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Medical-Surgical Nursing

Demystified

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Medical-Surgical Nursing

Demystified

Mary DiGiulio, RN, MSN, APRN

Donna Jackson, RN, MSN, APRN

Jim Keogh

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DOI: 10.1036/0071494502

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To the memory of Jim, Rose, and Margot

who always believed in me

To Dave

Who means more than he sometimes knows

To Kathleen and Jacqueline

who have the world in front of them

Mary DiGiulio, RN, MSN

To Ken

Thank you for loving me, believing in me, encouraging me, and running the race

with me. I’m glad I have you.

Love, Donna

Donna Jackson, RN, MSN

This book is dedicated to Anne, Sandy, Joanne, Amber-Leigh Christine, and Shawn,

without whose help and support this book couldn’t have been written.

Jim Keogh

This page intentionally left blank

CONTENTS

Introduction xiv

CHAPTER 1 Cardiovascular System 1

How the Cardiovascular System Works 3

Just the Facts 4

Aortic Aneurysm 4

Angina (Angina Pectoris) 7

Myocardial Infarction (MI) 11

Coronary Artery Disease (CAD) 15

Peripheral Arterial Disease (PAD) 18

Cardiac Tamponade 21

Cardiogenic Shock 23

Cardiomyopathy 26

Endocarditis 29

Heart Failure [Congestive Heart Failure (CHF)] 31

Hypertension (HTN) 35

Hypovolemic Shock 38

Myocarditis 41

Pericarditis 42

Pulmonary Edema 45

Raynaud’s Disease 47

Rheumatic Heart Disease 49

Thrombophlebitis 51

Atrial Fibrillation 53

Asystole 56

For more information about this title, click here

viii Medical-Surgical Nursing Demystified

Ventricular Fibrillation 58

Ventricular Tachycardia 59

Aortic Insufficiency (AI) 62

Mitral Insufficiency 63

Mitral Stenosis 65

Mitral Valve Prolapse 67

Tricuspid Insufficiency 69

Crucial Diagnostic Tests 71

Quiz 82

CHAPTER 2 Respiratory System 85

How the Respiratory System Works 86

Just the Facts 87

Acute Respiratory Distress Syndrome (ARDS) 87

Asbestosis 91

Asthma 93

Atelectasis 96

Bronchiectasis 99

Bronchitis 101

Cor Pulmonale 104

Emphysema 107

Lung Cancer 110

Pleural Effusion 113

Pneumonia 115

Pneumothorax 118

Respiratory Acidosis 120

Tuberculosis (TB) 122

Acute Respiratory Failure 124

Pulmonary Embolism 127

Influenza 130

Crucial Diagnostic Tests 132

Quiz 140

CHAPTER 3 Immune System 143

How the Immune System Works 144

Just the Facts 145

Acquired Immunodeficiency Syndrome (AIDS) 145

Anaphylaxis 147

Ankylosing Spondylitis 149

Kaposi’s Sarcoma(KS) 151

Lymphoma 153

Rheumatoid Arthritis 155

Scleroderma 157

Mononucleosis 159

Epstein-Barr Virus/Chronic Fatigue Syndrome 160

Lyme Disease 162

Septic Shock 163

Systemic Lupus Erythematosus (SLE) 165

Crucial Diagnostic Tests 167

Quiz 171

CHAPTER 4 Hematologic System 175

How the Hematologic System Works 176

Just the Facts 177

Anemia 177

Aplastic Anemia (Pancytopenia) 179

Iron Deficiency Anemia 181

Pernicious Anemia 183

Disseminated Intravascular Coagulation (DIC) 185

Hemophilia 187

Leukemia 189

Multiple Myeloma 192

Polycythemia Vera 194

Sickle Cell Anemia 197

Deep Vein Thrombosis (DVT) 199

Idiopathic Thrombocytopenic Purpura (ITP) 201

Crucial Diagnostic Tests 203

Quiz 206

CHAPTER 5 Nervous System 209

How the Nervous System Works 210

Just the Facts 212

Head Injury 212

Amyotrophic Lateral Sclerosis (ALS) 216

Bell’s Palsy 218

Brain Abscess 219

Brain Tumor 222

Cerebral Aneurysm 225

Contents ix

Encephalitis 227

Guillain-Barré Syndrome 230

Huntington’s Disease (Chorea) 232

Meningitis 234

