo-Synephrine, Mydfrin).
Nephrectomy, laparoscopic, 1127
Nephritis
chronic hereditary, 1115
interstitial, 1120
lupus, 1622
Nephrogenic diabetes insipidus, 12301231
Nephrogenic systemic fibrosis, 1139
Nephrolithiasis. See Urinary calculi.
Nephrolithotomy, 11101111
Nephron, 1076, 1077f, 1078t
Nephrosclerosis, 1093
hypertensive, 718
Nephroscope1089f
Nephrostogram, 1086t1090t
Nephrostomy, 1129, 1129t. See also Urinary diversion.
Nephrostomy tubes, 1126
Nephrotic syndrome, 1106, 1106t
Nephrotoxicity, 1081t
of contrast media, 1141
of drugs, 1140
Neptazane (methazolamide), for glaucoma, 399t400t
Nerve(s)
cranial, . 13771378, 1378t, 1380f See also Cranial nerves.
peripheral13771378, 1377f
regeneration of1373
spinal, 129, 129f, 133t
Nerve blocks, 130, 338t, 339342, 342f
epidural, 342, 342f
spinal, 347, 347f
Nerve conduction studies1389t
Nerve conduction velocity, 1386
Nerve impulses, 1373
Nervous system, 1372
common abnormalities in, 1182t
cranial nerve, 1383, 1383t
focused, 40, 40b
for reflexes, 1385
health history i1380, 1381t
mental status examination in, 1383
normal findings in, 1386t
75
th
physical examination in, 378379, 378b, 379t

autonomic, 1377
cells of915
central, 1135.See also Brain; Spinal cord.
divisions of, 1373
enteric, 876
parasympathetic, 1378. See also Nervous system.
peripheral, 1691
sympathetic, 1377 See also Nervous system.
in blood pressure regulation, 694695, 695t,
Nesiritide (Natrecor), for heart failure, 724t727t, 782
Neulasta (pegfilgrastim)
for cancer, 271272 271t
Neumega (oprelvekin)
for thrombocytopenia645, 656657
Neupogen (filgrastim)
for cancer271272, 270t
Neuralgia, postherpetic, 432b
Neurectomies, 130, 131f
Neuroaugmentation, 130
Neurodegenerative diseases, 14951496
Neurofibrillary tangles, 1484t, 1487f
Neurogenic bladder, 15211522, 1522t
Neurogenic bowel, 1517, 1523, 1524t
Neurogenic diabetes insipidus, 12311232
Neurogenic shock, 1501, 1677.See also Shock.
collaborative care for, 1734t303304, 304t
Neurogenic skin, 1523
Neuroglia, 1373
Neurohypophysis.1174 See also Pituitary gland.
Neurologic assessment
after spinal surgery1591
emergency, 1722, 1723t
in stroke, 1436
postoperative, 345
preoperative, 319
Neurologic disorders
chronic, 717
in burn injury, 451
respiratory failure in, 1703
Neuroma
acoustic, 406, 1407t
Mortons, 1594t
Neuromuscular blocking agents
for mechanical ventilation, 1666, 17091710
in anesthesia, 341t
Neuromuscular disorders, respiratory failure i1703
Neuromuscular junctions, 1533, 1534f
Neurons, 1373, 1373f
lower motor, 1375
upper motor, 1375
Neuropathic pain, 116, 118119, 118t
Neuropathy. See Diabetic neuropathy; Peripheral neuropathy.
Neuroplasticity, 117
Neurosyphilis, 1303, 15081509
Neurotransmitters, 1318, 1318t
Neurovascular assessment, for fractures, 1557, 1562, 1563
Neutropenia, 629, 665666
in cancer, 261268, 262t263t
Neutrophils, 171, 171f, 617f, 616617
decreased, 665666
segmented617618
Nevi, 420t, 437t,438
atypical/dysplastic, 428t, 429f, 430431
spider, 437t438t 438
in cirrhosis, 10461047
Nevus of Ota, 421422, 422
Newborn
gonorrheal eye infections in, 1302
lupus erythematosus in, 1626
Newton, Isaac, 81
Nexavar (sorafenib), for cancer, 296t297t
of liver, 1059
Nexium. See Esomeprazole (Nexium).
Niacin, for hyperlipidemia, 746b747b, 747, 747t
Nicardipine (Cardene)
Nicotine addiction, 154155. See also Smoking.
Nicotine replacement products, .155155t See also Smoking.
Nicotinic acid, for hyperlipidemia, 746b747b, 747, 747t
Nifedipine (Adalat, Procardia)
for achalasia, 957
Night terrors, 110
Nightingale, Florence, 3
Nightmares, 110
NIH Stroke Scale, 1436t, 14411442
Nilotinib (Tasigna), for cancer, 269t270t
Nilutamide (Nilandron), for prostate cancer, 1359t, 1360
Nimodipine (Nimotop), for cerebral vasospasm, 1436, 1436b
Niox Mino, 569
Nipple
abnormalities of, 1270t
discharge from, 1270t, 1281
cytologic study of, 1272t1275t, 1275
in breast cancer, 1283
in Pagets disease, 1283
Nipple-areolar reconstruction, 1295f
Nipride (sodium nitroprusside)
for heart failure, 724t727t, 782, 782b
Nisoldipine (Sular), for hypertension, 724t727t
Nissen fundoplication, 951, 951f
Nitrates
76
th
for chronic stable angina, 763, 763t, 751, 751t

long-acting, 751
short-acting 749 f
Nitric oxide
in asthma, 563
Nitrobid. See Nitroglycerin.
Nitrofurantoin (Furadantin, Macrodantin), for urinary tract infections,
10951096, 1096b
Nitrogen, liquid, 440
Nitroglycerin
for angina, 752t
for aortic valve stenosis, 832, 832b
for chronic stable angina, 750, 751
for heart failure781782, 782t, 784
for variceal bleeding1050
Nitropaste, 751
Nitrosureas, 255t256
Nitrous oxide, 340t
Nizatidine (Axid)
for peptic ulcer, 968
Nocardiosis, 533, 533t
Nociception, 114116, 114f
Nociceptive pain, 1, 118, 120, 120t
Nocturia, 1081, 1083t, 1096t
Nocturnal angina, 749
Nocturnal penile tumescence and rigidity testing, 1367
Nodes of Ranvier, 1374f, 1375
Nodules
breast, 1270t, 1280
ovarian, in endometriosis, 1329
rheumatoid, 1611
subcutaneous, in rheumatic fever, 828
thyroid, 1182t1183t, 12331234, 1234t
Nolvadex (tamoxifen)
for breast cancer, 12891290, 1290t
Nomenclatures, 9
Nonalcoholic fatty liver disease (NAFLD), 1044
Nonalcoholic steatohepatitis (NASH), 1044
Noncompliance, ethical aspects of, 834b
Nongonococcal urethritis, chlamydial, 1303
Non-Hodgkins lymphoma, 677, 667t
Noninvasive positive pressure ventilation, 17081709, 1709f
Nonnucleoside reverse transcriptase inhibitors, 230t
Non-rapid eye movement (REM) sleep, 101
Nonsmall cell lung cancer, 537, 538t. See also Lung cancer.
Nonsteroidal antiinflammatory drugs (NSAIDs), 122123, 123t
asthma and, 563
efficacy of, 122123
for dysmenorrhea, 1319
gastritis and, 962
gastrointestinal bleeding and, 958
overdose of, 1731t
peptic ulcers and, 965, 967969

types of, 122
NonST-segment-elevation myocardial infarction, 751f, 754, 754f. See
also Acute coronary syndrome.
Nonverbal communication, 2526
Norepinephrine, endogenous, 1172t, 1177, 1374t
Norepinephrine (Levophed), for shock, 1686t1687t
Normal pressure hydrocephalus, 1497
Normodyne (labetalol), 734b
Norovirus diarrhea, 983985, 983t
Norpace (disopyramide), for dysrhythmias, 809t
North American Nursing Diagnosis Association. See NANDA
International.
Nortriptyline (Aventyl)
for interstitial cystitis, 1102, 1103
for smoking cessatio154155, 155
Norvasc. See also Amlodipine (Norvasc).
Nose. See also under Nasal.
air filtration in, 576
Nosebleeds, 493, 494f, 626t627t
Novarel, for infertility1316t
NovoLog (aspart), 1196
Nplate (romiplostim), for immune thrombocytopenic purpura, 656
NPO status
after gastrointestinal surgery, 992b
preoperative, 323, 324t, 325b
NREM sleep, 101
NSAIDs. See Nonsteroidal antiinflammatory drugs (NSAIDs).
Nuchal rigidity, 1416
Nuclear cardiology, 703t707t, 709
Nuclear imaging
abdominal, 891t893t
in exercise testing703t707t
Nucleic acid amplification test, for gonorrhea, 1302
Nucleoside analogs, for hepatitis, 10381039
Nucleoside reverse transcriptase inhibitors230t
Nucleotide analogs, for hepatitis, 10381039
Nucleotide reverse transcriptase inhibitors, 230t
Nucynta (tapentadol), 1126t, 127
Nuflexxa (hyaluronic acid), for osteoarthritis, 1604
Nulliparous female, 1260
Nuprin. See Ibuprofen.
Nurse(s)
advanced practice, 34
assignment by, 14
circulating, 331
delegation by. See Delegation.
latex allergy in, 207208, 208t
licensed practical/vocational, 14
perioperative, 331, 331t
scrub, 331
sleep disturbances in, 110111
smoking cessation for, 157
supervision by, 14
Nurse anesthetist, 330331, 3356
Nursing. See also Nurse; Nursing practice.
changing populations in, 4
clinical decision making in, 45
community-based, 73
critical care, 1637 See also Critical care nursing.
critical thinking in, 45
definitions of, 3
77
th
emergency, 17211726
expanding knowledge base for, 4
gerontologic, 65. See also Older adults.
holistic, 82
interdisciplinary, 3
primary, 4
primary goals of, 10t
public health, 73
specialties in, 3
team, 4
technology in, 4
transcultural, 19. See also Culturally competent care; Culture.
view of humanity in, 3
Nursing: A Social Policy Statement (ANA), 3
Nursing assistive personnel, 14 See also Delegation.
Nursing care
delivery of, 4
relationship-based, 4
Nursing care plan, 10, 10f, 12b, 16. See also Planning.
for acute coronary syndrome, 737b737b
for Alzheimers disease, 638b638b
for anemia, 644, 644b665b
for asthma, 579b
for bacterial meningitis, 1419b1423b
for breast cancer surgery, 1283
for cirrhosis, 1052b1053
for colostomy, 1019b1020b
for COPD, 597b598b
for diarrhea, 985b
for enteral nutrition, 943
for fractures, 15531554b
for headaches1452b
for heart failure, 12b
for hepatitis, 1041b
for hypothyroidism, 1240
for hysterectomy, 1338b
for ileostomy, 1020b1021b
for increased intracranial pressure, 1403b1407b
for inflammatory bowel disease, 1003b1004b
for joint surgery, 1561b
for multiple sclerosis1467b1468b
for neutropenia, 666b
for parenteral nutrition, 918b
for Parkinsons disease, 1471b1472b
for peripheral arterial disease, 854b854b
for pneumonia, 525b526b
for pressure ulcers, 187
for prostate surgery, 1352b1353b
for rheumatoid arthritis, 1616b1617b
for seizures, 1460b1461b
for shock, 1686b1687b
for spinal cord injury, 1514b
for stroke, 1437
for systemic lupus erythematosus, 1626b1627b
for thoracic surgery, 550b
for thrombocytopenia, 658
for total laryngectomy/radical neck dissection, 515b516b
for tracheostomy, 506b508b
for valvular heart disease, 821
Nursing diagnoses, 1113
assessment and, 44, 44f
collaborative problems and, 13
data analysis and, 11
defining characteristics and, 13

definition of, 11
diagnostic statements for, 1113
etiologies of, 1213
NANDA-I, 11
PES format for, 113, 12t
problem identification and, 1112
related to statements in, 1213
risk, 1112
signs and symptoms and, 13
taxonomy of, 11
wellness, 1112
Nursing history, 34 See also Health history.
Nursing implementation, 1416
assignment in, 15
delegation in, 1415, 14t, 15b
supervision in, 15
Nursing informatics, 10
Nursing interventions, 14, 14t
Nursing Interventions Classification (NIC), 9, 14
NANDA-NOC linkages with , 14, 15f, 15t
Nursing Management Minimum Data Set, 9
Nursing Outcomes Classification (NOC), 9, 1314
NANDA-NIC linkages with, 14, 15f, 15t
Nursing practice, 2 See also Nurse; Nursing.
advanced, 34
certification in, 3
collaborative functions in, 11
current, 24
dependent functions in, 11
doctorate of, 4
domain of, 23
evidence-based. See Evidence-based practice.
future influences on, 310
independent functions in, 1011
nursing process in, 1011 See also Nursing process.
scope of, 23
Nursing process, 89
assessment in, 1011, 10f, 4344, 43f. See also Assessment.
definition of, 10
evaluation in, 581
implementation in, . See also Implementation.10, 10f, 1315
nursing diagnoses in, 1011, 10f, 4344, 43f.See also Nursing
diagnoses.
phases of, 10, 10f
planning in, 10, 10f, 12b, 1314. See also Nursing care plan.
problem identification in4445, 44f
standardized nursing terminologies in, 14, 15t, 15f
Nursing terminologies, standardized. See Standardized nursing
terminologies.
Nutrition. See also Diet; Feeding; Food.
antiaging effects of, 61
cultural aspects of, 27, 901
definition of, 897
enteral, 914918
normal, 900902
skin health and, 425
wound healing and, 181182
Nutritional assessment, 905t, 906907
for older adults, 63, 63t
preoperative, 320
Nutritional problems, 897
78
th
Nutritional supplements, 84, 86t

Nutritional therapy
after gastric surgery, 975
decision-making plan for, 909f
enteral nutrition in. See Enteral nutrition.
for acute pancreati1063
for anemia, 640t
for burn injury, 459t, 460, 464
for chronic kidney disease, 11461148, 1148t
for chronic pancreatitis, 10651066
for cirrhosis, 1052
for constipation, 984, 990
for COPD, 598599
for coronary artery disease, 745, 745t
for diabetes mellitus, 12021204, 1203t
for fractures, 15561557
for gallbladder disease, 1071
for GERD, 950
for gout, 1621
for heart failure, 785, 785b
for hepatitis, 1039
for hypertension720722, 720t, 728
for ileostomy, 1021
for increased intracranial pressure, 14031404
for inflammatory bowel disease, 1002
for intermaxillary fixation, 1571
for mechanical ventilation, 1666
for multiple organ dysfunction syndrome, 16961977
for pneumonia, 525
for stroke, 14221423, 1444
for systemic inflammatory response syndrome, 16961697
for urinary calculi, 1109, 1109t
in critical care nursing, 1638
in home care, 918
oral feeding in, 910
parenteral nutrition in, 914916
Nutritional-metabolic pattern, 37t, 38
Nystagmus, 160, 1383, 1386t
O
O blood type, 629630, 630t
Obesity, 921926
activity and exercise for, 929
android, 922, 923f, 923t
behavior modification for, 930

calorie-restricted diet for, 928, 928t
diagnosis of, 928t
environmental factors in, 948, 948t925, 925t
etiology of, 923925
gynoid, 922, 923f, 923t
health risks of, 923, 923b, 925, 926, 926f
implementation for, 927
in Cushing syndrome, 1247, 1248f, 1249f
in polycystic ovary syndrome, 1331
in surgical patient, 320
metabolic syndrome and, 936937, 937f, 937t
morbid, 921922, 922t
planning in, 927
primary vs. secondary, 921
psychosocial factors in, 925926
skin and, 426
stroke and, 14251426
support groups for, 930
surgery for, 931934, 931t. See also Bariatric surgery.
type II diabetes and, 11921193
Obesity-hypoventilation syndrome, 575t
Objective data, 35, 3940. See also Physical examination.
Oblique fractures, 15511551f
Obstipation, 988
Obstructive jaundice, 1032
Obstructive lung disease, 562
asthma, 562578
Obstructive shock, 1679. See also Shock.
Obstructive sleep apnea, 108, 108f, 109b
Obstructive uropathies, 1106
Obturators, 502f, 504, 505
Occipital lobe, 1735, 1736f, 1736t
Occupational asthma, 564
Occupational Health and Safety Administration (OSHA), 536
infection precautions and, 222, 221t
Occupational lung disease, 534536, 535t
chemical pneumonitis, 535
hypersensitivity pneumonitis, 535
idiopathic pulmonary fibrosis, 553
interstitial, 553
pneumoconiosis, 535
Occupational therapy, 79t
for burns, 464
Octreotide (Sandostatin)
for acromegaly, 1228
for diarrhea, 984t
79
th
Ocular decontamination, 1732

Ocular dryness, 371t
Oculocephalic reflex, 1401
Oculomotor nerve, 1378f, 1378t
compression of, 1395
Ocu-Pentolate (cyclopentolate), for pupillary dilation, 392t
Ocupress (carteolol), for glaucoma, 399t400t
Ocu-Tropine (atropine), for pupillary dilation, 392t
Odors, in skin disorders, 420
Odynophagia, 890t
Ofatumumab (Arzerra), for cancer, 269t270t
Ointments, 439
Older adults, 60
access to care for, 22
acute care for, 6871, 68t
acute kidney injury in, 1141
adult day care for, 65
Alzheimers disease in, 14851489
amputation in, 1575
anemia in, 639
anesthesia in, 342343, 360
arthritis in, 16181619
as caregivers, 63
assessment for, 66
asthma in, 584
attitudes toward, 6061
auditory system in, 375, 376t
bias toward, 21
breast changes in, 1282
burns in, 466
cancer in, 278
of breast, 1285
cardiovascular system in, 693, 694, 695t
care alternatives for, 6566
cascade disease pattern and, 66
cataracts in, 391, 393
chronic illness in, 5759, 61 See also Chronic illness.
chronic kidney disease in, 11651167
cognitive impairment in, 61, 62t
COPD in, 558
coronary artery disease in, 747
corticosteroid side effects in, 16181619
culturally competent care for, 63
delirium in, 1496
demographic trends for, 60
depression in, 70
diabetes mellitus in, 12231225
drug therapy for, 69, 70, 69f, 70t
emergency nursing for, 1726
endocrine system in, 1178, 1178t
enteral nutrition in, 914917
evaluation for, 7172, 71t
female, 6162, 62b
fluid and electrolyte balance in, 228
fluid intake in, 291
foot disorders in, 1593
fractures in, 1545t
frail, 60, 62
gastroesophageal reflux disease in, 952953
gastrointestinal system in, 822, 883t, 888, 889
glaucoma in, 400
hair in, 416, 416t
hearing loss in, 375, 410, 412, 410t
hematologic system in, 622, 622t

hiatal hernia in, 953954
home health care for, 65
homeless, 6263
hospitalization of6872, 68t
housing for, 65
hypertension in, 732
hyperthyroidism in, 1236t
immune response in, 200, 200t
infections in, 221
inflammatory bowel disease in, 1005
integumentary system in, 415416
life expectancy of, 6061
liver disease in, 1061
long-term care for, 65. See also Long-term care.
malnutrition in, 908910
metabolic bone disease in, 15981599
mistreatment of, 63, 64, 63t
musculoskeletal system in, 1534, 1535t, 1545
nails in, 416, 416t
nausea and vomiting in, 945
nervous system in, 13791380, 1381t
neutropenia in, 667
normal forgetfulness in, 1485t
NSAID side effects in, 16181619
nursing assessment for, 66
nursing implementation for, 6771
nutritional assessment for, 63, 63t, 906
obesity in, 936
old-old, 60
orthostatic hypotension in, 733
pain management for, 135
peptic ulcer disease in, 975
physical examination for, 42, 42t
physiologic changes in, 61
rehabilitation for, 68, 68b
reproductive system in, 1265, 1265t, 1266t
respiratory failure in, 1710, 1711
respiratory system in, 476, 477, 477t
restraints for, 7071
rural, 62
seizures in, 14601461
self-neglect by, 64
sexual function in, 1266t
skin in, 415416, 416f, 416t
sleep patterns/problems in, 70, 110111
social support/services for, 6364
spinal cord injury in, 1526
stroke in, 14471448
substance abuse in, 167168
surgery in
intraoperative care for, 342
teaching strategies for, 52t, 54
thrombocytopenia in, 667
urinary incontinence in, 1081
urinary system in, 1082, 1081t
urinary tract infections in, 1095
visual impairment in, 366, 383, 386
visual system in, 366, 367t
with special needs, 65
young-old, 60
Old-old adults, 60
Olfactory nerve, 1377f, 1377f
80
th

Oligodendrocytes, 1373
Oligomenorrhea, 13201321
Oliguria, 1085
Olmesartan (Benicar), for hypertension, 724t727t
Omaha System, 8
Omalizumab (Xolair), for asthma, 573t574t, 572
Omega-3 fatty acids, 86t
Omentum, 877878
Omeprazole (Prilosec)
Ommaya reservoir, 257
Omnaris (ciclesonide), for allergic rhinitis, 496t497t
Omnitrope (Somatropin), for hypopituitarism, 1229
Oncofetal antigens, 248
Oncogenes, 244
Oncotic pressure, 285
Ondansetron (Zofran), for nausea and vomiting, 942
Onglyza (saxagliptin), for diabetes mellitus, 1200t, 1201
Onsolis, 276
Onychomycosis, 433, 433f, 433t
Oocytes, 1260
Oophorectomy, 1266t, 1336f, 1336t
prophylactic, 1283
Opana (oxymorphone), 124t
Open fractures, 1551
infection of, 15631564
Open pneumothorax, 542, 543t, 543f
Operating room, 331
patient transport to, 327, 335
physical layout of, 330331
preparation of, 335
Ophthalgan (glycerin), for glaucoma, 399t400t
Ophthalmia neonatorum, 1302
Ophthalmic examination. See Visual system, assessment of.
Ophthalmoplegia, 1387t
Ophthalmoscopy, 370t
Opioids, 123127
abuse of, 153t154t, 160, 162
addiction to, 133134
administration of, 124t, 128130
agents to avoid, 125
dosage of, 128
for burns, 459, 459t, 464
for pain management
in cancer, 276277
in substance abusers, 136137, 165, 166, 165t
in anesthesia, 341t
in patient-controlled analgesia, 130
intraspinal, 129130, 129f
mechanism of action of, 116, 123
overdose of, 161t, 162
physical dependence on, 133, 133t
postoperative, 354
respiratory depression and, 125, 551t
rotation of, 133
side effects of, 124t, 125
to hasten death, 135
tolerance to, 133
types of, 123125, 124t
withdrawal from, 133, 133t, 153t

Opioid-sparing effect, 122
Opisthotonos, 1508
Opium, 154t, 162163
Opportunistic diseases
cytomegalovirus infection as, 523
definition of, 226
in HIV infection, 224226, 227t
pneumonia as, 227t, 236, 236f
Opposition, 1538t
Oprelvekin (Neumega)
for cancer, 271t
for thrombocytopenia, 645, 656657
Optic disc
cupping of, 397, 397f
examination of, 372
physiologic cup of, 373
swelling of, 394
Optic nerve, 366, 365f, 366f, 1378f, 1378t
Optic tracts, 365366, 365f, 366f
Optimine (azatadine), for allergic rhinitis, 901t902t
Oral candidiasis, 890t, 945t
Oral care
in cancer, 510
Oral cavity
cancer of, 510512, 945, 947, 946t, 947t. See also Head and neck
cancer.
disorders of, 890t
infections of, 945, 945t
inflammatory disorders of, 945, 945t
Oral contraceptives
breakthrough bleeding and, 1320
for premenstrual disorder, 1319
stroke and, 1426
Oral dryness
radiation therapy and, 262t263t, 513
Oral glucose tolerance test, 11841187
Oral hairy leukoplakia, HIV-related, 226, 226f, 227t
Oral herpes simplex virus infection, 890t, 945t
Oral hygiene
in nasogastric intubation, 1009
intermaxillary fixation and, 1571
Oral hypoglycemics, 1199t1200t
Oral mucositis, in cancer, 262t263t, 264
Oral ulcers, 890t, 945t
aphthous, 945t
Oramorph. See Morphine.
Orbital fractures, 14051406, 1405t, 1570, 1571, 1570t
Orchiectomy, 1266t
for prostate cancer, 1959t, 1360
81
th
for testicular cancer, 1365

