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DEWITT’S MEDICAL-SURGICAL NURSING: CONCEPTS
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AND PRACTICE, 4TH EDITION by Holly K. Stromberg.
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,TABLE OF CONTENT
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Chapter 01: Caring for Medical-Surgical Patients ......................................................................................... 4
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Chapter 02: Critical Thinking and the Nursing Process ............................................................................. 14
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Chapter 03: Fluid, Electrolytes, Acid-Base Balance, and Intravenous Therapy ........................................ 24
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Chapter 04: Care of Preoperative and Intraoperative Surgical Patients ..................................................... 34
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Chapter 05: Care of Postoperative Patients ................................................................................................. 44
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Chapter 06: Infection Prevention and Control ............................................................................................. 54
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Chapter 07: Care of Patients with Pain ....................................................................................................... 64
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Chapter 08: Care of Patients with Cancer ................................................................................................... 74
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Chapter 09: Chronic Illness and Rehabilitation ........................................................................................... 84
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Chapter 10: The Immune and Lymphatic System ....................................................................................... 95
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Chapter 11: Care of Patients with Immune and Lymphatic Disorders (with HIV and AIDS).....................105
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Chapter 12: The Respiratory System...........................................................................................................116
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Chapter 13: Care of Patients with Disorders of the Upper Respiratory System ......................................126
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Chapter 14: Care of Patients with Disorders of the Lower Respiratory System ......................................136
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Chapter 15: The Hematologic System ........................................................................................................147
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Chapter 16: Care of Patients with Hematologic Disorders ........................................................................157
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Chapter 17: The Cardiovascular System .....................................................................................................167
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Chapter 18: Care of Patients with Hypertension and Peripheral Vascular Disease..................................177
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Chapter 19: Care of Patients with Cardiac Disorders ................................................................................187
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Chapter 20: Care of Patients with Coronary Artery Disease and Cardiac Surgery ..................................197
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Chapter 21: The Neurologic System ...........................................................................................................208
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Chapter 22: Care of Patients with Head and Spinal Cord Injuries ...........................................................218
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Chapter 23: Care of Patients with Disorders of the Brain ........................................................................228
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Chapter 24: Care of Patients with Peripheral Nerve and Degenerative Diseases .....................................238
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Chapter 25: The Sensory System: Eye and Ear .........................................................................................248
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Chapter 26: Care of Patients with Disorders of the Eyes and Ears ..........................................................258
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Chapter 27: The Gastrointestinal System....................................................................................................269
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Chapter 28: Care of Patients with Disorders of the Upper Gastrointestinal System ................................280
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Chapter 29: Care of Patients with Disorders of the Lower Gastrointestinal System ...............................291
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Chapter 30: Care of Patients with Disorders of the Liver, Gallbladder, and Pancreas ..................................302
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Chapter 31: The Musculoskeletal System ...................................................................................................313
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Chapter 32: Care of Patients with Musculoskeletal and Connective Tissue Disorders ............................323
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Chapter 33: The Urinary System .................................................................................................................334
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Chapter 34: Care of Patients with Disorders of the Urinary System ........................................................346
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Chapter 35: The Endocrine System.............................................................................................................358
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Chapter 36: Care of Patients with Pituitary, Thyroid, Parathyroid, and Adrenal Disorders ..........................368
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Chapter 37: Care of Patients with Diabetes and Hypoglycemia................................................................380
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Chapter 38: Care of Women with Reproductive Disorders .......................................................................392
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Chapter 39: Care of Men with Reproductive Disorders ............................................................................404
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,Chapter 40: Care of Patients with Sexually Transmitted Infections..........................................................416
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Chapter 41: The Integumentary System ......................................................................................................426
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Chapter 42: Care of Patents with Integumentary Disorders and Burns ....................................................436
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Chapter 43: Care of Patients in Disasters or Bioterrorism Attack ............................................................447
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Chapter 44: Care of Patients with Emergencies, Trauma, and Shock.......................................................457
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Chapter 45: Care of Patients with Anxiety, Mood, and Eating Disorders ................................................469
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Chapter 46: Care of Patients with Substance Abuse Disorders .................................................................479
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Chapter 47: Care of Patients with Cognitive Disorders .............................................................................490
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Chapter 48: Care of Patients with Thought and Personality Disorders.....................................................500
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, Chapter 01: Caring for Medical-Surgical Patients
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deWit: Medical-Surgical Nursing: Concepts & Practice, 4th Edition
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MULTIPLE CHOICE mz
1. Which statement accurately describes the primary purpose of the state nurse practice
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act (NPA)?
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a. To test and license LPN/LVNs.
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b. To define the scope of LPN/LVN practice.
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c. To improve the quality of care provided by the LPN/LVN.
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d. To limit the LPN/LVN employment placement.
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ANS: m z B
While improving quality of care provided by the LPN/LVN may be a result of the NPA, the
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primary purpose of the NPA of each state defines the scope of nursing practice in that
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state.
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PTS: 1 DIF: Cognitive Level: Comprehension
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OBJ: 3 TOP: NPA
m z KEY: Nursing Process Step: Implementation m z mz mz mz m
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MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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2. The charge nurse asks the new vocational nurse to start an intravenous infusion, a skill that
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the vocational nurse has not been taught during her educational program. How should the
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vocational nurse respond?
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a. Ask a more experienced nurse to demonstrate the procedure.
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b. Look up the procedure in the procedure manual.
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c. Attempt to perform the procedure with supervision. mz mz mz mz mz mz
d. Inform the charge nurse of her lack of training in this procedure.
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ANS: m z D
The charge nurse should be informed of the lack of training to perform the procedure, and
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the vocational nurse should seek further training to gain proficiency. Although the other
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options might be helpful, they are not safe.
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PTS: 1 DIF: Cognitive Level: Application REF: 3 mz mz mz
OBJ: 1 TOP: Providing Safe Care
m z KEY: Nursing Process Step: m z mz mz mz mz mz
N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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3. Which patient statement indicates a need for further discharge teaching that the
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vocational nurse should address?
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a. ―I have no idea of how this drug will affect me.‖
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b. ―Do you know if my physician is coming back today?‖
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c. ―Will my insurance pay for mystay?‖ mz mz mz mz mz
d. ―Am I going to have to go to a nursing home?‖
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ANS: m z A
Lack of knowledge at discharge about medication effects and side effects is a concern that
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should be addressed by the vocational nurse. The other concerns in the options are the
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responsibility of other departments to which the nurse might refer the patient.
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PTS: m z m z 1 DIF: Cognitive Level: Application REF: 2 mz mz mz
OBJ: m z m z 1 TOP: Teaching KEY: Nursing Process Step: Implementation
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