Multiple Sclerosis (MS) 237

Myasthenia Gravis 240

Parkinson’s Disease 243

Spinal Cord Injury 246

Stroke 249

Seizure Disorder 252

Crucial Diagnostic Tests 255

Quiz 258

CHAPTER 6 Musculoskeletal System 261

How the Musculoskeletal System Works 262

Just the Facts 263

Carpal Tunnel Syndrome 263

Fractures 266

Gout 268

Osteoarthritis 271

Osteomyelitis 273

Osteoporosis 275

Crucial Diagnostic Tests 277

Quiz 280

CHAPTER 7 Gastrointestinal System 283

How the Gastrointestinal System Works 284

Just the Facts 286

Appendicitis 286

Cholecystitis 288

Cirrhosis 290

Crohn’s Disease 294

Diverticulitis Disease 297

Gastroenteritis 299

Gastroesophageal Reflux Disease (GERD) 301

Gastrointestinal Bleed 304

Gastritis 306

Hepatitis 308

Hiatal Hernia 311

x Medical-Surgical Nursing Demystified

Intestinal Obstruction and Paralytic Ileus 313

Pancreatitis 315

Peritonitis 317

Peptic Ulcer Disease (PUD) 319

Ulcerative Colitis 322

Crucial Diagnostic Tests 324

Quiz 329

CHAPTER 8 Endocrine System 331

How the Endocrine System Works 332

Just the Facts 333

Hypothyroidism (Myxedema) 333

Hyperthyroidism (Graves’ Disease) 335

Simple Goiter 338

Hypopituitarism 340

Hyperpituitarism (Acromegaly and Gigantism) 341

Hyperprolactinemia 343

Diabetes Insipidus 345

Syndrome of Inappropriate Antidiuretic Hormone

Secretion (SIADH) 346

Addison’s Disease 348

Cushing’s Syndrome 349

Primary Aldosteronism (Conn’s Syndrome) 351

Pheochromocytoma 353

Hypoparathyroidism 354

Hyperparathyroidism 356

Diabetes Mellitus 358

Metabolic Syndrome (Syndrome X/Dysmetabolic

Syndrome) 363

Crucial Diagnostic Tests 365

Quiz 370

CHAPTER 9 Genitourinary System 373

How the Genitourinary System Works 374

Just the Facts 375

Benign Prostatic Hypertrophy (BPH) 375

Bladder Cancer 377

Acute Glomerulonephritis 379

Kidney Cancer 381

Contents xi

Kidney Stones 382

Prostate Cancer 384

Pyelonephritis 386

Renal Failure 388

Testicular Cancer 390

Urinary Tract Infection 392

Crucial Diagnostic Tests 394

Quiz 396

CHAPTER 10 Integumentary System 399

How the Integumentary System Works 400

Just the Facts 401

Burns 401

Dermatitis 403

Skin Cancers 405

Cellulitis 407

Pressure Ulcers 409

Wounds and Healing 411

Crucial Diagnostic Tests 413

Quiz 415

CHAPTER 11 Fluids and Electrolytes 419

How Fluids and Electrolytes Work 420

Just the Facts 422

Hyponatremia 422

Hypernatremia 424

Hypocalcemia 426

Hypercalcemia 428

Hypokalemia 430

Hyperkalemia 432

Hypomagnesemia 434

Hypermagnesemia 436

Metabolic Acidosis 438

Metabolic Alkalosis 440

Hypophosphatemia 441

Hyperphosphatemia 443

Dehydration 444

Crucial Diagnostic Tests 446

Quiz 448

xii Medical-Surgical Nursing Demystified

CHAPTER 12 Mental Health 451

A Look at Mental Health 452

Just the Facts 453

Anxiety 453

Panic Disorder 456

Depression 458

Bipolar Disorder 461

Schizophrenia 463

Anorexia Nervosa 465

Bulimia Nervosa 467

Delirium 469

Quiz 471

CHAPTER 13 Perioperative Care 475

Perioperative Care 476

Surgical Classifications 476

The Preoperative Period 478

The Intraoperative Period 480

The Postoperative Period 482

Just the Facts 484

Cardiovascular Complications 484

Respiratory Complications 486

Infection 488

Gastrointestinal Complications 490

Quiz 492

CHAPTER 14 Women’s Health 495

The Female Body 496

Just the Facts 497

Breast Cancer 497

Cervical Cancer 500

Dysmenorrhea 502

Ectopic Pregnancy 503

Endometrial Cancer 505

Fibroids (Leiomyomas) 507

Infertility 508

Menopause 510

Ovarian Cancer 512

Ovarian Masses, Benign 514

Contents xiii