Orchitis, 1364
Orencia (abatacept), for rheumatoid arthritis, 1605t1607t, 16121614
Oretic (hydrochlorothiazide), for hypertension, 724t727t
Orexin, 101
Organ donation, 144
Organ of Corti, 374, 375f
Organ transplantation. See Transplantation.
Orgasms
female, 1265
male, 1264
Orlistat (Xenical), 930
Oropharyngeal cancer, 510512, 945, 947, 946t, 947t See also Head
and neck cancer.
Orthoclone OKT3 (muromonab-CD3), for transplantation, 214215,
214t
Orthopedic surgery. See Joint surgery.
Orthopnea, 480
Orthostatic hypotension, 695, 730, 731
antihypertensive-related, 728, 733
nitrate-related, 751
Orthotopic bladder reconstruction, 11291132
Orthovisc (hyaluronic acid), for osteoarthritis, 1608
Oseltamivir (Tamiflu), 500
Oslers nodes, 820
Osmitrol (mannitol), for glaucoma, 399t400t
Osmoglyn Oral (glycerin), for glaucoma, 399t400t
Osmolality, 285
measurement of, 285
plasma, 1176, 1176f
tonicity and, 285
urine, 1091t
Osmolarity, 285
Osmosis, 285, 285f, 1153f
Osmotic pressure, 285
Ossicles, 374375, 375f
Ossification, 1531
Osteitis deformans, 15971598
Osteitis fibrosa, in chronic kidney disease, 1145, 1145f, 1147
Osteoarthritis, 16011608
deformity in, 1602
drug therapy for, 16041608, 1605t, 1607t
heat and cold application for, 1604
idiopathic, 1061
involved joints in, 16021603, 1604f
of lumbar spine, 1588
pain in, 16021603
rest and joint protection for, 1604
secondary, 1601, 1602t
stiffness in, 1602
total joint arthroplasty for. See Arthroplasty.
vs. rheumatoid arthritis, 1611t
Osteoblasts, 1531
Osteochondroma, 1584, 1585t
Osteoclastoma, 1585t
Osteoclasts, 1531
Osteocytes, 1531
Osteomalacia
in chronic kidney disease, 1145, 1145f, 1146
Osteomyelitis, 1581, 1583, 1582f, 1582t, 1583t
Osteons, 1530, 1531f
Osteopenia, 1595
Osteophytes, in osteoarthritis, 1602, 1603f
Osteoporosis, 15941595
case study of, 1598
collaborative care for, 15951596, 1597
corticosteroid-induced, 1254
diagnosis of, 1595
drug therapy for, 1597t, 1596
etiology of, 1595
gender differences in, 1597
inflammatory bowel disease and, 1000b
postmenopausal, 13231324
T-score in, 15951596
Osteosarcoma, 1585, 1585f, 1585t. See also Bone cancer.
Osteotomy, 1575
stoma in. See Stoma(s).
Ostomy
adaptation to, 1021
care of, 10181021, 1018t
delegation of, 1020
colostomy, 884t, 1013, 1015, 1016t, 1018, 1021
end stoma, 1016
ileostomy, 884, 1016f, 1016t, 1021. See also Urinary diversion.
nursing care plan, 986b
pouches for. See Pouches.
sexual function and, 10211022
site of, 1017
temporary vs. permanent, 1017
types of, 1015, 1016f
Otalgia, 402
Otic drops, administration of, 402403
Otitis externa, 402
Otitis media
acute, 403
chronic, 404, 404t
with effusion, 403
Otorrhea1404, 1405, 1404f
Otosclerosis, 405, 405t
Otoscope, 378379, 378f, 379f
Ototoxic drugs, 408
Outcome identification. See Patient outcomes.
Out-of-hospital DNR, 145
Outpatient surgery. See Ambulatory surgery.
OVA1 test, 1335
Oval window, 374375, 375f
Ovarian suppression, for endometriosis, 1330
Ovary
cancer of, 1334, 1335, 1334t, 1334b See also Reproductive cancers,
female.
cysts of, 1331.1331f
82
th

nodules of, in endometriosis, 1329
radiation injury of, 262t263t, 267, 268
Overactive bladder, 1120, 1120b
Overdose, drug, 1731t. See also Poisoning.
Overdrive pacing, 811
Overflow incontinence, 1119, 1120t
Overlapping connective tissue disease, 1631
Overnutrition, 902. See also Obesity.
Over-the-counter drugs, safety concerns with, 577578
Overweight, 921, 922, 922f, 922t. See also Obesity.
Ovulation, 1260, 1263
assessment of, 1315
Ovulation prediction kits, 1315
Oxcarbazepine (Trileptal), for trigeminal neuralgia, 15021503
Oximetry, 445, 445t, 487t, 488t
Oxycodone (OxyContin), 124t
abuse of, 154t, 161162
Oxygen masks, 592594
Oxygen therapy
absorption atelectasis and, 596
administration of, 594595, 592t594t
carbon dioxide narcosis in, 595
delegation in, 595b
delivery systems for, 596f, 596t
fire risk with, 597t
for ARDS, 1715
for asthma, 570571
for cluster headaches, 1453
for COPD, 594596, 592t, 594t
for heart failure, 780, 783
for multiple organ dysfunction syndrome, 1696
for respiratory failure, 1707, 1715
for systemic inflammatory response syndrome, 16961697
humidification in, 595
hyperbaric, 181182
in home care, 596597, 596t597t
infection and, 596
low- vs. high-flow, 594
nebulization in, 595
pulse oximetry in, 1651
toxicity of, 595
Oxygen toxicity, 595
Oxygenation failure, 16991700. See also Respiratory failure.
Oxygencarbon dioxide exchange, 473474, 474f
Oxygen-hemoglobin dissociation curve, 473, 474f
Oxyhemoglobin, 617
Oxymetazoline (Dristan), for allergic rhinitis, 496t497t
Oxymorphone (Opana), 124t
Oxypurinol, for gout, 1621
Oxytocin, 1172t, 1175, 1176
P
Pacemaker (physiologic)
secondary, 799
sinoatrial node as, 799
Pacemakers (electronic), 811814, 812f. See also Pacing.
in cardiac resynchronization therapy, 783, 783f, 812
malfunctioning of, 813, 814f
monitoring of, 813

permanent, 812, 812f
temporary, 812, 812f813f, 813t
transcutaneous, 813, 813f
transvenous, 812
with implantable cardioverter-defibrillators, 811
Pacific Islanders. See also Race/ethnicity.
Pacing
antitachycardia, 811812
biventricular, 783
epicardial, 812
overdrive, 811
transvenous, 812
Pack years, 479
Packed red cells, 307308
PaCO2, 473474, 474t
Pagets disease
of bone, 15971598
of breast, 12831284
Pain, 113
abdominal
acute, 990991, 991t, 996f
chronic, 993994
rebound, 890t
acute, 116, 118t, 119
assessment of, 119121, 119t, 121b
associated symptoms with, 120
back. See Back pain.
breakthrough, 120
breast, 1279
case study of, 136b
central, 119
central sensitization in, 115
chest
causes of, 758t
chronic, 116, 118t, 119
chronic pelvic
in males, 1361
deafferentation, 119
deep, 118
definition of, 114
dimensions of, 114115, 114t
documentation of, 121
ear, 402
heel, 1594
in acute pancreatitis, 1062, 1065
in appendicitis, 996
in burns, 459, 459t, 464
in cancer, 276277, 276t
in cholecystitis, 1068, 1071
in cholelithiasis, 1068, 1071
in complex regional pain syndrome, 119
83
th
in diabetic neuropathy, 12201221

in diverticulitis, 1022
in dying patients, 147, 148t150t
in ectopic pregnancy, 1322
in female reproductive disorders, 1271t
in gallbladder disease, 1069, 1071
in headache. See Headaches.
in Hodgkins lymphoma, 674
in intestinal obstruction, 10081009
in mitral valve prolapse, 831
in musculoskeletal trauma, 1562t
in myocardial infarction, 749f, 755
in nephrolithiasis, 1108
in pancreatic cancer, 1067
in pelvic inflammatory disease, 1327
in peritonitis, 997
in pleurisy, 552
in prostatitis, 1362
in sickle cell disease, 648, 650, 650b
in trigeminal neuralgia, 15011503
in ulcerative colitis, 1000
in urinary disorders, 1083t
incident, 120
intensity of, 120, 120f
joint. See also Arthritis.
location of, 120
magnitude of problem, 113114
mechanisms of, 115117, 115f
menstrual, 1319
modulation of, 115f, 117
myofascial, 1632
neck, 1592, 1592t
neuropathic, 116, 118119, 118t
nociceptive, 115118, 115f, 118t
nursing diagnoses for, 133t
ocular, 371t
on intercourse, menopause and, 1323
on urination, 1085t, 1096t
onset and duration of, 120
patient beliefs/expectations/goals and, 121
patterns of, 120
perception of, 115f, 117
assessment of, 1384
peripheral sensitization in, 116
persistent, 117
personal meaning of, 115
postmastectomy, 1287, 1294
postoperative, 353
quality of, 120
referred, 117, 117f
somatic, 118
suffering and, 115
superficial, 118
sympathetically maintained, 119
transduction in, 115116, 115f

transmission of, 115f, 116117, 117f
dorsal horn processing in, 116117
to spinal cord, 116
to thalamus and cortex, 117
treatment of. See Analgesics; Pain management.
visceral, 118
Pain management, 121133
acupuncture in, 83, 131
barriers to, 132133, 134t
cognitive therapy in, 132
cold therapy in, 132, 132t
delegation in, 133b
distraction in, 132
drug therapy in, 122130. See also Analgesics.
ethical issues in, 135
exercise in, 131
for older adults, 135, 360
for substance abusers, 136137, 164165, 650b
heat therapy in, 131132, 132t
hypnosis in, 132
inadequate, 113114, 114t
institutional support for, 133134
massage in, 131
nerve blocks in, 130
neuroablative interventions in, 116, 131f
neuroaugmentation in, 131f
nondrug therapies in, 131132, 131t
nurses role in, 132
patient goals for, 121
patient/caregiver teaching for, 132134
patient-controlled analgesia in, 354
placebos in, 135
postoperative, 354
provider education about, 133134
regional anesthesia in, 116
relaxation techniques in, 132
spinal cord stimulation in, 131
TENS in, 131, 131f
Pain Thermometer Scale, 120, 120f
Painful bladder syndrome, 11021103, 1102t
Palifermin (Kepivance), 265
Palliative care, 139140, 140t. See also End-of-life care.
Pallor, 419t, 626t627t
Palmar drift test, 1401
Palmar erythema, in cirrhosis, 1046
Palmar-plantar erythrodysesthesia, in chemotherapy, 266267
Palpation, 3536, 39, 40f
in musculoskeletal assessment, 1537
of abdomen, 888, 888f
of breast, 1269
of chest, 481, 481f, 699
of kidney, 1084, 1084f
of liver, 627
of pulses, 698, 699f
of spleen, 627
of testes, 1269
of thyroid, 1181, 1182f
Pamidronate (Aredia), 297
84
th

Pancreas
abscess of, 1062
autodigestion of, 1061, 1061f
cancer of, 10671068
disorders of, 1060
in older adults, 882883, 883f, 1178t
structures and functions of, 881f, 882, 1177
transplantation of, for diabetes mellitus, 1206
Pancreatic enzymes, 879t
in acute pancreatitis, 1062, 1062f, 1063t
supplemental, for chronic pancreatitis, 10651066
Pancreatic hormones, 1172t, 11771178
Pancreatic insufficiency, in cystic fibrosis, 606, 609
Pancreatic islet cell transplantation, 1206
Pancreatic polypeptide, 1172t
Pancreatic pseudocyst, 1063
Pancreatin (Viokase), for chronic pancreatitis, 10651066
Pancreatitis
acute, 1061, 1062f, 1063t1064t
chronic, 1064t, 10651066
Pancrelipase (Cotazym), for chronic pancreatitis, 10651066
Pancytopenia, 628
in aplastic anemia, 645
Pandemics, 498499
Panel of reactive antibodies, 212
Panhypopituitarism, 1229
Panitumumab (Vectibix), for cancer, 269t270t
Pannus, 16091610
Panophthalmitis, 401
Pantoprazole (Protonix)
PaO2, 473, 474t475t
Pap test, 1269, 1272t1275t, 1275, 1332
Papillary muscle dysfunction, 756
Papilledema, 394, 1387t, 1395
Papillomas, intraductal, 1281
Papules, 418t
Paracentesis, 1050
Paradoxic respiration, 545, 544f, 1705
Paralysis
diaphragmatic, 473
in paraplegia, 1387t, 1510, 1513t
in quadriplegia, 1387t
in tetraplegia, 1387t, 1509, 1513
induced, in mechanical ventilation, 1666
neglect syndrome and, 1443
Paralytic ileus, 1007
postoperative, 848
Paranasal sinuses, 500f
cancer of, 510512. See also Head and neck cancer.
Paraneoplastic syndromes, 538
in lung cancer, 538
Paraphimosis, 1362, 1362
Paraplegia, 1387t, 1509, 1513
Parasomnias, 101t, 110. See also Sleep problems.
Parasympathetic nervous system, 1377. See also Nervous system.
Parathyroid glands, 11761177
autotransplantation of, 1246

disorders of, 1224
Parathyroid hormone, 1172t, 11761177
deficiency of, 1225t, 1225
excess of, 12241225, 1225t
Parathyroid scan, 1184t1187t
Parathyroidectomy, 1225
hypoparathyroidism after, 1225
Paregoric, for diarrhea, 984t
Parenteral nutrition, 915917. See also Nutritional therapy.
central, 916
complications of, 917t
fat emulsion in, 918
in home care, 919
infection in, 918919
peripheral, 916
solutions for, 915916
Parepectolin, for diarrhea, 984t
Paresthesias, 1387t, 1539t
Parietal fractures, 14041405, 1405t
Parietal lobe, 1375, 1375f, 1376t
Parietal peritoneum, 876877
Parietal pleura, 473
Parkinsonism, 1468
Parkinsons disease (PD), 14681473, 1470f
etiology of, 1468
surgery for, 1473
Parkland formula, 457, 457t
Parlodel (bromocriptine), for Parkinsons disease, 1472, 1472b
Parotid glands, 878
Parotitis, 945t
Paroxysmal nocturnal dyspnea, 696, 779
Paroxysmal supraventricular tachycardia, 802t, 803, 803f
Partial seizures,. See also Seizure(s).14561457, 1457t
Partial-thickness burns, 447f, 449, 449t
Passive acquired immunity, 194195, 195t
Passive smoking, 585
Passy-Muir valve, 510, 510f
Pastes, 442
Patch graft angioplasty, for peripheral arterial disease, 854
Patch testing, 205, 422, 423f, 423t, 433
Patellar dislocation, 1547
Patellar reflex, 1375, 1375f
assessment of, 1384, 1385f
Pathologic fractures, 1551f
in osteoporosis, 1539t, 15941595
Patient and caregiver teaching,. See also Learning.45
adult learning principles and, 4647, 47t
assessment in, 4850
85
th
caregiver support and, 48

challenges in, 48
communication skills for, 4748
definition of, 47
empowerment approach in, 12111213
evaluation in, 5457, 55t
for acute coronary syndrome, 767, 767t, 769t
for allergen avoidance, 496t
for allergic rhinitis, 496t
for Alzheimers disease, 1488t, 1498t
for amputation, 1574t
for antibiotic-resistant infections, 220t
for anticoagulants, 867t
for antiretroviral therapy, 234t
for autonomic dysreflexia, 1522t
for breast self-examination, 1278, 1278f
for cardiomyopathy, 840t
for cast care, 1562t
for chronic kidney disease, 1150t
for colostomy irrigation, 1021t
for complementary and alternative therapies, 86
for COPD, 581t, 579t, 575t
for coronary artery disease, 744t
for corticosteroids, 1254t
for diabetes mellitus, 1203, 12101213, 1212t
for disease management, 1212t
for exercise, 1204t
for foot care, 1222t
for glucose self-monitoring, 1205t
for insulin therapy, 1197t
for dry powder inhalers, 577t
for external otitis prevention, 403t
for eye surgery, 394t
for food poisoning, 979t
for head injury, 1408t
for headaches, 1454t
for heart failure, 790t
for heat and cold therapy, 132t
for hip fractures, 1568t
for HIV infection, 235t236t
for huff coughing, 599t
for drug therapy, 727729
for ileal conduit, 1131t
for laparoscopic cholecystectomy, 1073t
for low back pain, 15881589, 1588t
for malnutrition, 906t
for menstruation, 1264t, 1321
for mitral valve prolapse, 832t
for musculoskeletal disorders in older adults, 1545t
for neutropenia, 666t
for ostomies, 10171018, 1018t
for oxygen therapy, 597t
for pacemakers, 816t
for pain management, 133t135t
for peak flow meter, 582, 583t
for peptic ulcer disease, 973974, 974t
for peripheral artery bypass surgery, 857t
for pressure ulcers, 187t
for pursed-lip breathing, 581t
for radiation skin reactions, 266t
for rheumatoid arthritis, 1609t, 1618t
for seizures, 1463
for sexual assault prevention, 1341t

for sexually transmitted diseases, 1310t
for sinusitis, 501t
for smoking cessation, 158t
for spinal cord injury, 1521t, 1522t
for stress management, 98101
for stroke, 1436b
for supraglottic swallow, 512t
for systemic lupus erythematosus, 1626t
for testicular self-examination, 1365, 1365f, 1365t
for thrombocytopenia, 657t
for urinary tract infections, 1099t
goals in, 45, 5152
health literacy and, 50
learner characteristics and, 49t, 51
learning materials for, 5153
models for, 4647, 47t
overview of, 4546
physical factors in, 4950, 49t
planning in, 5153
process of, 4957
psychologic factors in, 49t, 50
regulatory mandates for, 4849, 49t
required competencies for, 4748
role of, 4546
self-efficacy and, 47, 50
sociocultural factors in, 49t, 5051
subject matter knowledge for, 4748
teaching plans for, 4546, 52
teaching strategies for, 5254, 52t53t
teaching-learning process in, 4649
technology in, 5254
time constraints in, 48
Patient outcomes
Nursing Outcomes Classification for, 9, 1314
nursing-sensitive, 13
Patient positioning. See Positioning.
Patient Self-Determination Act, 66, 144
Patient transport, to operating room, 326327
Patient-controlled analgesia, 130, 354
Pazopanib (Votrient), for cancer, 269t270t
Peak bone mass, 1595
Peak expiratory flow rate, 490491, 491t
in asthma, 581
Peak flow meter, 581, 582t
Pear- vs. apple-shaped body, 923924, 924f, 924t
Peau dorange skin, in breast cancer, 1284
Pectus carinatum, 481
Pectus excavatum, 481
Pedicle grafts,. See also Skin grafts.444
Pediculosis, 432433, 433t
Pedigrees, 190, 191f, 193
Peek test, 1476f
PEEP (positive end-expiratory pressure), 16841685, 1706t
for ARDS, 1715
Peer teaching, 51
PEG tubes. See Enteral nutrition.
Pegaptanib (Macugen), for macular degeneration, 396
Pegfilgrastim (Neulasta)
Pegylation, 1038
Pelvic examination, internal, 1269
86
th
Pelvic exenteration, 1336t, 1339, 1339f

Pelvic floor exercises, 1369b, 1371, 1371t1372t
Pelvic fractures, 1566
Pelvic imaging, 1272t1275t, 1276
Pelvic inflammatory disease (PID), 1275f, 13271328, 1327f, 1328f
chlamydial, 1305, 13071309
ectopic pregnancy and, 13211322, 13071308
gonococcal, 1302, 13071308
Pelvic laparoscopy, 1272t1275t, 1275f
Pelvic magnetic resonance imaging, 1272t1275t, 1276
Pelvic pain, chronic
in males, 1364
Pelvic support problems, 1339
Pelvis, female, structures and functions of, 1261
Penbutolol (Levatol), for hypertension, 724t727t
Penetrating keratoplasty, 390391
Penicillamine (Cuprimine, Depen), for arthritis/connective tissue disease,
1605t1606t
Penicillin
for infective endocarditis, 822t
for syphilis, 1305
Penicillin-resistant Streptococcus pneumoniae, 220221, 221t
Penile erection, 1264
Penile implants, 13681369
Penis
cancer of, 1362
circumcision of, 1362
discharge from, 1271t
disorders of, 1362
congenital, 1362
erythema of, 1271t
glans of, 12581259
lesions of, 1271t
Pentazocine (Talwin), 124t
abuse of, 154t, 161162
Pentobarbital (Nembutal), abuse of, 154t, 161
Pentolair (cyclopentolate), for pupillary dilation, 392t
Pentosan (Elmiron), for interstitial cystitis, 11021103
Pentoxifylline (Trental), for intermittent claudication, 853
Penumbra, 1425
Pepcid (famotidine), for upper GI bleeding, 950
Pepsin, 879
Pepsinogen, 879
Peptic ulcer disease, 964969
acute, 964
acute exacerbations in, 969
ambulatory and home care in, 972973
burns and, 459t, 461462
case study of, 980b
chronic, 964
conservative therapy for, 967
diagnosis of, 967
drug therapy for, 967, 967t968t
drug-induced, 965
duodenal, 965t, 966967, 967f
etiology of, 965967

evaluation in, 973
gastric, 964t, 963
gastric outlet obstruction in, 964965, 969, 971
H. pylori infection and, 963964
hemorrhage in, 964, 972
in spinal cord injury, 15131514, 1561
nursing management of, 970-974
perforation in, 963, 963f, 966, 969
planning in, 967
silent, 963
bile reflux gastritis and, 971
dumping syndrome and, 970971
postprandial hypoglycemia and, 970971
Zollinger-Ellison syndrome and, 973
Peptide YY, 924925, 924t
Pepto-Bismol (bismuth subsalicylate), for diarrhea, 984t
Percocet. See Oxycodone.
Percodan. See Oxycodone.
Percussion, 3536, 40, 40f
dullness on, 483t, 485t486t, 887
flatness on, 483t
hyperresonance on, 483t, 485t486t
in chest physiotherapy, 598599, 599f
in urologic assessment, 10841085, 1085f
of abdomen, 887
of chest
in cardiovascular assessment, 698t670t, 670
in respiratory assessment, 483, 483f, 483t, 485t486t
of kidney, 10841085, 1084f
of liver, 890t
resonance on, 483t
tympany on, 483t, 887
Percutaneous acetic acid injection, for liver cancer, 1059
Percutaneous coronary intervention, 753
emergent, 757758
Percutaneous diskectomy, 1590
Percutaneous endoscopic gastrostomy (PEG) tubes. See Enteral
nutrition.
Percutaneous ethanol injection, for liver cancer, 1059
Percutaneous radiofrequency rhizotomy, 1502
Percutaneous septal myocardial ablation, 840
Percutaneous tracheostomy, 503504
Percutaneous transhepatic cholangiography, 891t894t, 1069
Percutaneous transluminal balloon angioplasty, for peripheral arterial
disease, 851b, 854
Percutaneous transluminal balloon valvuloplasty, 833, 833f
Percutaneous ultrasonic lithotripsy, 1110
Perdiem (psyllium), for constipation, 989t
Performance scales, for cancer, 249
Perforomist (Formoterol), for asthma, 573t574t, 575
Pergolide (Permax), for Parkinsons disease, 1472, 1472b
Pergonal, for infertility, 1316t
Pericardial effusion
pericardiocentesis for, 824, 824f
87
th
Pericardial friction rub, 700t701t, 702

Pericardial knock, 826
Pericardial space, 690
Pericardiectomy, 826
Pericardiocentesis, 825, 825f
Pericarditis
acute, 823825
after myocardial infarction, 756
chronic constrictive, 826
in cancer, 262t263t
in Dressler syndrome, 756, 823
late, 756, 823
Pericardium, 690, 823f
Peri-Colace (docusate), for constipation, 989t
Perilymphatic fluid, 375
Perimenopause, 13231326, 1324t
Perimysium, 15331534
Perindopril (Aceon), for hypertension, 726t729t
Perineal burns, 459
Periodic limb movement disorder, 110
Perioperative nurse, 331, 332t
Perioperative Nursing Dataset, 8Periorbital ecchymoses, 1405,
1405f
Periorbital fractures, 15701571, 1571t
Periosteum, 1531, 1531f
Peripheral arteriography/venography, 703t707t, 711
Peripheral artery bypass grafting, 854, 854f, 857t
Peripheral artery disease, 843
bypass surgery for, 854, 857t
hypertension and, 718t, 719
lower extremity, 851854
case study of, 870b
critical limb ischemia in, 853
femoral artery stents for, 851b, 854
foot care in, 857, 857t
hyperlipidemia and, 852853
in diabetes mellitus, 843, 853, 12211222
intermittent claudication in, 719, 851
interventional radiology catheterbased procedures for, 854
planning in, 854855
surgery for, 854, 854f, 857t
vs. venous disease, 852t
Peripheral nervous system (PNS), 1372. See also Nervous system.
Peripheral neuropathy, 851
in cancer, 262t263t
in cirrhosis, 1047
stocking-glove, 12201221
Peripheral parenteral nutrition, 916
Peripheral smear, 628
Peripheral stem cell collection, 209
Peripheral stem cell transplantation, 271. See also Hematopoietic stem

cells, transplantation of.
Peripheral vascular disease. See Peripheral artery disease.
Peripherally inserted central catheters (PICCs), 309, 309f, 310t. See
also Central venous access devices.
Peristalsis, 878
Peritoneal dialysis, 11391140, 11531155. See also Dialysis; Renal
replacement therapy.
advantages and disadvantages of, 1153t
automated, 1154, 1154f
catheter placement in, 1153, 1154f
continuous ambulatory, 1155
cycles in, 1154
effectiveness of, 1155
in continuous renal replacement therapy, 11591160, 1159t
solutions for, 1154
vs. hemodialysis, 1153t
Peritoneal lavage, in abdominal trauma, 995
Peritoneoscopy, 891t894t, 1272t1275t
Peritoneovenous shunt, 1050
Peritoneum, 876878
Peritonitis, 997, 998, 997t
spontaneous bacterial, 1048
Peritonsillar abscess, 503Permissive hypercapnia, 1714
Pernicious anemia, 641t, 642, 644, 963
postgastrectomy, 974t
Persantine (dipyridamole), for stroke, 1432, 1434
Personal protective equipment, 220222, 221t
Personal space, cultural aspects of, 27
Personality factors, in coronary artery disease, 743
Perspiration, 288
Pertinent negative, 39
Pertussis, 220t, 521
Pes cavus, 1594t
PES format, for nursing diagnoses, 1113, 12t
Pes planus, 1539t, 1594t
Pessary, 1340
PETCO2 monitoring, 1657
Petechiae, 419t, 420, 421t, 626t627t, 627
Petit mal seizures, 1457
Petrissage, 86
Peyronies disease, 1363
pH, 300, 301f
blood, 473, 474t
regulation of, 1078
urine, 1091t
Phacoemulsification, 391392
Phagocytes, mononuclear, 196, 197f
Phagocytosis, 618
Phakic intraocular lens, 383
Phalens sign, 1548
Phantom limb sensation, 1573
Pharyngitis
acute, 502
gonococcal, 1302peritonsillar abscess and, 503
streptococcal, 502
rheumatic fever and, 827, 829
treatment of, 829
Pharynx
disorders of, 502
examination of, 480
88
th
Phenazopyridine (Pyridium), for urinary tract infections, 1097

Phenergan (promethazine), for nausea and vomiting, 942, 942t
Phenolphthalein, for constipation, 989t
Phentermine (Adipex-P), abuse of, 154t, 160
Phentolamine (Regitine), for hypertension, 724t727t
Phenylephrine (Neo-Synephrine, Mydfrin)
for neurogenic shock, 1686t1687t
for pupillary dilation, 392t
Phenytoin (Dilantin)
for seizures, 1460
Pheochromocytoma, 1180, 1255
Philadelphia chromosome, 670, 672
Phimosis, 1363, 1363f
Phlebectomy, ambulatory, 868
Phlebitis, 859
Phlebostatic axis, 1644, 1645f
Phlebotomy
for hemochromatosis, 651
for polycythemia, 651
Phlegmasia cerulea dolens, 861
Phoenix Society, 467
Phosgene, 1734
PhosLo (calcium acetate), for hyperphosphatemia, 1147
Phosphate
dietary restriction of, for chronic kidney disease, 1149
in musculoskeletal assessment, 1540t 1542t
supplemental, for hyperparathyroidism, 1246
Phosphate balance, 298299, 299t
disturbances of, 298299, 299t
Phosphate binders, for chronic kidney disease, 1147
Phosphate buffer system, 301
Phosphodiesterase inhibitors, for pulmonary hypertension, 557
Phospholipids, 702, 703t707t. See also Lipids/lipoproteins.
Phospho-Soda (sodium phosphate), for constipation, 989t
Photocoagulation, laser
for diabetic retinopathy, 12191220
for retinal breaks, 395396
for retinal detachment, 395396
interstitial, 1350
Photodynamic therapy
Photoevaporation of prostate, 1351
Photofrin (sodium porfimer), 955
Photophobia, 371t
Photopsia, 394
Photorefractive keratectomy, 383
Photosensitivity, drug-related, 425, 425t
Phototherapy, 435
Physical dependence, 153t
Physical examination, 39
auscultation in, 3536, 40, 40f
delegation for, 43b
documentation of, 42
equipment for, 4042, 40t
general survey in, 39, 41t42t
gerontologic, 42, 42t
inspection in, 3536, 40
motor system, 1384

negative findings in, 39
neurologic, 41t42t
of abdomen, 41t42t
of anterior thorax, 41t42t
of anus, 889
of auditory system, 378379, 378t, 378b
of cardiovascular system, 693
of chest, 41t42t
of endocrine glands, 1181
of extremities, 41t42t
of gastrointestinal system, 886889
of genitalia, 41t42t, 1269
female, 1269
male, 1269
of head and neck, 41t42t
of hematologic system, 625628, 626t, 627t
of integument, 41t42t, 418
of musculoskeletal system, 1537
of nervous system, 13821383
of nose, 480481
of oral cavity, 481
of pharynx, 481
of posterior thorax, 41t42t
of rectum, 889
of reproductive system, 41t42t, 12691270
female, 1269
male, 1269
of respiratory system, 480485
of urinary system, 18041085
of visual system, 369373, 370t
organization of, 41t42t, 42
palpation in, 3536, 40, 40f
percussion in, 3536, 40, 40
positive findings in, 39
vital signs in, 41t42t
Physical therapy, 79t
for burns, 459, 464
Physiologic cup, 373
Physiologic dead space, 16791681
Physiologic stress ulcers, 958
Pia mater, 1379
PICC lines, 309, 309f, 310t. See also Central venous access devices.
Pickwickian syndrome, 551t
PICOT question format, 7, 7t
Pigmentation, abnormalities of, 1182t1183t
Pilocarpine (Akarpine, Isopto Carpine, Pilocar, Pilopine, Piloptic,
Pilostat), for glaucoma, 399t400t
Pilonidal cysts, 890t
Pimecrolimus (Elidel), 439
Pindolol (Visken), for hypertension, 724t727t
Pineal gland, 1171f
Pinkeye, 387388
Pinna, 374, 374f
Pinpoint pupils, 1400f
Pioglitazone (Actos), for diabetes mellitus, 1200t, 1201
Pirbuterol (Maxair), 573t574t, 575
Pitavastatin (Livalo), 747t
Pitressin. See Vasopressin (Pitressin, Terlipressin).
Pitting edema, 698.699t700t
Pituitary adenomas, 1412t
Pituitary gland, 1171f, 11741176
anterior, 1175
disorders of, 1226
hyperfunction of, 1227
hypofunction of, 1229
89
th
hypothalamus and, 11741175, 1175f

in fluid balance, 286, 287f
posterior, 1175
reproductive system and, 12621263, 1262f
Pituitary hormones, 1172t, 11751176
Pituitary tumors, Cushing syndrome and, 12471249
Pivot joints, 1533f
Placebos
ethical aspects of, 135in pain management, 135
Plague, 220t
in terrorism, 17321734, 1733t1734t
Planning, 10, 10f, 12b, 1314. See also Nursing care plan.
nursing interventions and, 14, 14t
Nursing Outcomes Classification in, 9, 1314
outcome identification in, 13
priority setting in, 13
Plant sterols, for hyperlipidemia, 746b
Plantar fasciitis, 1539t
Plantar flexion, 1538t
Plantar neuroma, 1594t
Plantar warts, 431, 431f, 432t, 1594t
Plaque
amyloid, 1486, 1487f
atherosclerotic, 738, 739f
Plaquenil (hydroxychloroquine)
for rheumatoid arthritis, 1605t1607t, 1613, 1613t
Plaques, cutaneous, 418t
Plasma, 616
fresh frozen, 681t
Plasma cell myeloma, 678679
Plasma cells, 195
Plasma exchange. See Plasmapheresis.
Plasma expanders, 307308
Plasma osmolality, 1176, 1176f
Plasma proteins, 616
Plasmacytomas, 626t627t
Plasmapheresis
for autoimmune disorders, 209210
for Goodpastures syndrome, 1105
for myasthenia gravis, 1477
Plasminogen activator, recombinant
for angina, 752t
Plastic surgery. See Reconstructive surgery.
Plate method, 1203
Platelet(s), 617f, 619
decreased, in thrombocytopenia, 653657
disorders of, 653. See also Hemostatic disorders.
in coagulation, 619production of, 616, 617f
Platelet count, 629, 629t630t
Platelet transfusions, 680681, 681t
Platelet-derived growth factor, for wound healing, 182
Plateletpheresis, 209210
Platinum drugs, 255t256t
Plavix. See Clopidogrel (Plavix).
Pledgets, 494
Plenaxis (abarelix), for prostate cancer, 1359t
Plendil. See Felodipine (Plendil).
Plethora, in polycythemia, 652
Plethysmography, 1540t1542t
Pleura, 473
Pleural drainage systems, . 545547, 545f, 547t, See also Chest tubes.
Pleural effusion, 473, 549551, 552t
tubercular, 530
Pleural friction rub, 484, 485t486t, 552
Pleurisy (pleuritis), 552, 552t
Pleurodesis, 544
Plicamycin (Mithracin), 297
Ploidy, in breast cancer, 1285
Pneumatic dilation, for achalasia, 957, 957f
Pneumatic retinopexy, 395
Pneumaturia, 1085t
Pneumococcal pneumonia, 523f
immunization for, 479, 523, 524t
Pneumoconiosis, 535, 535t
coal workers, 535, 535t
Pneumocystis jiroveci pneumonia, 553, 553t
HIV-related, 227, 235236, 236f, 523
Pneumomediastinum, in mechanical ventilation, 1665
Pneumonectomy, 547550, 548t. See also Thoracic surgery.
Pneumonia, 521525, 552t
aspiration, 522
in stroke, 1440
prevention of, 526
assessment in, 526t
case study of, 559b
causative organisms in, 521, 521t
community-acquired, 521, 521t
etiology of, 521
evaluation for, 528
fungal, 533, 533t
hospital-acquired, 522, 522t
in burn injury, 455
nursing management of, 526, 528
nutrition in, 525
opportunistic, 523
HIV-related, 227, 235236, 236f, 523
planning in, 526
pneumococcal, 523f
immunization for, 479, 523524, 524t
Pneumocystis jiroveci, 227, 235236, 236f, 523, 533, 533t
risk classification for, 522, 522t
types of, 521523
ventilator-associated, 522, 522t, 526, 1665, 1714, 1714t
Pneumonia Patient Outcomes Research Team (PORT) Severity Index,
90
th
522, 522t
Pneumonic plague, 220t
in terrorism, 17321734, 1733t1734t
Pneumonitis
chemical, 523, 535
hypersensitivity, 535
radiation, 262t263t, 267
Pneumothorax, 542544, 542t, 552t
closed, 542
open, 542, 543f
tension, 543544, 543t, 543f
Pneumovax vaccine, 479, 523, 524t
Podagra, 16201621
Podofilox (Condylox), for genital warts, 1309
Podophyllin resin, for genital warts, 1309
Poikilothermism, 1514, 1677
Point of maximal impulse, 699t700t, 700f, 701f
Poisoning, 17311732, 1731t
acetaminophen, 1731t
acid, 1731t
activated charcoal for, 1731
alkali, 1731t
antidepressant, 1731t
bleach, 1731t
carbon monoxide, 447, 450, 451t, 1731t
cathartics for, 1732
cyanide, 1731t
Escherichia coli O157:H7, 979980, 979t, 983t
ethylene glycol, 1731t
food, 979980, 979t, 983t
gastric lavage for, 1731
iron, 1731t
nonsteroidal antiinflammatory drug, 1731t
whole-bowel irrigation for, 1732
Polaramine (dexchlorpheniramine), for allergic rhinitis, 496t497t
Polyclonal antibodies, for transplantation, 214t, 215
Polycystic kidney disease, 1114, 1115, 1115f, 1125f
Polycystic ovary syndrome, 1331, 1331f
Polycythemia, 651652, 652f
Polydipsia
in diabetes insipidus, 1232
Polyendocrine deficiency syndrome, 1251
Polyethylene glycol, for constipation, 989t
Polymyositis, 16301631
Polyneuropathies, 1505
Polyphagia, in diabetes mellitus, 11911192
Polypharmacy, 70Polyps
cervical, 1331
colonic, 1010, 1010f, 1010t, 1011t
laryngeal, 509
nasal, 501
asthma and, 564
Polysomnography, 102
Polyuria, 1085t
PORT Severity Index, 522, 522t
Portal circulation, 882
Portal hypertension, in cirrhosis, 10471048
Portosystemic shunts
distal splenorenal, 1052, 1052f
portocaval, 1052, 1052f
Ports, implanted infusion, 309, 310, 309f, 310t. See also Central venous
access devices.
Position sense, assessment of, 1384
Positioning
for defecation, 990
in ARDS, 17151716
intraoperative, 337
postoperative, 345347, 371, 371f
prone, 1642, 1705f, 17151716, 1716f
Positive acute phase proteins, 905
Positive end-expiratory pressure (PEEP), 16411642, 1663t
for ARDS, 1715
Positive feedback, in hormone secretion, 1173
Positive inotropes, 1643
Positive pressure ventilation, 1660, 1708
for ARDS, 1715
invasive. See Mechanical ventilation.
noninvasive, 1708, 1709f
Positive reinforcement, 51
Positron emission tomography (PET)
cardiac, 703t707t
pulmonary, 487t488t
Postanesthesia care unit, 345347. See also Postoperative care.
discharge from, 359.359t
Postauricular ecchymoses, 14041405, 1405f
Postcoital bleeding, 1268
Postcoital tests, 1315
Postconcussion syndrome, 1405
Posterior cerebral artery, 1378, 1379f
Posterior chamber, 365, 365f
Posterior colporrhaphy, 1341
Posterior cord syndrome, 1510
Posterior fossa fractures, 1405, 1405t
Posterior fourchette, 1261f, 1261
Postexposure prophylaxis
for HIV infection, 233
for rabies, 1730
Postherpetic neuralgia, 432b
Postmastectomy pain syndrome, 1287
Postmenopause, 13231325, 1323t
Postmortem care, 148
Postoperative care, 345
ambulation in, 352case study of, 361b
for cardiovascular problems, 350351
for fluid and electrolyte imbalances, 352353
for gastrointestinal problems, 355
for hyperthermia, 355
for hypothermia, 354355
for incisions, 357
for neurologic/psychologic problems, 353
for respiratory problems, 346349, 347f, 348t
for urinary problems, 356in ambulatory surgery, 359360, 359t
in postanesthesia care unit, 345347
admission in, 345347, 346t
fast-tracking in, 345346
initial assessment in, 346347, 346t
phases of, 346t
rapid progression in, 345346
positioning in, 350, 350b, 350f
Postoperative cognitive dysfunction, 352353
Postoperative delirium, in older adults, 360
91
th
Postprandial hypoglycemia, 973974

Postprandial hypotension, 695
Postprandial sleepiness, 101
Poststreptococcal glomerulonephritis, 1104, 1104t
Posttraumatic stress disorder, in burn patients, 467
Postural drainage, 598
Posture, assessment of, 1384
Posturography, 380t
Potassium
dietary restriction of, 1148t
for chronic kidney disease, 294, 1148
dietary sources of, 1148t
functions of, 294
in muscle disorders, 1540t1542t
normal values for, 294
regulation of, 282
Potassium balance
disturbances of, 294295, 294t
hyperkalemic, 294295, 294t
hypokalemic, 294t, 295
postoperative, 351
Potassium channel blockers, for dysrhythmias, 809t
Potassium chloride, for hypokalemia, 296
Potassium hydroxide test, 423t
Potassium-sparing diuretics, 724t727t
Pouches
colostomy, 1013
for urinary diversion, 10031004, 1016, 1129
Hartmanns, 1016, 1016f
hemi-Kock, 1129
ileostomy, 1021
J, 1003f, 1013
Kock, 10031004, 1016, 1129, 1129f
ostomy, 10031004, 1016, 1018
Studer, 1129
Poverty. See Socioeconomic status.
Power of attorney for health care, 144, 145t
Powerlessness, in dying patient, 147
PPD test, 147
PPOs (preferred provider organizations), 74
PQRST assessment, for angina, 748t
Pramipexole (Mirapex), for Parkinsons disease, 1472, 1472t
Pramlintide (Symlin), for diabetes mellitus, 1200t, 1201
PrandiMet (metformin-repaglinide), for diabetes mellitus, 1200t, 1201
Prandin (repaglinide), for diabetes mellitus, 12001201
Prasugrel (Effient), for angina/acute coronary syndrome, 751t
Pravastatin (Pravachol), for hyperlipidemia, 747t
Prazosin (Minipress), for hypertension, 724t727t
Precautions, infection, 220222, 220t
Precedex (dexmedetomidine), for increased intracranial pressure, 1403
Precose (acarbose), for diabetes mellitus, 1200t, 1201
Prediabetes, 1192
Prednisone
Preferred provider organizations (PPOs), 74
Pregabalin (Lyrica), for seizures, 1460
Pregnancy
ectopic, 13211322, 1322fgestational diabetes in, 1193
herpes simplex virus infection in, 1307
HIV transmission in, 223, 234

Pregnancy tests, 1270
Pregnyl, for infertility, 1316t
Prehypertension, 716, 716t, 741
Prelief (calcium glycerophosphate), for interstitial cystitis, 1102
Preload, 692, 16421643, 1643t
Premarin (estrogen), for menopausal symptoms, 1340
Premature atrial contractions, 803, 802t, 803f
Premature ventricular contractions, 802t, 807, 807f
Premenstrual dysphoric disorder, 1318
Premenstrual syndrome (PMS), 13181319, 1318t
Prempro (estrogen/progestin), for menopausal symptoms, 1324
Preoperative care, 314
anesthesia classification for, 320, 321t
assessment in, 315317
for allergies, 318
for substance abuse, 317medication history in, 317318
past health history in, 317
psychosocial, 315320, 316t
review of systems in, 318320, 322t
case study of, 348b
checklist for, 326
day-of-surgery, 324326
drug therapy and, 325326, 327t
ethical issues in, 324, 324b
fasting and, 323, 324t, 325b
for older adults, 319, 327329
interview in, 315laboratory and diagnostic testing in, 320321, 322t
legal issues in, 324
patient teaching in, 321323, 323t
physical examination in, 320321, 322t
safety concerns in, 323t
transport to operating room and, 327328
Preoperative holding area, 331
Prepuce, disorders of, 1362
Presbycusis, 375, 410412, 410t
Presbyopia, 336, 382
Preservatives, asthma and, 564
Pressure garments, for burns, 465
Pressure support ventilation, 1662, 1662t
Pressure ulcers, 183185, 183t185t
Pressure ventilation,. See also Mechanical ventilation.1661, 1663
Pressure-control inverse ratio ventilation, 1662, 1662t
Pressure-volume curve, intracranial, 1393, 1393f
Prestige cervical disk, 1591
Prevacid. See Lansoprazole (Prevacid).
Prevention
primary, 5859
secondary, 5859
Priapism, 1363
Prick tests, 205
Prilosec. See Omeprazole (Prilosec).
Primacor (milrinone), for heart failure, 782t, 783
Primary aldosteronism, 291292
Primary angle-closure glaucoma,. See also Glaucoma.397, 398
Primary biliary cirrhosis, 10441045
Primary diabetes insipidus, 12311232
Primary nursing, 4Primary open-angle glaucoma,. See also
Glaucoma.397398
92
th
Primary prevention, 5859

Primary sclerosing cholangitis, 1045
Primary survey, 17211723, 1722t1723t
Prinivil (lisinopril), for hypertension, 726t729t
Prinzmetals angina, 749, 750t
Prion diseases, 217, 1497
Privacy Rule, 35
ProAir. See Albuterol.
Probenecid (Benemid)
for gout, 621
for syphilis, 1301T
Probiotics, 86
Problem-focused coping, 93, 93T
Procainamide (Pronestyl), for dysrhythmias, 809T
Procaine penicillin, for syphilis, 1305
Procardia. See Nifedipine (Adalat, Procardia).
Procrit (epoetin ), for cancer, 270271, 270T
Proctitis, chlamydial, 13051306
Prodise-L artificial disk, 1591
Prodysrhythmias, 809
Profasi, for infertility, 1316t
Progesterone, 1172T
endogenous, 1262f, 1263
exogenous
in hormone replacement therapy. See Hormone replacement
therapy.
Prograf (tacrolimus), for transplantation, 12131214, 1214t
Progressive care units, 1638
Proinsulin, 1190
Projectile vomiting, 941
Prokine (sargramostim), for neutropenia, 666
Prokinetics
for GERD, 951
Prolactin, 1172t, 1175, 1263
Prolactinomas, 1228
Proleukin (aldesleukin), for cancer, 269t270t
Proliferative retinopathy, 394395
Proliferative vitreoretinopathy, 396
Prolonged grief disorder, 143
Promacta (eltrombopag), for immune thrombocytopenic purpura, 655
Promethazine (Phenergan), for nausea and vomiting, 941, 941b
Pronation, 1538t
Pronator drift, 1384
Prone positioning, 1685, 1750b, 17601761, 1761f
Pronestyl (procainamide), for dysrhythmias, 809t
Propafenone (Rhythmol), for dysrhythmias, 809t
Propine (dipivefrin), 399t400t
Propofol (Diprivan), in general anesthesia, 340t
Propoxyphene (Darvon), 125
Propranolol (Inderal)
Propylthiouracil, for hyperthyroidism, 1236
Proscar (finasteride), for benign prostatic hyperplasia, 1349, 1349b
Prostacyclin analogs, for pulmonary hypertension, 557
Prostaglandins, 173, 1079
endogenous
in inflammation, 173174, 173f, 173t
renal, 1079
exogenous, for induced abortion, 1320t
Prostate, 1259f, 1260
biopsy of, 1356
disorders of, 1361
hypertrophy of. See Benign prostatic hyperplasia.
massage of, 1361
transurethral resection of, 1350t, 1351
Prostate cancer, 13551360
chemoprevention of, 1356
conservative therapy for, 1357
cryotherapy for, 1358
cultural aspects of, 1355b, 1360
grading of, 1357
hormone refractory, 1358-1360
metastatic, 1356, 1356f
nerve-sparing procedures for, 1358
radical prostatectomy for, 13571358
screening for, 1356, 1361
staging of, 13561357, 1357t
surgery for, 13571358, 1358f
vaccine for, 1360
watchful waiting for, 1357
Prostate surgery
for benign prostatic hyperplasia, 1351
for cancer, 13571358
Prostatectomy, 1266t
laser, 1350t, 1351
radical, 1350t, 13571358
surgical approaches in, 1358f
Prostate-specific antigen, 1272t1275t, 1348
Prostatitis, 13611362
Prosthesis
breast, 1295
femoral head, 1568, 1568t
intervertebral disk, 1590
limb, 15731574, 1573f
penile, 13671368
voice, 516, 516f
Prosthetic heart valves, 834, 835f, 835t
Prostin E2 (dinoprostone), for induced abortion, 1317t
Proteases, 224
Proteasome inhibitors, for cancer, 230t, 270
Protein(s)
dietary, 900, 900t
restriction of, for chronic kidney disease, 1148
sources of, 907t
loss of, in peritoneal dialysis, 1158
negative acute phase, 905906
plasma, 617
positive acute phase, 905
serum, 896t
93
th
synthesis of, 190

urinary, 1091t
Protein buffer system, 301
Protein hormone receptors, 1173, 1173f
Protein-calorie malnutrition, 902
Proteinuria, 1086t1090t
Prothrombin, 896t
Prothrombin time, 630t
Proton pump inhibitors
for GERD, 951952, 951t, 952b
for peptic ulcers, 963t, 1968
Protonix. See Pantoprazole (Protonix).
Protooncogenes, 244
Protopic (tacrolimus), 439
Protozoal infections, 217
Proud flesh, 179t
Provenge vaccine, for prostate cancer, 1359
Proventil. See Albuterol.
Provera. See Medroxyprogesterone (Depo-Provera, Provera).
Proximal convoluted tubules, 1078, 1078t, 1011t
Pruritus, 356, 376
in cirrhosis, 1052
in gallbladder disease, 1070
management of, 442
opioid-related, 125
scratching in
excoriation and, 126t
lichenification and, 435t, 442
Pseudoaneurysm, 845, 845f
Pseudoarthrosis, 1553t
Pseudocyst, pancreatic, 1062
Pseudoephedrine (Sudafed)
Pseudofolliculitis, 421422
Pseudogout, 1621
Pseudohypertension, 716
Pseudomenopause induction, for endometriosis, 1329
Pseudomonas aeruginosa infection
of ear, 402
Pseudopolyps, in ulcerative colitis, 9991000
Pseudopregnancy induction, for endometriosis, 1329
Psoralen plus ultraviolet light (PUVA), 438
Psoriasis, 434, 435f, 435t436t
Psoriatic arthritis, 1619
Psychogenic diabetes insipidus, 1231
Psychogenic seizures, 1458
Psychologic dependence, 153t
Psychologic disorders
Psychomotor seizures, 1457
Psychoneuroimmunology, 91f, 9294, 93f
Psychosocial assessment
for surgical patient, 334
Psyllium, 746b
Pterygium, 367t
Ptosis, 371t
in stroke, 1443
Puberty, female, 1263
Pubic lice, 434435, 435t
Public health nursing, 80. See also Community-based nursing.
Pulmicort Turbuhaler (budesonide), for asthma, 573, 574t575t
Pulmonary angiography, 487t488t
Pulmonary artery catheterization,. See also Hemodynamic monitoring.475,
16461652, 1647
catheter for, 475, 1647f
complications in, 1651-1652
Pulmonary artery diastolic pressure, 1643t, 16461648
Pulmonary artery mean pressure, 1643t
Pulmonary artery pressure monitoring, 1648
catheterization for, 16461652
insertion technique for, 16501651
Pulmonary artery wedge position, 710
Pulmonary artery wedge pressure, 1643t, 1651, 1668
Pulmonary circulation, 472
Pulmonary compliance, 472
Pulmonary edema, 288, 553, 553t
alveolar, 553
in environmental lung disease, 534
in heart failure, 778, 778f
interstitial, 553
Pulmonary embolism, 553555
pathophysiology of, 553554, 554
prevention of, 555
surgery for, 555
Pulmonary fibrosis, 555
idiopathic, 553
Pulmonary function tests, 485t486t, 488489, 489t
in asthma, 568569
Pulmonary hypertension, 556558, 556f
cor pulmonale and, 558, 558t, 589591
in COPD, 588591
primary, 556558
secondary, 558
Pulmonary infarction, 554
catheter-related, 1651
Pulmonary rehabilitation
in COPD, 602603
Pulmonary secretions, mobilization of, 1708
in COPD, 597598, 598f
Pulmonary surfactant, 472473, 1711
Pulmonary thromboendarterectomy, for pulmonary hypertension, 557
94
th
558
Pulmonary vascular resistance, 16411643, 1642t
Pulmonary vascular resistance index, 1642t
Pulmonic stenosis,. See also Valvular heart disease.830t, 832
Pulmonic valve, 691, 691f
Pulse(s)
abnormal, 699t700t
apical, 699t700t
assessment of, 698, 699f, 848
for fractures, 1557
fluid imbalances and, 289
grading of, 698
water-hammer, 832
Pulse deficit, 698t699t, 700
Pulse oximetry, 475, 475t, 486t487t, 1651
Pulse pressure, 694
Pulseless electrical activity, 809
Pulsus alternans, 699t700t
Pulsus paradoxus
in asthma, 566567
measurement of, 824t
Pumps, implantable, for analgesia, 130
Punch biopsy, 440, 440f
Punnett squares, 192, 192f
Pupils
abnormalities in, 1400f
assessment of, 372
disorders of, 370t
examination of, 369t
in neurologic assessment, 13991400, 1400f
induced dilation of, 391400, 391t
pinpoint, 1400f
Purkinje fibers, 691, 692f
Purpura, 419, 626t627t
thrombocytopenic,. See also Thrombocytopenia.653656, 654f, 655t
656t
immune, 653656, 656t657t
thrombotic, 654, 655t656t, 656
Pursed-lip breathing, 484t485t, 581t, 597
Pus, 171, 173t
Pustules, 418t
PUVA (psoralen plus ultraviolet light), 429
Pyelolithotomy, 11101111
Pyelonephritis, 1094, 1094f
acute, 10991011, 1010f, 1010t
chronic, 1011
atrophic, 1011
Pyloroplasty, 884t
Pylorus, 878f, 879
Pyorrhea, 890t
Pyramidal tracts, 1387
Pyrazinamide, for tuberculosis, 530532, 530t531t
Pyridium (phenazopyridine), for urinary tract infections, 1097
Pyrosis, 890t, 948949
Q
Qi, 83, 83t
QSEN project, 5
Quaalude (methaqualone), 154t
Quad coughing, 17071708
Quadrantanopsia, 1383
Quadriplegia, 1387t
Quality and Safety Education for Nurses (QSEN), 5

QuantiFERON-TB test, 530
Quantitative protein test, 1086t1091t
Quantitative ultrasonography, 1540t1542t
Questran. See Cholestyramine (Questran)
Quinapril (Accupril), for hypertension, 724t727t
Quinidine (Quinora), for dysrhythmias, 809t
Qvar. See Beclomethasone (Qvar, Vancenase)
R
Rabeprazole (Aciphex)
Rabies, 14211427
postexposure prophylaxis for, 1730
Raccoon eyes, 493, 1404, 1405f
Race/ethnicity
breast cancer and, 1290b
cancer and, 241, 242b
of breast, 1290
culture and, 2223, 23t
definition of, 21
diabetes mellitus and, 1206, 1206b
discrimination and, 22
drug response and, 28, 28t
ethnocentrism and, 23
female reproductive cancers and, 1332b
gallbladder disease and, 1033b
health disparities and, 1920, 2425, 3033, 33t. See also Health
disparities.
heart failure and, 775b, 784
hematologic disorders and, 636b
in arthritis, 1610b
in connective tissue disorders, 1610b
in osteoporosis, 1596b
in prostate cancer, 1359
liver disease and, 1033b
lung cancer and, 536b
obesity and, 923b
pancreatic disease and, 1033b
prostate cancer and, 1386b, 1359
provider attitudes and, 22
skin assessment and, 185t, 419t, 421422
skin disorders and, 421422, 422f
stereotyping and, 23
stroke and, 1424
thalassemia and, 642
tuberculosis and, 528b
urologic disorders and, 1094b
Radial artery, in coronary artery bypass grafting, 760
Radiation, 258
cancer due to, 244
definition of, 245
effects of, 258
in terrorism, 17321734, 1733t
units of, 259, 259t
Radiation pneumonitis, 263t264t, 266
Radiation recall dermatitis, 265
Radiation therapy, 258261. See also specific cancers.
95
th
brachytherapy, 13371338. See also Brachytherapy.

dose in, 259
external, 260, 260f
for breast cancer, 1284b, 12871288, 1288t, 1289f
for female reproductive cancers, 13361337, 1339
for head and neck cancer, 510, 512
dry mouth and, 265, 513
for leukemia, 670
stereotactic, 539
for prostate cancer, 1357, 1358f
for skin cancer, 425
internal, 259260
principles of, 258
in lung cancer, 539
safety concerns with, 258, 260
side effects of, 261262, 425, 439
simulation in, 259, 260f
skin injury from, 425
stereotactic
tumor sensitivity to, 259, 259t
Radical neck dissection, 511, 512f, 947948. See also Laryngectomy.
Radical orchiectomy, 1365
Radical pancreaticoduodenectomy, 10671068, 1067f
Radical prostatectomy, 13561357
Radiculopathy, 1590
Radioactive iodine, for hyperthyroidism, 1237
Radioactive iodine uptake, 1184t1187t
Radiofrequency ablation, 814
for atrial flutter, 804
for liver cancer, 1059
Radiographic contrast media. See Contrast media.
Radiography, chest, 487t488t
Radioisotope studies, in musculoskeletal disorders, 1540t1542
Radiologic dispersal devices, 1734
Radionuclide cystography, 1086t1091t
Radiosurgery, stereotactic, 1414, 1416t,
Raloxifene (Evista)
Ramelteon (Rozerem), 104
Ramipril (Altace), for hypertension, 724t727t
Range of motion
active, 1537
assessment of, 1537
limited, 1539t
passive, 1537
Ranibizumab (Lucentis), for macular degeneration, 396397
Ranitidine (Zantac)
Ranolazine (Ranexa), for angina/acute coronary syndrome, 753
Rapamune (sirolimus), for transplantation, 215, 214t

Rape, 1341t1343t, 1341t1343t, 1732
Rapid eye movement (REM) sleep, 101
Rapid plasma reagin (RPR) test, 1272t1275
Rapid postanesthesia care unit progression, 345346
Rapid response team, 16381639
Rapidly progressive glomerulonephritis, 1105
Rapid-sequence intubation, 16551656, 1721, 1723f
Rasagiline (Azilect), for Parkinsons disease, 1472
Rash, 419t
heat, 17261727
in polymyositis/dermatomyositis, 1630
in rheumatic fever, 827830
in systemic lupus erythematosus, 1622, 1623f
RAST test, 205
Raynauds phenomenon, 859, 859f
in systemic sclerosis, 16271628
Razadyne (galantamine), for Alzheimers disease, 1589
Reach for Recovery, 1294
Reactive arthritis, 1619
Realize Band system, 931t, 932933, 932t
Real-time 3D echocardiography, 709, 709f
Rebetol (ribavirin), for hepatitis C, 1039
Rebif (interferon--1a), for multiple sclerosis, 14661467
Rebound tenderness, 890t
Rebreathing, for hypocalcemia, 1247
Receptors, hormone, 11701171, 1173f
Reclast. See Zoledronic acid (Reclast, Zometa).
Recombinant plasminogen activator
for angina, 752t
Recommended dietary intakes, 903, 904t
Reconstructive surgery
after mastectomy, 12951297, 1296f1297f
cosmetic, 442443. See also Cosmetic procedures.
microsurgery, 444
skin grafts in, 444445. See also Skin grafts.
Rectocele, 1266t, 13401341, 1340f
Rectovaginal fistulas, 1342, 1341f
Rectum, 880, 881f
cancer of, 10101011
examination of, 889
prolapsed, 1340, 1340f
Red blood cells. See Erythrocyte(s).
Red wounds, 177, 178t, 180
Red yeast rice, 746b
5--Reductase inhibitors, for benign prostatic hyperplasia, 1380
Reed-Sternberg cell, 674
Reemerging infections, 219220, 220t
Refeeding syndrome, 918
in anorexia nervosa, 918
Referencing, 16421643
Referred pain, 116117, 117f
Reflex(es)
Achilles tendon, 1385
biceps, 1384, 1385f
brachioradialis, 1384
cough, 476
deep tendon, 1387t
definition of, 1375
dolls eye, 1401
gag, 1384, 1443
Hering-Breuer, 476
96
th
muscle stretch, 1385

oculocephalic, 1401
patellar, 1408, 1375, 1385, 1385f
triceps, 1385
Reflex arcs, 1375, 1375f
Reflex bronchoconstriction, 476
Reflex incontinence, 1120t1121t
Refludan (lepirudin), for venous thromboembolism, 863, 865
Reflux
gastroesophageal. See Gastroesophageal reflux disease (GERD).
vesicoureteral, 10991100
Reflux nephropathy, 1101
Refraction, 366
Refractive errors, 366, 382384
Refractive intraocular lens, 383
Refractometry, 374t
Refractory hypoxemia, 1712
Refractory periods, 800801, 800f
Regeneration, 175, 175t
Regional anesthesia, 130, 338t, 339340. See also Anesthesia.
administration of, 340-341
ultrasonic-guided, 343
Registered nurse first assistant (RNFA), 333
Regitine (phentolamine), for hypertension, 324t327t
Reglan (metoclopramide), for nausea and vomiting, 942, 942b
Regurgitation
definition of, 941
in valvular heart disease, 830831, 830f
Rehabilitation
cardiac, 765t, 766
activity and exercise in, 767, 768t769t
patient teaching in, 767, 766t768t
sexual activity and, 768, 768t
for older adults, 6768, 68b
in burn injuries, 465
in stroke, 1436, 1444
pulmonary
in COPD, 602603
voice, after total laryngectomy, 516517
Reiters syndrome, 1619
Rejection, graft, 212213, 213f
Relationship-based patient care, 4
Relative refractory period, 691692, 799800, 800f
Relaxation breathing, 94, 94t
Relaxation strategies, 9496, 94t97t, 132
breathing, 94, 94t
imagery, 95 95t97t
massage, 8486, 97
meditation, 95, 95t
music, 9697
Relenza (zanamivir), 500
Religion, 2526, 26t. See also Spirituality.
diet and, 900
Relistor (methylnaltrexone), for constipation, 989
Relocation stress syndrome, 65, 75
REM sleep, 101
Remicade (infliximab)
Remodulin (treprostinil), for pulmonary hypertension, 556557
Renal arteriography, 1088t, 1088f
Renal artery stenosis, 1088f, 1114
Renal biopsy, 1086t1090t
Renal calculi. See Urinary calculi.
Renal cancer, 1116, 1116f1117ft

Renal circulation, 10781079
Renal colic, 1079
Renal cortex, 1078
Renal disorders
hereditary, 1114
immunologic, 1103
in diabetes mellitus, 1116, 1219t, 1220
in hypertension, 718t, 719720
infectious, 1093
neoplastic, 1117
traumatic, 1113
vascular, 1114
Renal failure
in ARDS, 1714
with hepatic failure, 1058
Renal lithiasis. See Urinary calculi.
Renal medulla, 1076
Renal pelvis, 1076
Renal replacement therapy. See also Dialysis.
continuous, 1140, 11591160, 1159, 1159f
hemodialysis in, 1140, 11551156
peritoneal dialysis in, 1140, 1153
Renal scan, 1086t1090t
Renal surgery, 1127
Renal toxicity
of contrast media, 1140
of drugs, 1140
Renal transplantation, 11601161
cancer after, 1165
cardiovascular disease after, 11641165
donor sources for, 11611162
graft rejection in, 1160
histocompatibility studies for, 1161
immunosuppressive therapy for, 1164
infection in, 1164
recipient selection for, 11601161
renal disease recurrence after, 1165
transplant placement in, 1161, 1163f
with live donor, 11621163
Renal trauma, 11131114
Renal tuberculosis, 1103
Renal tubules, 10781079
Renal ultrasonography, 1088t
Renal vein thrombosis, 1114
Renin, 1078
Renin-angiotensin-aldosterone cascade, 776
Renin-angiotensin-aldosterone inhibitors
for heart failure, 782t, 783
Renin-angiotensin-aldosterone system, 287f, 287, 1079f
in blood pressure regulation, 715716, 715f
in shock, 16811682
Renova (tretinoin), 441t
ReoPro (abciximab), for angina/acute coronary syndrome,
775fRepaglinide (Prandin), for diabetes mellitus, 12001201,
1200t
97
th
Repair, 175
Reperfusion dysrhythmias, 760
Repetitive strain injury (RSI), 1547
Reproductive cancers
diagnosis of, 12701275, 1272t1276t
female, 1332
cervical, 13321334
cultural aspects of, 1332b
endometrial, 13331334
evaluation in, 1340
implementation of, 1337-1338
ovarian, 13341335
planning in, 1337
radiation therapy for, 1337, 1338
surgery for, 1335-1336
vaginal, 13351336
vulvar, 1336
male, 13641365
tumor markers in, 12711272
Reproductive disorders
diagnosis of, 12701275, 1272t1275t
female, 1314
in cancer, 262t263t, 266-267
male, 1346
surgery for, 1266t
Reproductive system, 1258
female
in older adults, 1265, 1265t1266t
male
neuroendocrine regulation of, 1262, 1262f, 1263t
Repronex, for infertility, 1316t
Requip (ropinirole), for Parkinsons disease, 1472
Reserpine (Serpasil), for hypertension, 724t727t
Residential care facilities, 76t. See also Long-term care.
Residual urine, 1086t1088t
Residual volume, 190491, 490t
Resilience, 90
Respimat, 577578
Respiration. See also Breathing.
Biots, 481
chemoreceptors in, 475476
Cheyne-Stokes, 141, 481, 1400f
Kussmaul, 303, 481, 484t485t
in diabetic ketoacidosis, 1214
mechanical receptors in, 476

paradoxic, 544, 544f
physiology of, 473474
Respiratory acidosis, 302, 302t303t, 465
in mixed acid-based disorders, 303
Respiratory alkalosis, 302303, 302t303t
Respiratory depression
opioid-related, 125, 551t
postoperative, 345, 346t, 348t, 349
Respiratory disorders. See also Lung disease.
diagnosis of, 485491, 487489
in burn injury, 455. See also Inhalation injury.
in spinal cord injury, 1510, 15161517, 1522
postoperative, 345346, 347f, 348t
in clinical unit, 349
restrictive, 550
Respiratory distress, in dying patient, 147
Respiratory failure, 16991700
airway inflammation in, 1709
alveolar hypoventilation in, 1702
anxiety and agitation in, 17091710
bronchospasm in, 1709
classification of, 1700f
diffuse limitation in, 1702
dyspnea in, 1705
etiology of, 17001703, 1705t
evaluation in, 1710
hypercapnic, 16991700, 1700t, 1703, 1704t
hypoxemic, 16991700, 1700t, 1704t
in asthma, 1703
in central nervous system disorders, 1703
in chest wall disorders, 1703
in COPD, 590, 1703, 1705
in neuromuscular disorders, 1703
mechanical ventilation for, 17081709, 17151716. See also
Mechanical ventilation.
mobilization of secretions for, 17071708
orthopnea in, 17041705
oxygen therapy for, 1707
pain in, 17041705
planning in, 17061707
positioning in, 17041705
98
th
positive pressure ventilation for, 17081709

predisposing factors in, 1701t
prevention of, 1707
pulmonary congestion in, 1709
pulmonary infections in, 1709
tissue oxygen needs and, 1703
treatment of
medical supportive, 1710
nutritional, 1710
pharmacologic, 17101711
respiratory, 17071709
ventilation-perfusion mismatch in, 17001702
Respiratory infections. See also Pneumonia.
asthma and, 563
fungal, 534, 535t
in bronchiectasis, 611, 610f
mycobacterial, 530533. See also Tuberculosis.
atypical, 533534
Respiratory membrane, 472f
Respiratory rehabilitation
in COPD, 602603
Respiratory syncytial virus infection, asthma and, 564
Respiratory system, 470. See also under Pulmonary.
common abnormalities on, 484t485t
diagnostic studies in, 485491, 487488
focused, 485
defense mechanisms of, 476
lower tract, 470473, 471f472f
disorders of, 520
upper tract, 470471, 471f
Rest pain, in peripheral arterial disease, 851
Restless legs syndrome, 14771478
Restlessness, in dying patient, 148t149t
Restraints, for older adults, 7071
Restrictive cardiomyopathy, 838f, 837t, 839f, 840
Restrictive respiratory disorders, 550
Resuscitation
cardiopulmonary, 17211723
fluid. See Fluid therapy.
in end-of-life care, 144145, 145t
Reteplase (Retavase)
for acute coronary syndrome, 751, 751f
for angina, 751f
Reticular activating system, 1376
Reticular formation, 1376
Reticulocyte count, 621t
Reticulocytes, 617f, 618
Retina, 365f, 365
examination of, 373, 373f
Retin-A (tretinoin), 441t
Retinal breaks, 394
treatment of, 394395, 395f

Retinal detachment, 394395, 394t, 395f
Retinal holes, 394
Retinal tears, 394
Retinitis, cytomegalovirus, 400401
Retinopathy, 394
diabetic, 393394, 394f, 411b, 12191220
hypertensive, 393
Retrograde ejaculation, after transurethral resection of prostate, 1354
Retrograde pyelogram, 1086t1091t
Retroperitoneal lymph node dissection, 1357
Retroviruses, 224
Revatio. See Sildenafil.
Reverse transcriptase, 224
Reverse transcriptase inhibitors, 230t
Rewarming methods, 355, 1728
Rh incompatibility, 630
Rhabdomyolysis, in heatstroke, 1728
Rhegmatogenous retinal detachment, 394
Rheumatic fever, 827828, 827f, 828t
Rheumatic heart disease, 827828, 827f
infective endocarditis and, 818
Rheumatic pancarditis, 827
Rheumatoid arthritis, 16091610
autoimmunity in, 16091610
clinical manifestations of, 1610f, 16111612, 1612f
deformity in, 1610f, 16111612, 1612f
drug therapy for, 1605t1607t, 16131614
energy conservation in, 1609t, 16151616
extraarticular manifestations of, 1612f
Felty syndrome and, 1612
heat and cold therapy for, 16041605
joint protection in, 1609, 16151617, 1618t
patient teaching in, 1609t, 1618t
planning in, 1614
psychologic support in, 1618
range of motion exercises for, 1618
rest in, 16151616
Sjgrens syndrome and, 1612
stages of, 1611t
stiffness in, 1611
vs. osteoarthritis, 1611t
Rheumatoid factor, 1640t1641t, 16101611
Rheumatoid nodules, 1612
Rheumatrex. See Methotrexate (Folex, Rheumatrex).
Rhinitis
acute viral, 495496
allergic, 201, 495, 496t497t
99
th
sinusitis and, 501

Rhinocort (budesonide), for allergic rhinitis, 496t497t
Rhinoplasty, 494
Rhinorrhea, 14041405, 1405f, 1409
Rhinoviruses, asthma and, 563
Rhizotomy, 130, 131f
glycerol, 1502, 1503t
percutaneous radiofrequency, 15021503
Rhonchi, 484, 484t485t
Rhythmol (propafenone), for dysrhythmias, 809t
Rhytidectomy, 443, 444f
Rib fractures, 544545
in flail chest, 545, 545f
Ribavirin (Rebetol, Copegus), for hepatitis C, 1039
RICE therapy, 175
Rifabutin (Mycobutin), for tuberculosis, 531532, 531t
Rifampin (Rifadin), for tuberculosis, 531533, 531t
Rifapentine (Priftin), for tuberculosis, 531532, 531t
Rifaxamin (Xifaxin), for cirrhosis, 1053t
Rifle classification, of acute kidney disease, 1136, 1137t
Right atrial pressure, 1643t, 1648-1649
Right common carotid artery, 1379f
Rigidity, in Parkinsons disease, 1472
Ring sign, 1404-1405, 1405f
Ringworm, 433t
Rinne test, 380
Risedronate (Actonel)
for Pagets disease, 1596-1597
Risk nursing diagnoses, 1112
Ritalin (methylphenidate), abuse of, 154t
Rituximab (Rituxan)
for cancer, 269t-270t
for non-Hodgkins lymphoma, 676-677
Rivastigmine (Exelon), for Alzheimers disease, 1489
RNA, 190Robot-assisted surgery, 743
cardiothoracic, 761
Robsons staging system, 1117t
Rocaltrol (calcitriol), for hypoparathyroidism, 1247
Roferon-A (interferon-)
for cancer, 269t-270t
Role-relationship pattern, 37t, 38-39
Roman Catholics, health beliefs and practices of, 28t
Romazicon (flumazenil), for benzodiazepine overdose, 162
Romberg test, 1384
Rome III criteria, for irritable bowel syndrome, 994
ROME mnemonic, 304t
Romiplostim (Nplate), for immune thrombocytopenic purpura, 655656
R-on-T phenomenon, 807
Ropinirole (Requip), for Parkinsons disease, 1427, 1472b
Rosiglitazone (Avandia), for diabetes mellitus, 1200t, 1201
Rosuvastatin (Crestor), 747t
Rotary chair testing, 380t
Rotator cuff injury, 1545t, 1549
Rotavirus diarrhea, 982985, 983t
Roths spots, 820
Round ligament, 1260f1261
Round window, 375375, 375f
Roux-en-Y gastric bypass, 931t, 932f, 933
Rovsings sign, 996
Roxanol. See Morphine.
Roxicodone. See Oxycodone.
Rozerem (ramelteon), 104
RU-486 (mifepristone), 1317, 1317t
Rubber band ligation

for hemorrhoids, 1027
Rubella
congenital, hearing loss and, 408
immunization for, 408
Rugae, 878f, 879
Rule of nines, 450, 450f
Rumpel-Leede test, 630t
Rural older adults, 62
S
S1 heart sound, 701, 701f
S2 heart sound, 701, 701f
splitting of, 701
S3 heart sound, 699t700t, 701, 701f
S4 heart sound, 699t700t, 701, 701f
Saccular aneurysms, 845, 845f
Saddle joints, 1533f
Safe sex practices, 232233, 13101311
Safety concerns
for chemotherapy, 256
for defibrillation/cardioversion, 811b
for seizures, 1463b
for transfusions, 681682, 681b
intraoperative, 336337
national safety goals and, 5, 5t
preoperative, 326
QSEN project and, 5
with over-the-counter drugs, 577578
Sage Burn Diagram, 450
St. Johns wort, 85t, 97b
Salicylates, 122, 123t. See also Aspirin.
Saline
hypertonic, 307
hypotonic, 307
isotonic, 307
Saline instillation, for induced abortion, 1317t
Saline lavage, for variceal bleeding, 1054
Saline nasal spray, 501
Saliva, 878880, 879t
Salivary glands, 878
Salmeterol (Serevent), 573t574t, 575
for COPD, 594
Salmon calcitonin (Calcimar)
Salmonellosis, 979t, 983985, 983t
Salpingectomy, 1266t, 1336f, 1336t
Salpingitis, chlamydial, 1305
Salt, dietary restriction of. See Low-sodium diet.
Saltatory conduction, 1373
Same-day admission, 315
Same-day surgery. See Ambulatory surgery.
Sandimmune (cyclosporine), for transplantation, 213214, 214t
Sandoglobulin (immune globulin), for Guillain-Barr syndrome, 1506
Sandostatin. See Octreotide (Sandostatin).
SaO2, 473474, 474t, 1642
Saphenous vein, in coronary artery bypass grafting, 760
Sarcoidosis, 553
Sarcoma, 249, 249t, 1584, 1585t. See also Cancer.
100
th
Kaposi, 226, 226f, 227t

Sarcomeres, 1532
Sargramostim (Leukine, Prokine)
Sarin, 1734, 1734t
SARS (severe acute respiratory syndrome), 218219
Saw palmetto, 13491350, 1349b
Saxagliptin (onglyza), for diabetes mellitus, 1200
Scabies, 431432, 431f, 432t
Scald burns, 447f. See also Burns.
Scale, 419t
Scalp lacerations, 1404
Scars, 176177, 176t, 419t
burn, 465
corneal, 390391
hypertrophic, 179f, 179t, 419t, 420421, 422f
in skin disorders, 442
keloid, 179f, 179t, 420421, 422f
Scheduled toileting, 1122t, 1124
Schilling test, 644
Schwann cells, 1373, 1373f
Schwannoma
acoustic, 1412t
vestibular, 406
Sciatica, 120
straight-leg-raising test for, 1538, 15891590
Scintigraphy
abdominal, 891t894t
hepatobiliary, 891t894t
Sclera, 365f, 364
examination of, 372
Scleral buckling, 395, 395t
Sclerodactyly, 1628
Scleroderma, 16271629, 1628f1629f, 1629t
renal involvement in, 1116
Sclerotherapy
for varicose veins, 868
Scoliosis, 1538, 1538f, 1539t
Scopolamine (Isopto Hyoscine), for pupillary dilation, 392t
Scotomas, 396
Scratch tests, 205
Scratching
excoriation and, 419t
lichenification and, 442, 485t
Screening
for breast cancer, 1272t1275t, 1276
for cervical cancer, 1269, 1272t1275t, 1275, 1320, 1332
for colorectal cancer, 891t894t, 892, 986987, 10101013
virtual, 891t894t, 892
for diabetes mellitus, 1207, 1207t
for hearing loss, 381
for HIV infection, 226, 228t, 234
for prostate cancer, 1356, 1360
for sexually transmitted diseases, 1311
for substance abuse, 162164, 163t
Scrotum, 12581259, 1259f
erythema of, 1271t
masses in, 1271t
skin disorders of, 1363

Scrub nurse, 332
Scrubbing, preoperative, 335336
ScvO2, 1646t, 16501651
Sebaceous glands, 414
Seborrheic keratosis, 436f, 436t437t
Sebum, 414
Secobarbital (Seconal), abuse of, 154t, 162
Second spacing, 286, 454
Secondary prevention, 58
Secondary survey, 17231725, 1724t
Second-degree atrioventricular block, 802t, 806, 806f
Secondhand smoke, 585
Secretin, 880, 880t
Secretin stimulation test, for chronic pancreatitis, 1065
Sectral (acebutolol), for hypertension, 724t727t
Sedation
for burns, 459, 459t
for ICU agitation, 1392, 1403
in mechanical ventilation, 1667, 17091710, 1710b
opioid-related, 125, 125t
Sedative-hypnotics
abuse of, 153t154t, 160162
overdose of, 162, 162t
Sedimentation, 476
Segmental lung resection, 548t
Segmented neutrophils, 618619
Seizure(s), 14561460
absence (petit-mal), 14561457
atonic, 1456
automatisms and, 1458
biofeedback for, 1461
brain tumorrelated, 1411, 1413
classification of, 1450f, 1456, 1456t
clonic, 1456
driving restrictions and, 1464
drug therapy for, 14591460, 1460t. See also Antiseizure drugs.
etiology of, 1456
evaluation for, 1464
generalized, 1456, 1456t
idiopathic, 1456
in epilepsy, 1456. See also Epilepsy.
in status epilepticus, 1458, 1460
in stroke, 1434
in tetanus, 15071508
ketogenic diet for, 1461
mortality from, 1458
myoclonic, 1457
partial, 14561457, 1456t
posttraumatic, 1409
psychogenic, 1458
psychomotor, 1458
101
th
psychosocial aspects of, 1458, 1464

subclinical, 1458
Seizure(s) (Continued)
surgery for, 14601461, 1461t
temporal lobe, 1457
tonic, 1456
tonic-clonic (grand mal), 14551456
tonic-clonic (grand-mal), 1456
vagal nerve stimulation for, 1461
Seizure focus, 1455
Selective estrogen receptor modulators (SERMs)
Selective serotonin reuptake inhibitors (SSRIs). See also
Antidepressants.
for obesity, 930
Selegiline (Eldepryl), for Parkinsons disease, 1472
Self perceptionself concept pattern, 37t, 38
Self-efficacy, 4647, 50
Self-management, in chronic illness, 59
Self-neglect, by older adults, 64
Selye, Hans, 8991
Semen, 1259
Semen analysis, 1272t1275t
for infertility, 1369
Semicircular canal, 375, 375f
Semilunar valves, 690, 691f
Seminal vesicles, 1259
Seminiferous tubules, 1258, 1259f
Senescent gynecomastia, 1281
Sengstaken-Blakemore tube, 1051, 1051f
Senile cataracts, 390, 393. See also Cataracts.
Senna (Senokot), for constipation, 989t
Sensipar (cinacalcet), for hyperparathyroidism, in chronic kidney
disease, 1147
Sensitivity testing, antibiotic, 1097
Sensorineural hearing loss, 373, 407. See also Hearing loss.
Sensory cortex, 1376t
Sensory neuropathy, diabetic, 12201222
Sensory overload, in critical care, 1640
Sensory system, assessment of, 1384, 1386t
Sensory-perceptual problems, in critical care, 1640
Sentinel node dissection, in breast cancer, 12831284
Sepsis
diagnosis of, 1678t
severe, 1678
transfusion-related, 683t, 684
Septa, cardiac, 691, 691f
Septic arthritis, 1619
Septic shock, 16771678. See also Shock.
precipitating factors in, 1673t, 1678t
Septra (trimethoprim/sulfamethoxazole), for urinary tract infections,
10961097
Septum, deviated, 493
Sequential compression devices, 863
Sequestra, 1582, 1582f
Serevent (salmeterol), 573t574t, 572
for COPD, 594
Seroconversion, 224225
Serophene (clomiphene), 1316t, 1331
Serotonin, endogenous, 1374t
Serpasil (reserpine), for hypertension, 724t727t
Serum, 616
Serum protein electrophoresis, 631t

Seventh-Day Adventists, health beliefs and practices of, 26t
Severe acute respiratory syndrome (SARS), 218219
Severe sepsis, 1677
Sevoflurane (Ultane), 340t
Sex hormones, 1172t, 12611262, 1262f, 1263t
in older adults, 1178t, 1265
Sexual assault, 1342, 13421343, 1341t1343t, 1732
Sexual assault nurse examiners, 1732
Sexual counseling, for erectile dysfunction, 1368
Sexual function
after abdominal-perineal resection, 1015
after laryngectomy, 517
after myocardial infarction, 769, 769t
after transurethral resection of prostate, 1353, 1355
antihypertensives and, 728729
in cancer, 267268
in COPD, 604
in diabetic neuropathy, 1221
safe sex practices and, 232233, 13101311
stroke and, 1447
with ostomy, 10211022
Sexual history, 1268, 1269t
Sexual intercourse, painful, menopause and, 1323
Sexual response
female, 1265
male, 12641265
Sexuality-reproductive pattern, 37t, 39
Sexually transmitted diseases, 1300, 1310
bacterial, 1301, 1301t
case finding for, 1311
compliance and follow-up in, 1311
contraception and, 1301
definition of, 1300
diagnosis of, 1272t1275t, 1275
education and research programs for, 1311
evaluation in, 1312
hygiene in, 1312
pelvic inflammatory disease and, 1302, 1306, 13271328
planning in, 1310
prevention of, 13101311
psychologic issues in, 13111312
rates of, factors affecting, 13001301
safe sex practices and, 232233, 13101311
screening for, 1311
sexual activity during, 13121313
urethritis in, 1101
viral, 1301t, 1306
Shamans, 25
Shearing forces, 183
Sheehan syndrome, 1229
102
th
Shenjing shuairuo, 29t

Shift to the left, 171
Shift work, sleep disturbances and, 110111
Shigellosis, 983t
Shin splints, 1545t
Shingles, 431, 431f, 432t
postherpetic neuralgia and, 432b
Shock, 16721690
anaphylactic, 1676
assessment in, 1690
body temperature in, 1693
burn, 453454, 453f454f
cardiogenic, 756, 1672
cardiovascular status in, 1676t, 1681t1682t, 1692
diagnosis of, 1681t1682t, 1684
disseminated intravascular coagulation in, 1681t1682t
distributive, 1673t1674t, 1676t, 16751677
drug therapy for, 16861688, 1686t1687t
emotional support in, 1693
evaluation in, 1694fluid resuscitation in, 16841686, 1685t
gastrointestinal status in, 1676t, 1681t1682t, 1693
hemodynamic monitoring in, 16991701, 1701t, 17091710
hemodynamic parameters in, 1674t, 1681t1682t
hepatic status in, 1681t1682t
hypovolemic, 16741675
clinical manifestations of, 1676tcollaborative care for, 1688, 1689t
in burn injury, 453454, 453f454f
multiple organ dysfunction syndrome and, 1673f, 16941696, 1695t
1696t
neurogenic, 1675
neurologic status in, 1676t, 1681t1682t, 1692
obstructive, 1673t1674t, 1676t, 1679, 1690
collaborative care for, 1689 t, 1690
oxygenation in, 1684
personal hygiene in, 1693

planning in, 1690
renal status in, 1676t, 1681t1682t, 1693
respiratory status in, 1676t, 1681t1682t, 16921693
septic, 16771678
precipitating factors in, 1673t, 1678t
skin changes in, 1676t, 1681t1682t, 1693
spinal, 1510, 1675
stages of, 16791684
compensatory, 16791682, 1680f
irreversible, 1683, 1684f
progressive, 16821683, 1683f
systemic inflammatory response syndrome and, 1673f, 16941696
temperature changes in, 1675, 1681t1682t, 1693
ventilation in, 1676t, 1684
Short arm casts, 1554, 1555f
Short bowel syndrome, 10031004, 1026
Short leg casts, 1555, 1555f
Short Michigan Alcoholism Screening TestGeriatric Version (SMASTG), 167
Short-leg gait, 1539t
Shotty nodes, 481
Shoulder, rotator cuff injury of, 1549
Shoulder arthroplasty, 1577
Shower, cart, 458f
Shunts
anatomic/intrapulmonary, in respiratory failure, 17031705
surgical
distal splenorenal, 1052, 1052f
peritoneovenous, 1050
portocaval, 1052, 1052f
transjugular, 1052, 1052f
ventricular, 14111412
Sibutramine (Meridia), 930, 930b
Sickle cell anemia, 647648
Sickle cell crisis, 648
Sickle cell disease, 641t, 647649, 647b, 649f
complications of, 638t, 648
diagnosis of, 641t, 648649
etiology of, 647648
genetic factors in, 647b
nursing and collaborative management of, 649
sickling episodes in, 648, 648f
types of, 647648
Sickle cell trait, 647648
Sickle cellthalassemia, 648649
Sickle Hb C, 647648
Sigh, 472
Sighted-guide technique, 385
Sigmoid colostomy, 1016, 1016f
Sigmoidoscopy, 891t894t, 10121013
Sign language, 410
Signal-averaged electrocardiogram, 801
Sildenafil
for pulmonary hypertension, 556
nitrates and, 784
Silent ischemia, 749
Silicosis, 535, 535t
Silo fillers disease, 535, 535t
103
th
Silver sulfadiazine, for burns, 459460, 458f, 460b

Silymarin, 1038b
Simponi (golimimab), for rheumatoid arthritis, 1605t1607t, 1614
Sims-Huhner test, 1272t1273t
Simulect (basiliximab), for transplantation, 214t, 215
Simvastatin (Zocor), 747t, 746b
Sinemet (levodopa/carbidopa), for Parkinsons disease, 1471, 1471b
Single-Item Literacy Screener, 50
Single-photon emission computed tomography (SPECT), 703t707t
Singulair (montelukast)
for asthma, 571572, 573t574t
Singultus, postoperative, 355
Sinoatrial node, 691, 691f692f, 795
as pacemaker, 799
Sinus bradycardia, 801, 801f, 802t
Sinus tachycardia, 802, 801f, 802t
Sinuses, paranasal, 500f
obstruction of, 501502
Sinusitis, 496t497t, 500501
asthma and, 563
Sirolimus (Rapamune), for transplantation, 215, 214t
Sitagliptin (Januvia), for diabetes mellitus, 1200t, 1201
Situation-Background-Assessment-Recommendation (SBAR)
technique, 5, 6t
Sitz bath, 1027
Six Ps, of acute arterial ischemia, 858
6-minute walk test, 491, 703t707t
Sjgrens syndrome, 1631
rheumatoid arthritis and, 1611
Skeletal traction, 15531554
Skelid (tiludronate)
Skenes glands, 1261
Skilled nursing facilities, 77t. See also Long-term care.
Skin
age-related changes in, 415416, 416f, 416t
assessment of , 416422. See Integumentary system, assessment of.
preoperative, 319
biopsy of, 422, 422t
dark
assessment of, 419t, 421, 422
disorders of, 421422, 422f
exercise and, 425
functions of, 415
glands of, 414f, 415
hygiene practices and, 425
in fluid imbalances, 289290, 290f
neurogenic, 1523
nutrition and, 425
preoperative preparation of, 337
sleep and rest and, 425
sun damage in, 415416, 416f, 424425, 425f
prevention of, 415416, 416f, 424425
tumors of
benign, 416
malignant. See Skin cancer.
Skin appendages, 414. See also Hair; Nails.

Skin cancer, 245, 416, 418
basal cell, 418, 419t, 420f
melanoma, 418523, 419t
nonmelanoma, 426
of ear, 403
squamous cell, 420f, 418, 419t
Skin care, 425
after dermatologic surgery, 442443
after stroke, 1441
for chest tubes, 547t
for dying patient, 150t151t
for feeding tubes, 912
in parenteral nutrition, 916
in spinal cord injury, 1519, 1523, 1524t
postoperative, 357
Skin culture, 423t
Skin decontamination, 1732
Skin disorders, 421t, 424
allergic, 433, 434t
case study of, 444b
common benign, 433434, 435t436t
contagious, 431
in cancer, 262t263t, 265267, 266f, 266t
in dark-skinned patients, 421422, 422f, 426f
in obesity, 425
infectious, 429t, 430431. See also Skin infections.
infestations and insect bites, 433434, 434f, 434t
odors in, 420
postoperative, 357
pruritus in, 442
psychologic effects of, 443
radiation-related, 425
scarring in, 443
scrotal, 1363
secondary infections in, 442
treatment of
baths in, 442
drug therapy in, 425, 438440, 438t
laser therapy for, 438, 438t
phototherapy in, 438
radiation therapy in, 438
self-treatment in, 425
surgical, 440443
wet dressings in, 441442
wound care in, 442443
Skin flaps, 445
in amputation, 1572
Skin grafts, 445446, 462464
artificial skin for, 463464
autografts, 445, 462
cultured epithelial, 463, 463f
blebs and, 462
donor site care for, 456f, 463f
104
th
facial, 462
flaps, 445446, 1572
for burns, 458, 458t, 462464, 463f
for venous leg ulcers, 869
free, 445446
isografts, 445
pedicle, 445sources of, 458t
Skin infections, 429t, 430433
bacterial, 430t, 431, 431f
fungal, 433, 433f, 433t
viral, 431, 431f, 432t
Skin lesions. See also Rash.
descriptive terms for, 420, 420t
distribution of, 420t
types of, 418t419t
Skin preparation
for electrocardiography, 799
for surgery, 336
Skin scraping, 440
Skin tags, 436t437t
Skin tenting, 290291, 291f
Skin tests, 489
for allergens, 205, 422, 423f, 423t
for tuberculosis, 204, 486, 489t, 530
Skin traction, 15331534
Skin turgor, 290291, 290f, 419
Skip lesions, 999, 999t
Skull, structure of, 1379
Skull fractures, 14041405, 1405f, 1405t. See also Head injury.
Sleep, 101
circadian rhythms and, 101102
definition of, 100
fragmented, 100, 104, 110
insufficient, 100, 102
nonrestorative, 102
NREM, 100
physiology of, 99100
postprandial, 99
REM, 100
Sleep apnea, obstructive, 108, 108f, 109b
Sleep architecture, 100
Sleep assessment, 103104, 106t
Sleep behavior, 99
Sleep efficiency, 99
Sleep hygiene, 102, 104t, 104
inadequate, 100101
Sleep paralysis, 106
Sleep patterns, in older adults, 70
Sleep problems, 98, 101t, 101
case study of, 111b
circadian rhythm disorders, 106107, 111112
complementary and alternative therapies for, 1325b, 86t, 104, 105b
dyssomnias, 101t
impact of, 98100
in chronic illness, 102, 103t
in COPD, 605606
in hospitalization, 106
in menopause, 1325b, 1325
in nurses, 111112
in Parkinsons disease, 1471
in skin disorders, 425
incidence of, 98
insomnia, 102105
narcolepsy, 106107
obstructive sleep apnea, 107108
parasomnias, 101t, 110
periodic limb movement disorder, 110
restless legs syndrome, 14771478
shift work and, 111112
untreated, 101
Sleep terrors, 111
Sleep-disordered breathing, 107108
Sleepiness
excessive daytime, 106107
postprandial, 106107
Sleep-rest pattern, 37t, 38
Sleep-wake cycle, 101
Sleepwalking, 111
Sling procedures, for urinary incontinence, 1122
Slings, 1554
Slow-twitch fibers, 1532
Sludging, 455
Small bowel series, 891, 891t894t
Small cell lung cancer, 537, 537t, 539. See also Lung cancer.
Small intestine
absorption in, 879
secretions of, 879t
transplantation of, 1026
Smallpox, in terrorism, 17321734, 1733t1734t
Smoke inhalation, 446448, 455457, 455t. See also Inhalation injury.
management of, 453, 452t, 455457, 456t
Smokeless tobacco, 154
head and neck cancer and, 513
Smokers patch. See Leukoplakia.
Smoking, 152155, 154t
asthma and, 563
cessation strategies for, 155157, 155b, 156t157, 157f, 540, 592
preoperative, 319, 549
complications of, 153t154t, 153154
COPD and, 584585, 585t
effects on respiratory system, 585t
lung cancer and, 536537
pack years in, 479
pancreatitic cancer and, 1063
passive, 585
perioperative management of, 319
peripheral arterial disease and, 852, 857
prevention of, 155
stroke and, 1426
thromboangiitis obliterans and, 858
Snellen chart, 372
SNOMED CT, 9
Snuff, head and neck cancer and, 513
Soap, 426
Social isolation, in chronic illness, 58
Social support, for older adults, 6364
Social workers, 79t
Socioeconomic status
malnutrition and, 902
obesity and, 925
Sodium
105
th
dietary restriction of. See Low-sodium diet.

functions of, 291
Sodium balance
disturbances of, 291292, 292f, 393t
hypernatremic, 291293, 292f, 393t
hyponatremic, 293, 293t
in syndrome of inappropriate antidiuretic hormone, 1230
Sodium bicarbonate. See also Bicarbonate.
Sodium channel blockers, for dysrhythmias, 809t
Sodium nitroprusside (Nipride)
Sodium polystyrene sulfonate (Kayexalate)
for hyperkalemia, 295, 1139t
Sodium porfimer (Photofrin), 955
Sodium-potassium pump, 284, 284f
Soft corns, 1594t
Soft tissue expanders, 444
Soft tissue injuries, 1545
Soft tissue rheumatic syndromes, 1631
Solar (actinic) keratosis, 416, 427, 428t
Solu-Cortef. See Hydrocortisone (Solu-Cortef).
Solu-Medrol (methylprednisolone), for asthma, 572, 573t574t
Solutions
additives to, 307
colloid, 307
dialysis, 1153
hypertonic, 285, 285f, 306308, 306t
hypotonic, 285, 285f, 306308, 306t
isotonic, 285, 285f, 306308, 306t
parenteral, 915916
Soman, 1734t
Somatic pain, 117
Somatomedin C, 1184t1187
Somatosensory evoked potentials, 1540t1542t
Somatostatin, for upper gastrointestinal bleeding, 960
Somatotropin. See Growth hormone.
Somatropin (Omnitrope, Genotropin, Hymatrope), for hypopituitarism,
1229
SOMI brace, 1519, 1519f
Somnote (chloral hydrate), 154t, 161
Somogyi effect, 1199
Sonata (zaleplon), 104
Sorafenib (Nexavar), for cancer, 269t270t
of liver, 1060
Sorbitrate (isosorbide dinitrate), for angina/acute coronary syndrome,
752t
Sotalol (Betapace), for dysrhythmias, 809t
Sound transmission, 375
Soy, 1325b
Spacers, 572, 572f, 575
Spastic gait, 1539t
Spasticity, 1539t
after stroke, 1442, 1445
in musculoskeletal trauma, 1562t
in tetanus, 1508
Spatial-perceptual deficits, after stroke, 1430, 1446
Specific gravity, urine, 1091t
SPECT (single-photon emission computed tomography), 703t707t
Spectral karyotyping, 632t, 633
Speech. See also Communication.
esophageal, 517
with tracheostomy, 503t, 507509, 509f510f
Speech problems, 1387
after stroke, 1430, 1443, 1443t, 1447
after total laryngectomy, 516517
Speech reading, 409
Speech therapists, 79t
Spermatic cord, 1259
Spermatocele, 1363f, 1364
Spermatogenesis, 1258
Spermatozoa, 1258
Sphincter electromyography, 1086t1089t
Sphincters, esophageal, 878879
SPICES assessment tool, 67, 66f
Spider angiomas, in cirrhosis, 1046
Spider nevus, 626t627t, 627
Spinal analgesia, 128129, 129f
postoperative, 354
Spinal anesthesia, 342, 342f
Spinal cord. See also Nervous system.
disorders of, 1509
Spinal cord compression, in cancer, 275
Spinal cord injury, 15081521
anterior cord syndrome in, 1509, 1512f
autonomic dysreflexia in, 1521, 1522t
Brown-Squard syndrome in, 1509, 1512f
cauda equina syndrome in, 1510
central cord syndrome in, 1509, 1512f
clinical manifestations of
cardiovascular, 15121513, 1519
integumentary, 1514
respiratory, 1512, 15181519
urinary, 1513
complete vs. incomplete, 1512, 15091510
conus medullaris syndrome in, 1510
degree of, 15091510
depression in, 15251526, 1526t
etiology of, 1508
functional level of, 1509, 1512f, 1513t
grief in, 15251526, 1526t
home care in, 15211526
mechanism of, 1509, 1511f
metabolic needs in, 1514
neurogenic bladder in, 15221523, 1523t
neurogenic bowel in, 1514, 1523, 1523t1524t
106
th
neurogenic shock in, 1509

nonoperative stabilization in, 15151518
paraplegia in, 1509, 1513t
patient teaching for, 1522t, 1524t
planning in, 1516
posterior cord syndrome in, 1510
primary injury in, 15081509
reflexes in, 1521
safety concerns in, 1516b
secondary injury in, 15081509, 1510f
sensory deprivation in, 1521
sexual dysfunction in, 15231524, 1525t
skin care in, 1519, 1524, 1524t
spinal shock in, 1509
stress ulcers in, 15121513, 1520
surgery for, 1515
tetraplegia in, 1519, 1513
thermoregulation in, 1513, 1520
thrombosis in, 1514, 1520
traction in, 15151519
urinary catheterization in, 1512, 15201523
Spinal cord stimulation, for pain, 131
Spinal cord tumors, 1527, 1527f, 1527t
Spinal fusion, 1591
Spinal nerves, 1377, 1377f
Spinal shock, 1677. See also Shock.
Spinal stenosis, 1589
Spinal surgery
for intervertebral disk disease, 1590
Spine
osteoarthritis of, 1589
osteoporosis of, 1539t, 15941595
structure of, 129f, 1377f, 1379, 1380f
Spinocerebellar tracts, 13741375
Spinothalamic tracts, 13741375
Spiral CT scan, for pulmonary embolism, 554
Spiral fractures, 1551, 1551f
Spiritual assessment, 143t
Spiritual distress, 143
Spirituality, 25, 26t
end-of-life care and, 143, 143t
pain and, 115
Spiriva (tiotropium)
for COPD, 594
Spirometry, 491
Spironolactone (Aldactone)
for heart failure, 784, 784b
Spleen
disorders of, 679680, 680t, 890t
enlarged, 626t627t, 627, 679680, 680t, 790t
functions of, 195, 195f, 621
imaging of, 632t
in immune system, 195, 195f
palpation of, 627, 888
Splenectomy, for immune thrombocytopenic purpura, 656

Splenomegaly, 626t627t, 627, 679680, 680t, 790t
Splint(s)
lower extremity, 1554
nasal, 493
sugar-tong, 1554
Splinter hemorrhages, 699t700t, 820
Splinting, of incisions, 350, 350f, 484t485t
SpO2, 475, 475t
in exercise testing, 491
Spondyloarthropathies, 16181619
Spontaneous bacterial peritonitis, 1048
Sports injuries, 1545t
Spots, visual, 371t
Spotting, 1320, 1323
Sprains, 1545
Sprue, celiac, 1026, 1026t
Sprycel (dasatinib), for cancer, 269t270t
Sputum, blood in, 479
Sputum studies, 478479, 485489, 487t488t
in asthma, 568
Squamocolumnar junction, 1260
Squamous cell carcinoma, 427, 428t, 429f
of head and neck,. See also Head and neck cancer.510513
of skin, 426, 427t, 430f
Square wave test, 1644, 1645f
St. Johns wort, 85t, 97b
Stadol (butorphanol), 124t
Staged coughing, 1708
Staghorn calculi, 1108f
Staging, of cancer, 248249, 249t
TNM system for, 249250, 250t, 539
Stalevo (carbidopa/levodopa/entacapone), for Parkinsons disease, 1473
Standard precautions, 222223
Standardized nursing terminologies, 89, 9t
NANDA-I, 11, 14
NANDA-NOC-NIC linkages and, 14, 15f, 15t
Nursing Interventions Classification, 9, 14, 15f, 15t
Nursing Outcomes Classification, 9, 1314, 15f, 15t
Standardized teaching plans, 51
Stapedotomy, for otosclerosis, 405
Stapes, 374375, 375f
Staphylococcal food poisoning, 979t, 984t
Staphylococcus aureus, methicillin-resistant, 220221, 221t
Starch blockers, for diabetes mellitus, 1200t, 1201
Starlix (nateglinide), for diabetes mellitus, 12001201
Starvation, pathophysiology of, 904
Statins,. See also Lipid-lowering drugs.746, 747t
Stature, assessment of, 1384
Status epilepticus, 1458, 1460
Steal syndrome, 1156
Steatohepatitis, nonalcoholic, 10441045
Steatorrhea, 890t, 1025
Steatosis, 10441045
Stem cells, 193194, 242
adult, 193194
collection of, 209
embryonic, 193
hematopoietic, 616617
in cancer, 243
107
th
injection of, for urinary incontinence, 1122

transplantation of. See Hematopoietic stem cells, transplantation of.
Stenosis, in valvular heart disease, 830831, 831f
Stents
airway, for lung cancer, 539
brain, 14321433, 1433f
carotid artery, 14321433, 1433f
coronary artery, 753, 753f
emergent placement of, 751752
femoral artery, for peripheral arterial disease, 851b, 854
ureteral, 1112
urethral, 1112
intraprostatic, 1350t, 1351
Step-down units, 1638
Steppage gait, 1539t
Stereognosis, 1385
Stereoptic vision, assessment of, 373
Stereotactic core biopsy. See also Biopsy.
of breast, 1278
Stereotactic radiation therapy, for lung cancer, 539540
Stereotactic radiosurgery, 14141415, 1414t, 1415f
Stereotyping, 23
Sterile field, maintenance of, 336, 336t
Sterilization, surgical
female, 1266t
male, 1266t, 13651366, 1366f, 1366b
Sternal-occipital-mandibular immobilizer (SOMI) brace, 1516, 1516f
Steroid hormones,. See also Corticosteroids.1177
receptors for, 11711172
Steroids. See Corticosteroids.
Stiff neck, in bacterial meningitis, 1416
Stiffness, in osteoarthritis, 16021603
Stimulants
abuse of, 153t154t, 160, 160t
for narcolepsy, 106107, 107t
Stings, 433434, 434t, 17301731
Stocking-glove neuropathy, 12201221
Stockings, antiembolism, 862
Stoma(s), . See also Ostomy.1015
common concerns about, 1012
end, 1003, 1016
food effects on output and, 1020t
loop, 1003, 1016
types of, 10151017, 1016f
Stoma care
for ileal conduit, 1128f, 11291133, 1131f1132f, 1131t
for ileostomy, 1003
for laryngectomy, 517
for tracheostomy, 505
Stomach. See also under Gastric; Gastrointestinal.
digestion in, 878
Stomatitis, 945t
aphthous, 945t
cancer treatment and, 262t263t, 265, 512
Stool
blood in, 640, 890t, 961962
fatty, 890t, 1066
Stool analysis, 890t893t

in diarrhea, 983
Stool culture, 890t893t
Stool softeners
Stool transplantation, 984985
Strabismus, 371t, 390, 390f
Straight catheterization, 11271128
Straight-leg-raising test, 1538, 15881589
Strains, 15441556
Strength, assessment of, 1384, 15371538, 1538t
Streptococcal infections, glomerulonephritis and, 1104
Streptococcal pharyngitis, 502
rheumatic fever and, 827, 829
treatment of, 829
Streptococcus pneumoniae, penicillin-resistant, 220221, 221t
Stress, 89
assessment of, 9697
caregiver, 48, 7779, 78t
case study of, 98b
causes of, 90, 90t
coping with. See Stress management.
definition of, 8990
fluid and electrolyte balance and, 287, 287f
health effects of, 9394, 93t
immune system and, 91f, 9294
relocation, 65, 74
Takotsubo cardiomyopathy and, 837
Stress echocardiogram, 705t708t, 710
Stress fractures, 1596f
Stress incontinence, 1085t, 11181111, 1120t
Stress management, 94, 94t
complementary and alternative therapies in, 97b, 97b98b
for nurses, 9899, 99t
implementation of, 98100, 99t
relaxation techniques for, 9597, 95t97t
Stress response, 90
fight-or-flight, 92, 92f
general adaptation syndrome and, 9091
physiologic, 9193, 91f92f
psychologic, 90, 90t
Stress testing, 705t708t, 710, 801
nuclear imaging in, 705t708t
6-minute walk test in, 490491, 705t708t
Stress ulcers
in mechanical ventilation, 16651666, 1714
physiologic, 958
Stressors, 8990, 90t
Stress-related disorders, 9394, 93t
Stress-related mucosal disease, 958
Strictures
definition of, 1113
esophageal, 956957
ureteral, 1113
urethral, 1113
Stridor, 484t485t, 1240
Stroke, 1424
acute care for
108
th
for hemorrhagic stroke, 1435

for ischemic stroke, 14331435
affect in, 1440
aspiration pneumonia in, 441
neurologic, 1436
nursing, 14341435, 1435t
atherosclerosis and, 1436
bowel management in, 1441, 1452, 14551456
cardiovascular system in, 1452
cognitive deficits in, 14401441
communication and, 1440, 14531454, 1453t, 1455
community integration after, 1455
coping strategies for, 1454, 1455
embolic, 1437f, 1437f, 1438
emergency management of, 1443
emotion and affect in, 14541455
emotional lability in, 1440, 14541455
gastrointestinal system in, 1452
health promotion for, 1442b, 14481451
hemorrhagic, 1437f, 1437t, 14381439
acute care for, 1445
intracerebral, 1437t, 14381439
subarachnoid, 1437t, 1439
integumentary system in, 1452
involved arteries in, 1439
ischemic, 14371438, 1437
acute care for, 14431445
lacunar, 1438
left- vs. right-brain damage in, 1440f
motor deficits in, 14391440, 1455
musculoskeletal system in, 1452, 1455
neurologic system in, 14511452
NIH Stroke Scale and, 1447t, 14511452
nutritional therapy for, 1453, 1455
patient teaching for, 1446b
planning in, 1448
prevention of, 14421443, 1442b, 14481451
rehabilitation for, 1446, 1454
sensory-perceptual alterations in, 14451456
sexual function and, 1457
speech/language deficits in, 1440, 1445, 1445t, 1454

thrombotic, 1437f, 1438
transient ischemic attacks and, 14371438
types of, 14371439
urinary incontinence in, 1441, 14521455
urinary system in, 14521453, 1455
warning signs of, 1451t
Stroke volume, 693, 16421643
measurement of, 1643t, 1649
Stroke volume index, 16421643
Struvite stones,. See also Urinary calculi.1109t
ST-segment-elevation myocardial infarction,. See also Acute
coronary syndrome.753f, 756, 756f
Studer pouch, 1129
Sty, 370t, 387, 387f, 389
Subacute cutaneous lupus, 1622
Subacute granulomatous thyroiditis, 1234
Subarachnoid bolt/screw, in intracranial pressure monitoring, 1397
Subarachnoid hematoma,. See also Head injury.1406f
Subarachnoid hemorrhage, 1437t, 1439
Subarachnoid space, 129f, 1379
Subclavian artery, 1379f
Subconjunctival hemorrhage, 370t
Subcultures, 22
Subcutaneous tissue, 414, 414f, 449
Subdural hematoma,. See also Head injury.14071408, 1407f, 1407t
Subjective data,. See also Health history.3539
Sublimaze. See Fentanyl.
Sublingual glands, 878
Subluxations, 1539t, 1547
Submaxillary glands, 878
Submersion injuries, 17281730, 1729f, 1729t
Suboxone (buprenorphine plus naloxone), 124t
Substance abuse,. See also Alcohol use/abuse; Smoking and specific
abused substances.152
addiction in, 132133
assessment for, 163165, 163t164t
definition of, 153, 153t
dependence in, 132, 153, 153t
HIV transmission in, 233234
motivational interview in, 156, 156t, 166167
overdose in, 153t, 162163, 162t
pain management and, 165166, 650b
planning in, 165
relapse in, 153t
related health problems in, 153, 153t
surgery and, 165, 165t
tolerance in, 132, 153t
withdrawal in, 153t154t, 142
Substance dependence, 153, 153t
on opioids, 132
physical, 153t
psychologic, 153t
Substance P, 1374t
Substituted justice, 953b
Suburethral sling, 11221123
Sucralfate (Carafate)
for GERD, 951
109
th

Suction curettage, 1317t
Suctioning
blind, 1708
in mechanical ventilation, 16571660, 1658f, 1657t, 1659f
intracranial pressure and, 1403
nasogastric, fluid intake and, 291
of endotracheal tube, 16571660, 1657t
of laryngectomy tube, 516
of tracheostomy tube, 504f, 505, 505t
delegation of, 518b
through mini-trach, 1708
Sudafed (pseudoephedrine)
Sudden cardiac death, 770
Suffering, 114
Sugar-tong splints, 1554
Suicide, assisted, 135
Sular (nisoldipine), for hypertension, 724t727t
Sulfasalazine (Azulfidine)
for inflammatory bowel disease, 10001001, 1001t, 1001b, 1003
Sulfonylureas, for diabetes mellitus, 1269, 1269t
Sumatriptan (Imitrex), for migraine, 1452, 1453b
Sumatriptan/naproxen (Treximet), for migraine, 1452
Sun exposure, skin damage from, 424425, 424t
prevention of, 415,416, 416f, 424425
Sun protection factor (SPF), 425
Sundowning, 1493
Sunitinib (Sutent), for cancer, 269t270t
Sunscreens, 425
Supartz (hyaluronic acid), for osteoarthritis, 1608
Superficial vein thrombosis, 860, 860t, 861. See also Venous
thromboembolism.
Superior vena cava, 693
Superior vena cava syndrome, 274, 275f
Superoptic nuclei cells, 1708
Supervision, 15
Supination, 1538t
Support groups, for obesity, 930
Suprachiasmatic nucleus, 100101
Supraglottic laryngectomy, 511
Supraglottic swallow, 512, 512t
Suprane (desflurane), 340t
Suprapubic catheters, 1126
Supraventricular tachycardia, paroxysmal, 802t, 803, 803f
Suprax (cefixime), for gonorrhea, 1302t
Suprefact (buserelin), for prostate cancer, 13591360, 1359t
Surfactant, 472473, 1712
Surfak (docusate), for constipation, 989t
Surgeon, 333
Surgeons assistant, 333Surgery. See also specific procedures and
disorders.
abdominal, 991992postoperative care in, 992

alcohol abuse and, 165, 165t
ambulatory (same-day), 315, 323324
postoperative care in, 358359, 359t. See also Postoperative care.
preoperative care in. See Preoperative care.
anesthesia in, 337338. See also Anesthesia.
anxiety and fears about, 316317
bloodless, 343
breast, 1294
catastrophic events in, 342
cranial, 14151416. See also Cranial surgery.
definition of, 314
ear, 404, 404t
elective, 314
emergency, 314
consent for, 324
eye, patient teaching for, 393t
foot, 15931594
gastrointestinal, 884t
NPO status after, 993b
in health history, 36
informed consent for, 324, 324b
intraoperative care in, 330. See also Intraoperative care.
joint, 15751577
laser. See Laser therapy.
minimally invasive, 343
nasal, 493
operating room in, 331
patient transport to, 327328, 335
physical layout of, 331
preparation of, 335
outpatient, 315, 323
patient transport for, 327328, 335
postoperative care in, 345. See also Postoperative care.
preoperative care in, 314. See also Preoperative care.
purposes of, 314
reconstructive. See Reconstructive surgery.
remote, 343
renal, 1127
reproductive tract, female, 13361337
robot-assisted, 343
cardiothoracic, 761
same-day admission for, 315
settings for, 314315
spinal, 1591
for intervertebral disk disease, 1589
terminology for, 315t
thoracic, 550553. See also Thoracic surgery.
transesophageal echocardiography in, 343
ureteral, 1127
urinary tract, 1127
Surgical Care Improvement Project (SCIP), 331
Surgical hand antisepsis, 335336
Surgical menopause, 1338
Surgical site preparation, 337
Surgical suite, 331
Surgical team, 331333
anesthesia care provider in, 333
licensed practical/vocational nurse in, 332registered nurse first
assistant in, 333
registered nurse in, 332
surgeon in, 333
surgeons assistant in, 333
Surgical technologist, 332
Surgical time-out, 336
Sustiva (efavirenz), 229b
Susto, 29t
Sutent (sunitinib), for cancer, 269t270t
Sutures, 177
SvO2, 1642, 16501651, 1650t
Swallow, supraglottic, 511, 512t
Swallowing, 878
Swallowing problems
110
th
after stroke, 1443

in head and neck cancer, 262t263t, 265, 511
with tracheostomy, 506
Swan neck deformity, 1539t, 1612, 1612f
Swan-Ganz catheter, 16461650
Swayback, 1539t
Sweat chloride test, 608
Sweat glands
apocrine, 414f, 415
eccrine, 414f, 415
Sweating, 288
Swelling, 1539t
Swimmers ear, 402
Swing-through gait, 1563
Swing-to gait, 1563
Sydenhams chorea, 828
Symbicort (budesonide/formoterol), for asthma, 573t574t, 575
Syme amputation, 1572
Symlin (pramlintide), 1200t
Symmetrel (amantadine), for Parkinsons disease, 1472
Sympathectomies, 130, 131f
Sympathetic nervous system, 1377. See also Nervous system.
in blood pressure regulation, 713714, 715t, 715f
Sympathoadrenal response, 91
Sympathomimetics, for shock, 16861687
Synapses, 1373
Synarel (nafarelin)
Synarthrotic joints, 1532f
Synchronized cardioversion, 810
Synchronized intermittent mandatory ventilation, 16611662
Syncope, 816817
heat, 1726
Syndrome of inappropriate antidiuretic hormone (SIADH), 287,
293, 1230, 1230f, 1230t, 1231t
hyponatremia and, 293
in cancer, 275
Syndrome X, 936937
Synovectomy, 1575
Synovial fluid analysis, 1540t1542t, 1543
in gout, 1620
Synovial joints, 1532, 1532f1533f
Synthroid (levothyroxine), for hypothyroidism, 1241
Synvisc (hyaluronic acid), for osteoarthritis, 1608
Syphilis, 1301t, 13031305, 1304f1305f, 1304t1305t
neurosyphilis in, 1508
tertiary, 1508
Syringes, insulin, 11971198
Systemic inflammatory response syndrome, 1673f, 16941696
Systemic lupus erythematosus, 16221625
cardiopulmonary involvement in, 1622
dermatologic involvement in, 1623, 1623f
etiology of, 1622

hematologic involvement in, 1623
infections in, 1624
multisystem involvement in, 1623f
musculoskeletal involvement in, 1622
neonatal, 1626
neurologic involvement in, 16211622
pregnancy in, 1624
psychosocial issues in, 16241626
renal involvement in, 1116, 1621
Systemic sclerosis, 16261628, 1626f, 1627f, 1627t
renal involvement in, 1116
Systemic vascular resistance, 694, 714, 16421644
Systemized Nomenclature of Medicine Clinical Terminology
(SNOMED CT), 9
Systole, 693
Systolic blood pressure, 694. See also Blood pressure.
Systolic dysfunction, 1672
Systolic heart failure, 775
T
T cell(s), 619
CD4, 224, 225f
cytotoxic, 195, 248, 248f
helper, 197f, 196
T cell lymphoma, 676, 676f, 677t
cutaneous, 428t, 438
T lymphocytes, 195, 195196, 197f. See also Lymphocyte(s).
helper, 196f, 196
T tube, in cholecystectomy, 1071, 1071f, 1072
T3. See Triiodothyronine (T3).
T4. See Thyroxine (T4).
Tabes dorsalis, 1303, 1508
Tabun, 1734t
Tachycardia
paroxysmal supraventricular, 802t, 803, 803f
sinus, 802, 801f, 802t
ventricular, 802t, 807808, 808f
Tachypnea, 484t485t
Tacrolimus (Prograf, FK506, Protopic), for transplantation, 213214,
214t, 439
Tactile fremitus, 482, 484t485t
Tadalafil (Cialis)
nitrates and, 784
Tagamet (cimetidine)
Tai Chi, for osteoarthritis, 1609
Takotsubo cardiomyopathy, 836
Talc pleurodesis, 552
Talwin (pentazocine), 124t
abuse of, 154t, 162
Tambocor (flecainide), for dysrhythmias, 809t
Tamiflu (oseltamivir), 500
Tamoxifen (Nolvadex)
for breast cancer, 12891290, 1289t
111
th

Tamponade
balloon, for variceal bleeding, 1050, 1051f, 1054
cardiac. See Cardiac tamponade.
Tampons, toxic shock syndrome and, 1321
Tanning, 424, 425
Tapazole (methimazole), for hyperthyroidism, 1236
Tapentadol (Nucynta), 126t, 127
Tarceva (erlotinib), for cancer, 269t270t
Tardive dyskinesia, 1498
Target tissues, 1171, 1171f, 1172t
Targeted therapy, 268. See also Biologic and targeted therapy.
Tasigna (nilotinib), for cancer, 269t270t
Tasmar (tolcapone), for Parkinsons disease, 1472
Tasosartan (Verdia), for hypertension, 724t727t
Taste alterations, in cancer, 262t263t, 265, 274
Tau proteins, 1486, 1487f
Tavist (clemastine), for allergic rhinitis, 496t497t
Taxanes, 255t256t
Taxonomies, 8
NANDA-I, 11
Taxotere (docetaxel), for prostate cancer, 1360
Tazarotene (tretinoin), 441t
Teaching
definition of, 45
patient and caregiver. See Patient and caregiver teaching.
Teaching plans, 45
Teaching process, 48
Team nursing, 4
Technology, 4
in community-based nursing, 74
in home health care, 7576
nursing informatics and, 10
Tegretol (carbamazepine)
for seizures, 1459, 1460b
Tekturna (aliskiren), for hypertension, 724t727t
Telangiectasia, 421t, 626t627t, 627
electrodessication/electrocoagulation for, 440
Telbivudine (Tyzeka), for hepatitis, 10381039, 1039b
Telehealth, 53
Telemetry monitoring, 798
Teletherapy, 260, 260f, 343. See also Radiation therapy.
Telmisartan (Micardis), for hypertension, 724t727t
Temozolomide (Temodar), for brain tumors, 1412
Temperature. See also Fever.
basal body, in fertility workup, 1272t1275t, 1315, 1315f
sensation of, assessment of, 1384
Temperature regulation, in spinal cord injury, 1513, 1520
Temporal arteritis, 402t
Temporal fractures, 14041405, 1405t
Temporal lobe, 1375, 1375f, 1376t
Temporal lobe absence, 1457
Temporal lobe seizures, 1457
Temsirolimus (Torisel), for cancer, 269t270t
Tenckhoff catheter, 1153, 1154f, 1155
Tendinitis, 1545t
Achilles, 1539t
Tendons, 1534
Tenecteplase (TNKase)
for angina, 752t
Tenesmus, 890t
Tenex (guanfacine), for hypertension, 724t727t
Tennis elbow, 1539t

Tenofovir (Viread), for hepatitis, 10381039, 1039b
Tenormin. See Atenolol (Tenormin).
Tenosynovitis, 1539t
TENS (transcutaneous electrical nerve stimulation), 131, 131f
Tensilon test, 1476
Tension pneumothorax, 543544, 543t, 543f
Tension-type headaches, 14491450, 1450f, 1450t, 1453t. See also
Headaches.
Tenting, skin, 290291, 290f, 421t
Tentorial herniation, 1394f, 1395
Tentorium cerebelli, 1379, 1395
Terazosin (Hytrin), for hypertension, 724t727t
Teriparatide (Forteo), for osteoporosis, 1596
Terlipressin. See Vasopressin (Pitressin, Terlipressin).
Terminal illness. See End-of-life care.
Terminologies. See Standardized nursing terminologies.
Terrorism, 17321734
Testicular cancer, 1364f, 13651366
Testicular self-examination, 1365, 1365f, 1365t
Testicular torsion, 1266t, 1364f, 1365
Testis, 1171f
acquired, 13641365
congenital, 1364
inflammatory/infectious, 1364
radiation injury of, 262t263t, 266
structures and functions of, 1258, 1259f, 1364f
undescended, 1364
Testosterone, 1172t
endogenous
age-related decrease in, 1368, 1369t
Testosterone replacement therapy, 1368
Tetanus, 15071508
immunization for, 1508, 1725t
for burns, 459
postexposure prophylaxis for, 1725t
Tetanus antitoxin, 1508
Tetanus immune globulin, 1725t
Tetany, 298, 298f
Tetracycline
Tetraplegia, 1387t, 1509, 1513t
Teveten (eprosartan), for hypertension, 724t727t
Thalamic ablation, for Parkinsons disease, 1473
Thalamus, 1376, 1376t
in pain transmission, 117
Thalassemia, 641t, 642643
Theophylline
for asthma, 573t574t, 575, 575b
for COPD, 594
TheraCys. See Bacille Calmette-Gurin vaccine.
TheraPEP Therapy System, 599
Therapeutic lifestyle changes diet, 745, 745t
Thermal burns, 446, 447f
Thermodilution method, for cardiac output measurement, 16491650
Thermography, 1540t1542t
Thermoregulation, in spinal cord injury, 15131514
Thiamine, for alcohol intoxication, 160
Thiazide diuretics, 724t727t
Thiazolidinediones, for diabetes mellitus, 1200t, 1201
Thin blood, 29t
112
th
Thiopental (Pentothal), in general anesthesia, 340t

Third spacing, 275, 286, 454, 16741675
Third-degree atrioventricular block, 802t, 807
Thirst
regulation of, 286
Thoracentesis, 487t488t, 489490, 490f, 544, 552
Thoracic aortic aneurysms, 844845. See also Aortic aneurysms.
Thoracic cage, 473. See also Chest.
Thoracic injuries, 541, 541t543t, 543f. See also Chest trauma.
Thoracic surgery, 549550
incisions in, 550
postoperative care in, 550, 549b
types of, 548t
video-assisted, 489, 490f, 550, 548t
Thoracotomy, 550, 548t. See also Thoracic surgery.
Thoratec Ventricular Assist Device, 791
3D echocardiography, 709, 709f
Thrills, 699701, 699t700t
Thrombin, 620
Thrombin time, 630t
Thromboangiitis obliterans, 858859
Thrombocytes. See Platelet(s).
Thrombocytopenia, 653657
etiology of, 653654, 653t655t
heparin-induced, 654, 655t656t, 656, 864
in cancer, 261, 262t263t
in immune thrombocytopenic purpura, 653655, 655t656t
in thrombotic thrombocytopenic purpura, 654, 655t656t, 656
Thrombocytosis, 629
Thromboembolism
arterial, 857858
venous. See Venous thromboembolism.
Thrombolytics
for acute arterial ischemia, 858
for angina, 752t
for stroke, 1433
indications/contraindications to, 759, 759t
Thrombopoietin, 619
Thrombosis
arterial, 857858
coronary artery, 755. See also Myocardial infarction.
venous. See Venous thrombosis.
Thrombotic strokes, 1428. See also Stroke.
Thrombotic thrombocytopenic purpura, 635688, 655t656t. See
also Thrombocytopenia.
Thromboxane, 172, 172f
Thrush, 890t, 945t
Thymectomy, for myasthenia gravis, 1477

Thymus, 195, 195f
Thyroglobulin, measurement of, 1184t1188t
Thyroid acropachy, 1236, 1236f
Thyroid function tests, 1184t1188t
Thyroid gland, 1176
cancer of, 12331234
structures and functions, 1171f, 1176, 1176f
Thyroid hormones, 1172t, 1176
imbalances of. See Hyperthyroidism; Hypothyroidism.
Thyroid nodules, 1182t1183t, 12331234, 1234f
Thyroid scan, 1184t1187t
Thyroid storm, 1236, 1238
Thyroid uptake, 1184t1187t
Thyroidectomy, 1237
Thyroiditis, 1234, 1234f
Thyroid-stimulating hormone, 1172t, 11751176
deficiency of, 1229
Thyrotoxic crisis, 1236
Thyrotoxicosis, 1234
Thyrotropin-releasing hormone
Thyroxine (T4), 1172t, 1176
Tiazac (diltiazem), for hypertension, 724t727t
Tibial fractures, 1556f, 1569
Tic douloureux, 15011503, 1503f, 1502t
Tick bites, 433, 434t
Ticlidopine (Ticlid), for stroke, 1432, 1432b, 1434
Tidal volume, 471, 490t
Tikosyn (dofetilide), for dysrhythmias, 809t
Tilade (nedocromil), for allergic disorders, 207
Tiludronate (Skelid)
Timolol (Blocadren), for hypertension, 724t727t
Timolol maleate (Timoptic, Istalol), for glaucoma, 399t400t
Timolol maleate-dorzolamide (Cosopt), for glaucoma, 399t400t
Timolol-brimonidine (Combigan), for glaucoma, 399t400t
Tinea corporis, 433t
Tinea cruris, 433t
Tinea pedis, 433t
Tinea unguium, 433f, 433t
Tinels sign, 1548
Tinnitus, 375
Tinzaparin (Innohep), for venous thromboembolism, 863t
Tiotropium (Spiriva)
for COPD, 594
Tirofiban (Aggrastat), for angina/acute coronary syndrome, 752t
Tissue expanders, 444, 1288t
in breast reconstruction, 1282, 1296f
Tissue plasminogen activator (tPA)
for angina, 752t
for stroke, 1433
Titration, analgesic, 128
113
th
TNKase (tenecteplase)
for angina, 752t
TNM staging system, 249250, 249t, 538
Tobacco use, 152155. See also Smoking.
head and neck cancer and, 512
Tocilizumab (Actemra), for rheumatoid arthritis, 1605t1607t, 1614
Todds paralysis, 1457
Toe
claw, 1594t, 1595f
hammer, 1594t, 1595f
Mortons, 1594t
TOF peripheral nerve stimulation, 1666, 1667f
Tolcapone (Tasmar), for Parkinsons disease, 1472
Tolerance, 153t
to opioids, 133
Tolterodine (Detrol), for overactive bladder, 1122, 1123b
Tongue, 878
cancer of, 945947, 946t947t
examination of, 886
geographic, 890t
smooth, 890t
Tonic seizures, 1456
Tonic-clonic seizures, 1456
Tono-pen tonometry, 370t, 372, 373f
Tonometry, 370t, 372, 373f
Tonsillitis, peritonsillar abscess and, 503
Tophi, in gout, 1620, 1620f
Topical drug therapy, 438439, 441
application in, 443
common bases for, 438t
Topiramate (Topamax), for migraine prevention, 1453
Topoisomerase inhibitors, 255t256t
Toradol (ketorolac), 123t
Toremifene (Fareston), for breast cancer, 1289t, 1290
Torisel (temsirolimus), for cancer, 269t270t
Torsemide (Demadex), for hypertension, 724t727t
Torticollis, 1539t
Tositumomab (Bexxar)
Total colectomy, with ileoanal reservoir, 1003, 1003f, 1017
Total hemolytic complement (CH50), 1540t1542t
Total intravenous anesthesia, 338
Total iron-binding capacity, 622t, 630631
in anemia, 641t
Total joint arthroplasty. See Arthroplasty.
Total laryngectomy. See also Laryngectomy.
Total lung capacity, 489491, 490t
Total parenteral nutrition. See Parenteral nutrition.
Total proctocolectomy
with continent ileostomy, 1003
with permanent ileostomy, 1003
Touch
assessment of, 1384
Tourniquet test, 630t
Toxic megacolon, 983, 1000
Toxic nodular goiter, 1235
Toxic shock syndrome, tampons and, 1321
Trabeculectomy, 398
Trabeculoplasty, argon laser, 398
Trace elements, 900, 902t
Trachea, 470, 471f472f

obstruction of. See Airway obstruction.
Tracheal deviation, 482, 484t485t
Tracheostomy, 503504, 1654. See also Endotracheal intubation.
aspiration and, 506
definition of, 503
mini, 1708
nursing management of, 504509, 503t504t
delegation in, 517b
percutaneous, 503504
speech with, 503t504t, 507509, 509f510f
stoma care for, 505
swallowing problems and, 506
vs. endotracheal intubation, 503
Tracheostomy collar, 592t594t
Tracheostomy T bar, 592t594t
Tracheostomy tubes
changing of, 506, 506f
cleaning, 505
cuffed, 502f, 503t504t , 505
inflation/deflation of, 505506
dislodgment of, 505
emergency insertion of, 505
face plate (flange) of, 502f, 504505
fenestrated, 502f, 503t504t , 509f, 509
obturator for, 502f, 504
parts of, 502f
removal of, 509
securing ties for, 505
speaking, 503t504t, 507509, 509f510f
suctioning of, 505506, 504f, 505t
delegation of, 517b
types of, 502f, 503t504t
uncuffed, 503t504t, 505
Tracheotomy, 503, 1655
Trachoma, 387388, 1305
Tracleer (bosentan), for pulmonary hypertension, 557
Traction
for fractures, 15531554, 1560
skeletal, 1553
skin, 15531554
Traction alopecia, 421, 422f
Tractotomies, 130, 131f
Traditional Chinese medicine, 8283, 83t
Traditional healers, 25
Train-of-four peripheral nerve stimulation, 1666, 1667f
TRAM flap, 1288t, 1296, 1297f
Tramadol (Ultram), 126t, 127
Trandate (labetalol), for hypertension, 724t727t
Trandolapril (Mavik), for hypertension, 724t727t
Tranexamic acid (Cyklokapron), for hemophilia, 660, 660t
Trans fat, 900
Transbronchial lung biopsy, 489, 490f
Transcellular fluid, 282, 283f. See also Fluid.
Transcranial Doppler, 1388t1389t
in stroke, 1430
Transcription, 190
Transcultural nursing, 23. See also Culturally competent care;
Culture.
Transcutaneous electrical nerve stimulation (TENS), 131, 132f
Transduction, in pain, 115116, 115f
Transesophageal echocardiography, 703t707t, 709
intraoperative, 342
114
th
Transferrin, 631t, 619, 630631

in anemia, 641t
Transferrin saturation, 631, 631t
Transfusion(s), 680686. See also Fluid therapy.
albumin, 681t
autotransfusion, 685687, 1558
blood products for, 681t
blood substitutes for, 332t
clotting factor (cryoprecipitate), 663, 660t, 681t
for hemophilia, 663, 660t
erythrocyte, 681t
for hemorrhage, 646
for thalassemia, 642643
fresh frozen plasma, 681t
graft-versus-host disease and, 215216
HIV transmission via, 223224, 232233, 684
infection transmission via, 683t, 684685
packed red cell, 307308
platelet, 680681, 681t
predeposit, 685686
Rh incompatibility and, 630
safety measures for, 681682, 681b
Transfusion reactions, 682685, 683t
allergic, 682684
delayed, 684685, 684t
febrile, 682
hemolytic, 203, 682, 683t
massive, 684
Transfusion-related lung injury, 683t, 684
Transhepatic biliary catheterization, 1071
Transient ischemic attacks, 1427
Transjugular portosystemic shunt (TIPS), for esophageal/gastric varices,
1051, 1052f
Translation, 190
Transluminal angioplasty, 14321433, 1432f
Transmissible spongiform encephalopathies, 218
Transmission, of pain, 115f, 116117. See also Pain, transmission of.
Transmission-based precautions, 222
Transmyocardial laser revascularization, 761
Transparent film dressings, 180, 181t
Transplantation, 212215
cardiac, 791793, 791t
corneal, 390, 390f
donor compensation for, 1160b
ethical issues in, 1160b1161b, 1165b
graft-versus-host disease and, 215216
hematopoietic stem cell. See Hematopoietic stem cells, transplantation
of.
immunosuppressive therapy for, 213215, 214t, 215f
liver, 10601061
lung, 558560, 558t
for COPD, 597
for pulmonary hypertension, 557558
organ donation and, 144, 1726
pancreatic, 1206
pancreatic islet cell, 1206
parathyroid, 1246
rejection in, 213, 213f
renal. See Renal transplantation.
stool, 983984
tissue typing for, 212213
Transport, to operating room, 327

Transrectal ultrasonography, 1275
Transsphenoidal hypophysectomy, for acromegaly, 12271228, 1227f
Transtheoretical Model of Health Behavior Change, 4647, 47t
Transthoracic needle aspiration, 489, 490f
Transudative effusion, 551
Transurethral electrovaporization of prostate, 1349, 1350t
Transurethral incision of prostate (TUIP), 1350t
Transurethral microwave thermotherapy, for benign prostatic
hypertrophy, 1349, 1350t
Transurethral needle ablation (TUNA), 13491350, 1350t
Transurethral resection of prostate (TURP), 1350t, 1351, 1351f
sexual function after, 1352, 1354
Transurethral resection with fulguration, for bladder cancer, 11181119
Transvaginal ultrasonography, 1275
Transvenous pacing, 812
Transverse fractures, 1551, 1551f
Transverse rectus abdominis musculocutaneous (TRAM) flap, 1288t,
1296, 1297f
Trapped lung, 551
Trastuzumab (Herceptin)
cardiotoxicity of, 267
Trauma. See also specific types.
abdominal, 994995, 995t
barotrauma, 16651666, 1714
chest. See Chest trauma.
cumulative, 1547
facial, 1570
from terrorism, 17321734
from violence, 1732
head, 14041407. See also Head injury; Traumatic brain injury.
lower gastrointestinal, 1040
musculoskeletal. See Musculoskeletal trauma.
ocular, 386, 386t, 1570
renal, 11131114
spinal cord. See Spinal cord injury.
volutrauma, 1665, 1714
Traumatic brain injury, 1404. See also Head injury.
case history of, 1422b
diagnosis of, 1407
diffuse, 1405
diffuse axonal, 1405
focal, 1406
Travel, diabetes mellitus and, 1211
Travopost (Travatan), for glaucoma, 399t400t
Trazodone (Desyrel), 104
Treadmill test, 491
Treatment adherence, ethical aspects of, 834b
Treatment entitlement, 1566b
Treatment refusal, 680b, 1509b
Treatment withholding, 145, 277b, 1165b, 1417b, 1566b
Trelstar (triptorelin), for prostate cancer, 1359, 1359t
Tremor
flapping, 1049
in Parkinsons disease, 1471
Trench mouth, 945t
Treponema pallidum, 1303
115
th
Treponema pallidum particle agglutination (TP-PA) test, 13041305

Treprostinil (Remodulin), for pulmonary hypertension, 557
Tretinoin (Retin-A, Renova, Tazarotene), 441t
Treximet (sumatriptan/naproxen), for migraine, 1452
Triage, 17351738
Triamcinolone (Nasacort), for allergic rhinitis, 496t497t
Triamterene (Dyrenium)
Triceps reflex, assessment of, 1385
Trichlormethiazide (Metahydrin, Naqua), for hypertension, 724t727t
Trichloroacetic acid, for genital warts, 1309
Trichomoniasis, 13261327, 1326t
TriCor (fenofibrate), 747t
Tricuspid stenosis, 831t, 833. See also Valvular heart disease.
Tridil. See Nitroglycerin.
Trigeminal nerve, 1378t, 1380f, 1502f
Trigeminal neuralgia, 15011503, 1503f, 1502t
Trigger point massage, 131
Triglycerides, 702, 703t707t, 708, 740. See also Hyperlipidemia;
Trigone, 1080
Triiodothyronine (T3), 1172t, 1176
Trileptal (oxcarbazepine), for trigeminal neuralgia, 15011503
Trilisate (choline magnesium trisalicylate), 122, 123t
Trimethaphan (Arfonad), for hypertension, 724t727t
Trimethoprim-sulfamethoxazole (Bactrim, Septra), for urinary tract
infections, 1097
Tripod position, 1704
Triptans, for migraine, 1452
Triptorelin (Trelstar), for prostate cancer, 1359, 1359t
Trisenox (arsenic trioxide), for leukemia, 671
Trismus, 1508
Trochlear nerve, 1378f, 1378t
Trolamine salicylate (Aspercreme, Myoflex Creme), 129
Tropic hormones, 1175
excess of, 12281229
Tropicamide (Mydriacyl, Tropicacyl), for pupillary dilation, 392t
Troponin
cardiac, 702, 703t707t
Trousseaus sign, 298, 298f
Trusopt (dorzolamide), for glaucoma, 399t400t
Trypsin, in acute pancreatitis, 1062
T-score, 1595
T-tube, drainage from, 358t
Tubal patency studies, 1315Tube feeding. See Enteral nutrition.
Tuberculin skin test, 486, 489t, 530
Tuberculosis, 528532
diagnosis of, 530
skin testing in, 204, 486, 489t, 530
adherence with, 531, 531b
directly observed, 531
for active disease, 530532
for latent infection, 532
etiology of, 528529
health care disparities and, 528b
HIV-related, 529

in immigrants, 28
latent infection in, 529, 529t
treatment of, 532, 531t
miliary, 530
multidrug-resistant, 528
reactivation of, 529
of, 219, 220t
renal, 1103
Tubo-ovarian abscess, 13271328, 1327f
Tularemia, in terrorism, 17321734, 1733t1734t
Tumor(s)
benign, 244, 244t
biopsy of, 251
bone, 1584
brain, 14101412. See also Brain tumors.
malignant, 244, 244t. See also Cancer.
ocular, 401, 401f
spinal cord, 15261527, 1527f
Tumor angiogenesis, 246
Tumor lysis syndrome, 275276
Tumor markers, 248
in reproductive cancers, 1272
Tumor necrosis factor, 198t
Tumor necrosis factor receptor, clinical uses of, 199t
Tumor suppressor genes, 244
Tumor-associated antigens, 247
Tuning fork tests, 380, 380t
Turbinates, nasal, 470
Turgor, skin, 290291, 290f, 420
Twinrix vaccine, 1040
2D echocardiography, 709, 709f
Two-point discrimination, 1384
Two-point gait, 1563
Tykerb (lapatinib)
for breast cancer, 1290, 1290b
Tylenol. See Acetaminophen (Tylenol).
Tylox. See Oxycodone.
Tympanic membrane, 374375, 375f
disorders of, 379t
examination of, 378379, 378f, 379t
perforation of, 404, 404f
tympanometry, 380t
Tympanoplasty, 389, 404, 404t
Tympanostomy tubes, 403
Tympany, 482t, 887
Type A personality, coronary artery disease and, 743
Tyrosine kinase inhibitors, for cancer, 269t270t
Tysabri (natalizumab)
Tyzeka (telbivudine), for hepatitis, 10381039, 1039b
Tzanck test, 423t
U
Ulcer(s), 418t
arterial, 851, 853
corneal, 388, 388f
116
th
Curlings, 459t, 462

diabetic foot, 1219t, 1220f, 1221f, 12211222, 1222t
in peripheral arterial disease, 851, 853
oral, 890t, 945t
aphthous, 945t
cancer treatment and, 262t263t, 265, 513
peptic. See Peptic ulcer disease.
pressure, 183185
stress
in mechanical ventilation, 16651666, 1714
physiologic, 958
varicose, 868869, 869f
venous leg, 868869, 869f
Ulcerative colitis, 9981004, 1000f. See also Inflammatory bowel
disease.
vs. Crohns disease, 999t
Ulnar deviation, 1539t
Ulnar drift, 1611, 1612t
Uloric (febuxostat), for gout, 1621
Ultane (sevoflurane), 340t
Ultradian rhythms, 1174
Ultrafiltration
continuous arteriovenous, 11591160
in continuous renal replacement therapy, 11391140, 1159t
in peritoneal dialysis, 11531154
Ultram (tramadol), 127, 126t
Ultrasonic-guided regional anesthesia, 343
Ultrasonography
abdominal, 891t894t
Doppler
cardiac, 709
duplex venous, 1540t1542t
in stroke, 1431
transcranial, 1388t1389t
endoscopic, 891t894t
intracoronary, 703t707t, 710711
ocular, 374t
of abdomen, 632t
of endocrine tumors, 1184t1187t
of liver, 632t
of reproductive system, 1274t, 1275
of spleen, 632t
pelvic, 1272t1275t, 1275
quantitative, 1540t1542t
renal, 1086t1090t
transrectal, 1272t1275t, 1275
transvaginal, 1272t1275t, 1275
Ultrasound core biopsy. See also Biopsy.
of breast, 1279
Ultraviolet light
skin damage from, 424425, 425t
therapeutic, 438
Umbilical hernias, 1024, 1024f
Uncal herniation, 1394f, 1395
Unconsciousness
neurologic assessment in, 14001401
Undernutrition, 902
case study of, 919b
Underweight, 921922, 922t
Undescended testis, 1364
Univasc (moexipril), for hypertension, 724t727t

Universal Protocol, 336
Unstable angina, 749t, 754, 754f. See also Acute coronary syndrome.
collaborative care for, 750t, 751f, 758761
Upper esophageal sphincter, 878
Upper gastrointestinal bleeding, 958960. See also Gastrointestinal
bleeding.
Upper gastrointestinal disorders, 940
Upper gastrointestinal series, 891, 891f, 892f, 891t894t
Upper motor neurons (UMNs), 1374
Upper respiratory system, 470471, 471f 489490. See also Respiratory
system.
disorders of, 493
Urachus, 1080
Uremia, 1142. See also Chronic kidney disease.
Uremic fetor, 1144
Ureter(s), 1076, 1077f
obstruction of, 1107
Ureteral catheterization, 11251126
Ureteral strictures, 1113
Ureteral surgery, 1127
Ureteroileosigmoidostomy, 1128f
Ureterolithotomy, 1111
Ureteroneocystostomy, 1113, 1163
Ureteropelvic junction, 1079
obstruction in, 1108
Ureterostomy, 1128f
Ureteroureterostomy, 1113
Ureterovesical junctions, 1079
Urethra, 1077f, 1080
Urethral catheterization, 11251126. See also Urinary catheterization.
Urethral diverticula, 11011102
Urethral obstruction, in benign prostatic hyperplasia, 1353
Urethral stents, intraprostatic, 1350t, 1351
Urethral strictures, 1113
Urethritis, 1094, 1094f, 1101
chlamydial, 1305
gonococcal, 13011303
Urethrovaginal fistulas, 1341, 1341f
Urethrovesical unit, 10801081
Urge incontinence, 1120t
Uric acid, 1186t1190t, 1540t1542t
Uric acid stones, 1109t. See also Urinary calculi.
Uricosurics, for gout, 1621
Urinalysis, 1086t1091t, 1091, 1096
in endocrine disorders, 1184t1187t
specimen collection for, 1086t1090t, 1096
Urinary calculi, 11071111, 1108f
calcium oxalate, 1110f
diagnosis of, 1109
etiology of, 1108
fractures and, 15581560
gender differences in, 1125t
lithotripsy for, 1110
surgery for, 1111types of, 1108, 1108f, 1109t, 1110f
urologic procedures for, 1110
117
th
Urinary catheterization, 11251128

catheters for, 1125, 1125f
drainage in, 358t
for urinary retention, 11241125
in benign prostatic hyperplasia, 1351
intermittent, 1127
postoperative, 1336
in hysterectomy, 1338
in transurethral resection of prostate, 13511354
suprapubic, 1126
ureteral, 1126
urethral, 11251126
Urinary continence, 1080
Urinary disorders, 1083t, 1085t
postoperative, 356
Urinary diversion, 11281129. See also Ileal conduits; Ileostomy.
continent, 1129
incontinent, 1129
methods of, 1128f, 1128t
neobladder, 1129
Urinary elimination, 1080
abnormalities of, 1083t, 1085t
after stroke, 14301431.14411442
burning on, 1083t
in double voiding, 1124
in multiple sclerosis, 1466t, 1468t
in scheduled toileting, 1124
nocturnal, 1083, 1085t, 1096t
painful, 1085t, 1096t
postoperative, 356
regulation of, 1079
Urinary frequency, 1085t, 1096t
Urinary hesitancy, 1085t, 1096t
Urinary incontinence, 1085t, 1096t, 11191122
after radical prostatectomy, 13561357
after stroke, 14301431.14411442, 1445
collaborative care for, 1120t1121t, 11201121
diagnosis of, 11191120drug therapy for, 1121
etiology of, 1120t
functional, 1120t
in cauda equina syndrome, 1510.1589
in stroke, 14301431.14411442, 1445
nursing management of, 1121t, 11221124
overflow, 1119, 1120t
pelvic floor exercises for, 1119b, 1121b
postoperative, 1120t
posttraumatic, 1120t
reflex, 1120t
stress, 1085t, 1120t

surgery for, 1122
types of, 1120t
Urinary intermittency, 1096t
Urinary ketones, 1091t
Urinary obstruction, 11061107
Urinary retention, 1085t, 1096t, 11191122
catheterization for, 1124
postoperative, 356
in hysterectomy, 1338
surgery for, 1124
Urinary system, 1076, 1077f
auscultation in, 1085
palpation in, 1084, 1084f
percussion in, 1084, 1084f, 1085t
preoperative, 319
disorders of, 1093
drugs affecting, 1119t
imaging of, 10851092, 1096
surgery of, 1128
Urinary tract infections, 10931097
etiology of, 1094t, 1095, 1107f
infection sites in, 1094f, 1107f
predisposing factors for, 1095t
prevention of, 10971099
recurrent, 1094, 1096, 1099
urinary calculi and, 11071109
Urinary urgency, 1096t
Urination. See Urinary elimination.
Urine
blood in, 1085t
composition of, 1083t
erythrocytes in, 1091t
118
th
formation of, 10771078

glucose in, 1091t
leukocytes in, 1091t
pH of, 1091t
protein in, 1086t1091t
residual, 1086t1091t
specific gravity of, 290
Urine concentration test, 1086t1090t
Urine culture, 1086t1091t, 1096
sensitivity testing and, 1096
Urine cytology, 1086t1090t
Urine flow study, 1086t1090t
Urine osmolality, 1091t
Urine output, 1079, 1083t
decreased, 1085t
postoperative, 345
increased
Urine specific gravity, 1091t
Urine specimens, 1091
clean-catch, 1086t1090t, 1096
collection of, 1086t1090t, 1096
midstream, 1086t1090t, 1096
Urine studies, 1086t1090t
Urised, for urinary tract infections, 1097
Urobilinogen, urinary, 896t
Urodynamics, 1086t1090t, 1092
Uroflow, 1086t1090t
Urofollitropin (Fertinex, Bravelle), 1316t
Urosepsis, 1094, 1099, 1100
Urothelium, 1080
Ursodeoxycholic acid (ursodiol), for primary biliary cirrhosis, 1044
Ursodiol (Actigall), for primary biliary cirrhosis, 1044
Urticaria, 201.435t
Uterine adnexa, 1260
Uterine artery embolization, for leiomyomas, 1331
Uterine balloon thermotherapy, for menorrhagia, 1321, 1321f
Uterine bleeding, dysfunctional, 1320
Uterine fibroids. See Leiomyomas.
Uterine prolapse, 1340, 1340f
Uterosacral ligament, 1260f, 12601261
Uterus, structures and functions of, 1260f, 12601261
Uveal melanoma, 401, 401f
Uveitis, 400401
Uvulopalatopharyngoplasty, 109
V
Vaccines. See Immunization.
Vacuum constriction devices, for erectile dysfunction, 1368
Vacuum-assisted wound closure, 180
Vagal stimulation
for paroxysmal supraventricular tachycardia, 803
for seizures, 1461
Vagina
Vaginal atrophy, menopause and, 1324
Vaginal bleeding, abnormal, 1268, 13201321
Vaginal cancer, 1336. See also Reproductive cancers, female.
Vaginal discharge
assessment of, 1326
causes of, 1326
Vaginal fistulas, 1342, 1341f

Vaginal hysterectomy. See Hysterectomy.
Vaginal introitus, 1260f, 1261
Vaginal smears, 1272
Vaginectomy, 1336t
Vaginitis, 13261327
severe recurrent, 13261327, 1326t
Vagotomy, 884t
Vagus nerve, 1378f, 1378t
Valacyclovir (Valtrex), for genital herpes, 1308, 1308t
Valerian, 85t, 105
Valgus deformity, 1539t
Valium (diazepam), abuse of, 154t, 162
Valproic acid (Depakote), for migraine prevention, 1453
Valsalva maneuver, 881
in elimination, 988
Valsartan (Diovan), for hypertension, 724t727t
Value-belief pattern, 37t, 39
Values, 22
Valvular heart disease, 830
aortic valve regurgitation, 831t, 832833
aortic valve stenosis, 831t, 832
case study of, 841b
diagnosis of, 833
mitral valve prolapse, 831t, 831832, 831f, 832t
mitral valve regurgitation, 831t, 831
mitral valve stenosis, 830, 830f
percutaneous transluminal balloon valvuloplasty for, 834, 833f
pulmonary stenosis, 831t, 833
regurgitation in, 830, 830f
stenosis in, 830, 830f
tricuspid stenosis, 831t, 833
types of, 831t
valve repair for, 834
valve replacement for, 834836, 835f, 835t
Valvuloplasty, 834, 834
balloon, 834, 833f
Valvulotomy, 834
Vancenase (beclomethasone), for allergic rhinitis, 496t497t
Vancomycin, for infective endocarditis, 822t
Vancomycin-resistant enterococci, 220221, 220t
Vanillylmandelic acid, measurement of, 1184t1187t
Vardenafil (Levitra), for erectile dysfunction, 1368t
Varenicline (Chantix), 155, 156t
Variant angina, 749, 750t
Varices
esophageal, 958, 1048, 1050, 1054
management of, 1050, 1051f1052f, 1054
gastric
in cirrhosis, 1048
management of, 1050, 1051f
Varicocele, 1363f, 1364
infertility and, 1364b, 13691370
Varicocelectomy, 1266t
Varicose ulcers, 869870, 869f
Varicose veins, 421t, 867868, 868f
thrombosis of, 859, 859t, 861
Varum deformity, 1539t
Vas deferens, 1259, 1259f
Vascular dementia, 1482. See also Dementia.
119
th
Vascular disorders, 843873

pulmonary, 553
Vascular endothelium
in coronary artery disease, 737, 739f
Vascular grafts
for peripheral arterial disease, 855, 854f
Vascular resistance, 1642
Vascular system. See also under Cardiovascular.
Vasectomy, 1266t, 1366, 1366f, 1366b
Vasodilators
for shock, 16871688
Vasogenic cerebral edema, 1393
Vasomotor instability, in menopause, 1323
Vasopressin, endogenous. See Antidiuretic hormone.
Vasopressin (Pitressin, Terlipressin)
for septic shock, 1688
Vasospasm, cerebral, in subarachnoid hemorrhage, 1428, 1436
Vasotec. See Enalapril (vasotec).
Vasovagal syncope, 816817
VDRL test, 1272, 1272t1275t, 1303
Vectibix (panitumumab), for cancer, 269t270t
Vegan diet, 901
Vegetarians, 901
Vegetations
in infective endocarditis, 818, 819f
in rheumatic endocarditis, 827, 827f
Veins, 693, 693f. See also Circulation.
varicose, 421t, 867868, 868f
thrombosis of, 859, 859t, 861
Velcade (bortezomib), for cancer, 269t270t
Vena cava, 693
Vena cava filters, 865
Venereal Disease Research Laboratory (VDRL) test, 1272, 1272t1275t,
1303
Venereal diseases, 1300. See also Sexually transmitted diseases.
Venography. See also Angiography.
peripheral, 703t707t, 711
Venous dermatitis, 869870
Venous disease, 860
vs. peripheral arterial disease, 852t
Venous hemoglobin oxygen saturation, 1643t
Venous insufficiency, chronic, 862, 861865
Venous leg ulcers, 869870, 869f
Venous oxygen saturation, 16501651
Venous stasis, 860
Venous thromboembolism, 861865
antiembolism stockings for, 862

definition of, 859
diagnosis of, 862t
endothelial damage and, 861
hypercoagulability and, 861, 860t
Venous thromboembolism (Continued)
in fractures, 1565
postoperative, 318, 351352
prevention of, 525, 864
pulmonary embolism and, 554. See also Pulmonary embolism.
venous stasis and, 860
vs. superficial vein thrombosis, 859t
Venous thrombosis, 859865
deep vein, 554, 860, 859t
after stroke, 1441
prevention of, 555
definition of, 859
etiology of, 860861
left ventricular, 780
prevention of, 555
renal vein, 1114
superficial vein, 860, 859t, 861
Ventavis (iloprost), for pulmonary hypertension, 557
Ventilation, 473
maximal voluntary, 490t
mechanical. See Mechanical ventilation.
Ventilation-perfusion (V/Q) mismatch, 1679, 1702f
Ventilation-perfusion (V/Q) scan, 487t488t
Ventilator bundle protocol, 1714, 1714t
Ventilator-associated pneumonia, 522, 522t, 526, 1665, 1714, 1714t.
See also Pneumonia.
prevention of, 526
Ventilatory demand, 1699
Ventilatory failure, 1699. See also Respiratory failure.
Ventilatory supply, 1699
Ventolin. See Albuterol.
Ventral hernias, 1024
Ventricles
cardiac, 690, 691f
cerebral, 1376
Ventricular aneurysms, 757
Ventricular assist devices, 781, 783, 791, 1654, 1654f
for cardiomyopathy, 839
Ventricular bigeminy, 807
Ventricular contractions, premature, 802t, 807, 807f
Ventricular fibrillation, 756, 802t, 808809, 808f
Ventricular gallop, 701
Ventricular hypertrophy, 693
hypertension and, 718719, 718f
in hypertrophic cardiomyopathy, 839, 839f
Ventricular remodeling
120
th
in coronary artery disease, 756

Ventricular shunts, for brain tumors, 1411
Ventricular tachycardia, 802t, 807808, 808f
Ventricular trigeminy, 807
Ventriculectomy, for hypertrophic cardiomyopathy, 839840
Ventriculostomy
for cerebrospinal fluid drainage, 1397f, 1397
for intracranial pressure monitoring, 1396, 1397f1398f
Venturi mask, 592t594t, 594
Venules, 693, 693f
Veramyst (fluticasone furoate), for allergic rhinitis, 496t497t
Verapamil
Verdia (tasosartan), for hypertension, 724t727t
Verelan. See Verapamil.
Verruca vulgaris, 432t
Vertebrae, 1379, 1380f. See also under Spinal; Spine.
fractures of, 15691570
pathologic, 1539t, 1583, 15951596
spinal cord injury in, 15081515. See also Spinal cord injury.
osteoporosis of, 1539t, 15941595
Vertebral column, 1379, 1380f
Vertebroplasty, 1596
Vertical banded gastroplasty, 931t, 932, 932f
Vertical sleeve gastrectomy, 931t, 932f, 932
Vertigo, 375
benign paroxysmal positional, 406
Very low-density lipoproteins, 703t707t, 708. See also Hyperlipidemia;
Vesicants, extravasation of, 256, 257f
Vesicles, 418t
Vesicoureteral reflux, 10991100
Vesicovaginal fistulas, 1342, 1341f
Vesicular breath sounds, 484, 483f
Vestibular schwannoma, 406
Vestibular system, 375
Vestibule, 375, 375f, 1261f, 1261
Vestibulocochlear nerve, 1378f, 1378t
Viagra. See Sildenafil.
Vibramycin. See Doxycycline (Vibramycin).
Vibration, in chest physiotherapy, 598
Vibration sense, assessment of, 1384
Vicodin (hydrocodone), 124t
Vidarabine (Vira-A), for encephalitis, 1421
Vidaza (azacitidine), for myelodysplastic syndrome, 668669
Video-assisted thoracic surgery (VATS), 489, 490f, 538, 550, 548t
Videourodynamics, 1086t1091t
Villi, intestinal, 879880
Vinca alkaloids, 255t256t
Vincents infection, 945t
Violence, 1732
family and intimate partnerm, 1732
sexual, 1338b, 13421343, 1341t1343t, 1732
workplace, 1732
Vira-A (vidarabine), for encephalitis, 1421
Viral encephalitis, 1418t, 14191421
Viral infections, 219t
cancer and, 245
Viral load, 222223, 223f
Viral meningitis, 1418t, 1419
Viral rhinitis, acute, 495497
Virchows triad, 860, 860f
Viread (tenofovir), for hepatitis, 10381039, 1039b
Viremia, 224
Virtual colonoscopy, 891t894t, 892
Visceral pain, 117
Visceral peritoneum, 877
Visceral pleura, 473
Visceral vs. abdominal fat, 921, 923f, 923t
Visken (pindolol), for hypertension, 724t727t
Visual accommodation, 366
Visual acuity testing, 370372, 370t, 1383
Visual agnosia
after stroke, 1431
Visual fields
defects in, 371t
in stroke, 1431, 14421443
examination of, 369t, 1382
Visual impairment
correctable, 382384. See also Refractive errors.
in transient ischemic attacks, 1427, 1443f
levels of, 384, 385t
uncorrectable, 396
Visual laser ablation of the prostate (VLAP), 1350
Visual pathways, 366, 366f
Visual problems, 371t, 382
case study of, 411b
extraocular, 387
in stroke, 1431, 14421443
intraocular, 390
traumatic, 386
Visual system. See also Eye.
common abnormalities in, 371t
diagnostic studies in, 373, 374t
focused, 378, 378b
initial observation in, 370
inspection in, 373
of color vision, 370t, 373
of stereopsis, 373
physical examination in, 369373, 370t
visual acuity testing in, 370372, 370t, 1383
disorders of, traumatic, 386, 386t, 1572
Vital capacity, 491, 490t
Vital signs, 41t42t
Vitamin(s), 900
deficiencies of, 903
ocular disorders and, 402t
for inflammation, 174t
for wound healing, 181
recommended intake of, 904, 903t
Vitamin B12, 631t
deficiency of
anemia and, 641t, 643644
causes of, 643
gastritis and, 963
supplemental, 644
Vitamin D
in calcium metabolism, 1078
121
th
supplemental
for hypocalcemia, 1147
for hypoparathyroidism, 1247
for osteoporosis prevention, 1595
Vitamin K, 896t
Vitiligo, 421, 421t, 422f
Vitrectomy, 395
Vitreous humor, 366
Vocal cords, 470
Voice prosthesis, 516, 516f
Voice rehabilitation, after total laryngectomy, 516517
Voiding. See Urinary elimination.
Voiding cystourethrogram, 1086t1091t
Voiding pressure flow study, 1086t1091t
Volkmanns ischemic contracture, 1564, 1564f
Volume expanders, 343
Volume ventilation, 1660. See also Mechanical ventilation.
Volume-assured pressure ventilation, 1663
Volutrauma, 1665, 1714
Volvulus, 1008
Vomiting, 940. See also Nausea and vomiting.
Vomitus, blood in, 623, 890t
Von Willebrands disease, 657661, 659t
Von Willebrands factor, 619, 620f, 654
VoSpire. See Albuterol.
Votrient (pazopanib), for cancer, 269t270t
V/Q mismatch, 1695
V/Q scan, 487t488t
Vulva, 1261, 1261f
cancer of, 1336. See also Reproductive cancers, female.
surgery for, 1338
discharge from, 1271t
erythema of, 1271t
lesions of, 1271t
Vulvar intraepithelial neoplasia, 1336
Vulvectomy, 1336t, 1339
Vulvovaginal candidiasis, 13261327, 1326t
VX (chemical weapon), 1734t
W
Waist circumference, obesity and, 921, 922t
Waist-to-hip ratio, 921
Wake behavior, 101
Waking up wild, 352353
Walk test, 491492
Walkers, 1563
Walking. See also Activity and exercise.
after amputation, 1574
assistive devices for, 1563
coordinated, 604
fractures and, 1563
in COPD, 604
postoperative, 352
Warfarin (Coumadin)
bleeding due to, 866
for atrial fibrillation, 804, 805t, 805b
for venous thromboembolism, 863864, 863t

Warts, 431, 432t
genital, 13071308, 1307f, 13251326
plantar, 731, 431f, 432t, 1594t
Wasp stings, 433434, 434t, 1730
Water. See also Fluid.
body, 281282, 282f
Water deprivation test, 1184t1187t
Water exercise, for multiple sclerosis, 1467, 1470f
Water-hammer pulse, 832833
Weakness
in polymyositis/dermatomyositis, 1630
Weaning, ventilator, 1660b, 16671668, 1668t
Weber test, 380381, 400t
Wedge lung resection, 548t
Weight. See also Obesity.
fluid imbalances and, 290
measurement of, 905
Weight gain, in heart failure, 779, 785
Weight loss
strategies for, 934937
Weight Watchers, 930
WelChol (colesevelam), 747t
Wellness nursing diagnoses, 1112
Wenckebach heart block, 802t, 806, 806f
Wernickes aphasia, 1430t
Wernickes area, 1375, 1376t
Wernickes encephalopathy, 157158
West Nile virus infection, 218220, 1419
Western biomedical model, vs. integrative health care model, 81, 82t
Wet dressings, 441442
Wet mount, 1327
Wheal-and-flare reactions, 201, 201t
Wheals, 418t
Wheezing, 479, 483, 484t485t
in asthma, 566
in COPD, 588
Whipple procedure, 10671068, 1067f
Whisper test, 379380
Whispered pectoriloquy, 483, 484t485t
Whitaker study, 1086t1090t
White blood cells. See Leukocyte(s).
White coat hypertension, 720
White lung, 1713, 1713f
Whiteout, 1713, 1713f
Whitmore-Jewett staging system, 1356, 1356t
Whole medical systems, 8283
Whole-bowel irrigation, for poisoning, 1732
Whooping cough, 220t, 521
Window period, 226
Withdrawal, 153t
alcohol, 160161, 160t
postoperative, 353
caffeine, headache and, 320
definition of, 153t
opioid, 133, 133t, 162
sedative-hypnotic, 162
stimulant, 160
Wolff-Parkinson-White syndrome, 803
Women. See Gender differences.
Woods lamp examination, 423t
Workplace violence, 1732
Wound(s)
122
th
black, 177, 178t, 181

dressings for, 180181, 181t
hyperbaric oxygen for, 181182
hypertrophic, 179f, 179t
measurement of, 180f, 186
negative-pressure therapy for, 181
platelet-derived growth factor for, 182
red, 177, 178t, 180f
surgical. See Incision(s).
yellow, 177, 177t, 180181
Wound contractures, 179t
Wound culture, 183
Wound debridement, 176, 180181, 182
Wound dehiscence, 179f, 179t, 357
Wound drainage, 180, 180f
Wound evisceration, 179t
Wound healing, 175177
by primary intention, 176, 176f, 180
by secondary intention, 176177, 176f, 176
by tertiary intention, 176f, 177
delayed, 177, 178t
nutrition and, 182183
postoperative, 345
regeneration in, 175176, 175t
repair in, 175177
Wound infections, 179t, 183
Wound management, 177
after dermatologic surgery, 442443
for bites, 1730
for burns, 457458, 458f, 462for pressure ulcers, 185186
postoperative, 357
psychologic aspects of, 183
Wrights stain, 423t
Wrist
Colles fracture of, 1565
median nerve compression of, 1548, 1548f
Wry neck, 1539t
Wytensin (guanabenz), for hypertension, 724t727t
X
X Stop (interspinous process decompression system), 1590
Xalatan (latanoprost), for glaucoma, 399t400t
Xanax (alprazolam), abuse of, 154t, 162
Xeloda (capecitabine)
Xenical (orlistat), 930
Xerostomia
radiation therapy and, 262t263t, 265, 512
Xifaxin (rifaxamin), for cirrhosis, 1053t
Xigris (drotrecogin alfa)
for septic shock, 1686t1687t, 16881689
Xolair (omalizumab), for asthma, 572, 573t574t
Xopenex (levalbuterol), for asthma, 572, 573t574t
X-ray studies
abdominal, 891892, 891t894t
chest. See Chest X-ray.
in musculoskeletal disorders, 1540, 1540t1541t
kidney-ureter-bladder, 1086t1090t
Xylocaine (lidocaine)
transdermal, 126, 128
Xyzal (levocetirizine), for allergic rhinitis, 496t497t
Y
Yellow jacket stings, 1730
Yellow wounds, 177, 178t, 180
Yoga, 97b
Young-old adults, 60
Z
Zafirlukast (Accolate)
for asthma, 571572, 573t574t
Zaleplon (Sonata), 104
Zanamivir (Relenza), 500
Zantac (ranitidine), for upper GI bleeding, 960t
Zaroxolyn (metolazone), for hypertension, 724t725t
Zebeta (bisoprolol), for hypertension, 724t725t
Zenapax (daclizumab), for transplantation, 214t, 215
Zenkers diverticulum, 956, 956f
Zeroing, 1643, 1645f
Zestril (lisinopril), for hypertension, 724t727t
Zetia (ezetimibe), 747t
Zevalin (ibritumomab tiuxetan/yttrium-90)
for Non-Hodgkins lymphoma, 676
Zileuton (Zyflo)
for asthma, 571572, 573t574t
Zinc, for colds, 488b489b
Zithromax (azithromycin)
for chlamydial infections, 1305, 1305t
for gonorrhea, 13011303, 1302t, 1302b
Zocor (simvastatin), 747t, 747b
Zofran (ondansetron), for nausea and vomiting, 942
Zoladex (goserelin), for prostate cancer, 15391540, 1539t
Zoledronic acid (Reclast, Zometa)
Zollinger-Ellison syndrome, 966967
Zolpidem (Ambien), for insomnia, 104
Zometa. See Zoledronic acid (Reclast, Zometa).
Zonule, 366
Zoonosis, 218
Zovirax. See Acyclovir (Zovirax).
Z-technique, for wound specimens, 182
Zyban (bupropion), for smoking cessation, 155156, 155b, 156t
Zydonel (hydrocodone), 124t
Zyflo (Zileuton)
for asthma, 471472, 473t474t
Zygomatic arch fractures, 15701571, 1570t
Zygote intrafallopian transfer, 13151316
Zyloprim (allopurinol), for gout, 16211622
Zyrtec (cetirizine), for allergic rhinitis, 497t498t
123
th

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Absence seizures, 1456

Acidosis, 300. See also Acid-base imbalances.

Acute alcohol toxicity, 159

complications of, 17131714

Adrenaline, endogenous, 1172t, 1177, 1374t

Adult inclusion conjunctivitis, 387

in head and neck cancer, 514516

Allegra (fexofenadine), for allergic rhinitis, 496t497t

Alpha-fetoprotein, 248, 896t

Alveolar hypoventilation. See also Hypoventilation.

Ambulatory electrocardiography, 703t707t, 708, 801

Ampyra (famipridine), for multiple sclerosis, 1467

laboratory findings in, 641t

classification of, 845, 845f

in fluid and electrolyte balance, 287f, 287, 1079

for peptic ulcers, 968

plasma osmolality and, 1176, 1176f

for seizures, 14591460, 1459t

prevention of, 857, 857t

with tracheostomy, 507

chest examination in, 486t

Asymmetric septal hypertrophy, 839

Auditory system. See also Ear; Hearing.

assessment of, 375379

in breast cancer, 1284, 1286

Balloon pump, intraaortic, 781, 783, 1653t

Benazepril (Lotensin), for hypertension, 726t

side effects of, 574t

for rheumatoid arthritis, 1605t1607t, 1612

Bladder outlet obstruction, 1106

Blood gas values

types of, 1530

Brace, SOMI, 1519, 1519f

sexuality and, 1295sites of, 1284, 1284f

definition of, 446

dressings in, 457, 458f, 460b

hyperparathyroidism and, 1275

oral, 510512, 945947, 946t947t

Capillary fragility test, 630t

gender differences in, 698b

materials for, 1554

Cell death, programmed, 670

in spinal surgery, 15911592

classification of, 256

emergency management of, 542t

Cholesterol, 702, 703t707t, 708, 741. See also Hyperlipidemia;

collaborative care for, 11461149, 1146t

patient teaching for, 581t, 597t, 603t

Clostridial food poisoning, 979t, 983t

radiation therapy for, 1014

nursing roles in, 75

patient teaching for, 86

Constipation, 881, 988990, 990t, 991t

Cor pulmonale, 556f, 558, 558t

pathophysiology of, 738, 739f740f

in muscle disorders, 15401542t

race and, 2223, 23t

pathophysiology of, 606607

Demand analgesia, 130

Desirudin (Iprivask), for venous thromboembolism, 863

culturally competent care for, 1206

hemodialysis, 11381139, 11561157. See also Hemodialysis.