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LWBK397-FM pi-x.qxd9/1/0912:11 PMHANDBOOKPage iFORBRUNNER & SUDDARTH’STextbook ofMedical-SurgicalNursingTWELFTH EDITION

LWBK397-FM pi-x.qxd9/1/0912:11 PMPage iiAcquisitions Editor: Hilarie SurrenaProduct Director: Renee GagliardiVendor Manager: Cindy RudyDesign Coordinator: Joan WendtSenior Manufacturing Manager: William AlbertiCompositor: Aptara, Inc.12th EditionCopyright 2010 by Wolters Kluwer Health / Lippincott Williams & Wilkins.Copyright 2008, 2004, 2000 by Lippincott Williams & Wilkins. All rights reserved. Thisbook is protected by copyright. No part of it may be reproduced, stored in a retrieval system,or transmitted, in any form or by any means—electronic, mechanical, photocopy, recording,or otherwise—without prior written permission of the publisher, except for brief quotationsembodied in critical articles and reviews and testing and evaluation materials provided bypublisher to instructors whose schools have adopted its accompanying textbook. Printed inthe United States of America. For information write Wolters Kluwer Health/LippincottWilliams & Wilkins, 530 Walnut Street, Philadelphia, PA 19106.Materials appearing in this book prepared by individuals as part of their official duties as U.S.Government employees are not covered by the above-mentioned copyright.9 8 7 6 5 4 3 2 1Library of Congress Cataloging-in-Publication DataHandbook for Brunner & Suddarth’s textbook of medical-surgical nursing.—12th ed.p. ; cm.Rev. ed. of: Handbook for Brunner & Suddarth’s textbook ofmedical-surgical nursing / Joyce Young Johnson. 11th ed. c2008.Includes index.ISBN 978-0-7817-8592-11. Nursing—Handbooks, manuals, etc. 2. Surgical nursing—Handbooks,manuals, etc. I. Johnson, Joyce Young. Handbook for Brunner &Suddarth’s textbook of medical-surgical nursing. II. Title: Textbook ofmedical-surgical nursing. III. Title: Handbook for Brunner andSuddarth’s textbook of medical-surgical nursing.[DNLM: 1. Nursing Care—Handbooks. 2. Perioperative Nursing—Handbooks. WY 49 H2326 2010]RT41.J56 2010617'.0231—dc222009028731ISBN-13: 978-0-7817-8592-1Care has been taken to confirm the accuracy of the information presented and to describegenerally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the informationin this book and make no warranty, express or implied, with respect to the content of thepublication.The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendationsand practice at the time of publication. However, in view of ongoing research, changes ingovernment regulations, and the constant flow of information relating to drug therapy anddrug reactions, the reader is urged to check the package insert for each drug for any changein indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug.Some drugs and medical devices presented in this publication have Food and DrugAdministration (FDA) clearance for limited use in restricted research settings. It is theresponsibility of the health care provider to ascertain the FDA status of each drug or deviceplanned for use in his or her clinical practice.LWW.com

LWBK397-FM pi-x.qxd9/1/0912:11 PMPage iiiPrefaceThis Handbook for Brunner & Suddarth’s Textbook of MedicalSurgical Nursing, 12th edition, is a comprehensive yet conciseclinical reference designed for use by nursing students and professionals. Perfect for use across multiple health care settings,the Handbook presents need-to-know information on nearly200 commonly encountered diseases and disorders. The easyto-use, colorful, consistent, and alphabetized outline formatenables readers to gain quick access to vital information on Disease (Pathophysiology) Clinical Manifestations Assessment and Diagnostic Methods Medical, Surgical, and Pharmacologic Management Nursing Management according to the Nursing ProcessFor readers requiring more in-depth information, theHandbook is completely cross-referenced to chapters in Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 12th edition.Special FeaturesThe Handbook places special emphasis on home- and community-based nursing practice, patient education, andexpected outcomes of care. Additional features include thefollowing:Gerontologic Considerations—Thumbnail descriptions andinterventions related to the care of the older adult population,whose health care needs continue to expand at a rapid rate.Nursing Alerts—Instant notes focused on priority care issuesand hazardous or potentially life-threatening situations.iii

LWBK397-FM pi-x.qxd9/1/0912:11 PMPage iviv PrefaceSelected tables and boxes—At-a-glance presentations of additional diseases, disorders, measurements, and the like.Up-to-date appendices for use in clinicals, on the unit, and athome or in the community. These include the following: Important lab values Current nursing diagnoses Acronyms and abbreviations

LWBK397-FM pi-x.qxd9/1/0912:11 PMPage vContentsAAcquired Immunodeficiency Syndrome(HIV Infection) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Acute Coronary Syndrome and MyocardialInfarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Acute Respiratory Distress Syndrome . . . . . . . . . . . . . . . . . 22Addison’s Disease (Adrenocortical Insufficiency) . . . . . . . 25Alzheimer’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28Amyotrophic Lateral Sclerosis . . . . . . . . . . . . . . . . . . . . . . 33Anaphylaxis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37Anemia, Aplastic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41Anemia, Iron Deficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . 43Anemia, Megaloblastic (Vitamin B12 and FolicAcid Deficiency) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45Anemia, Sickle Cell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48Aneurysm, Aortic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54Aneurysm, Intracranial . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57Angina Pectoris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62Aortic Insufficiency (Regurgitation) . . . . . . . . . . . . . . . . . . 66Aortic Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69Arterial Embolism and Arterial Thrombosis . . . . . . . . . . . 71Arteriosclerosis and Atherosclerosis . . . . . . . . . . . . . . . . . . 73Arthritis, Rheumatoid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80Asthma: Status Asthmaticus . . . . . . . . . . . . . . . . . . . . . . . . 82BBack Pain, Low . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85Bell’s Palsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88Benign Prostatic Hyperplasia and Prostatectomy . . . . . . . . 90Bone Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92v

LWBK397-FM pi-x.qxd9/1/0912:11 PMPage vivi ContentsBowel Obstruction, Large . . . . . . . . . . . . . . . . . . . . . . . . . . 96Bowel Obstruction, Small . . . . . . . . . . . . . . . . . . . . . . . . . . 97Brain Abscess . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99Brain Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100Bronchiectasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104Bronchitis, Chronic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105Buerger’s Disease (Thromboangiitis Obliterans) . . . . . . . . 106Burn Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108CCancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121Cancer of the Bladder . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136Cancer of the Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138Cancer of the Cervix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147Cancer of the Colon and Rectum(Colorectal Cancer) . . . . . . . . . . . . . . . . . . . . . . . . . . 151Cancer of the Endometrium . . . . . . . . . . . . . . . . . . . . . . . 158Cancer of the Esophagus . . . . . . . . . . . . . . . . . . . . . . . . . . 159Cancer of the Kidneys (Renal Tumors) . . . . . . . . . . . . . . 161Cancer of the Larynx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164Cancer of the Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171Cancer of the Lung (Bronchogenic Carcinoma) . . . . . . . 175Cancer of the Oral Cavity and Pharynx . . . . . . . . . . . . . . 178Cancer of the Ovary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180Cancer of the Pancreas . . . . . . . . . . . . . . . . . . . . . . . . . . . 181Cancer of the Prostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184Cancer of the Skin (Malignant Melanoma) . . . . . . . . . . 191Cancer of the Stomach (Gastric Cancer) . . . . . . . . . . . . 196Cancer of the Testis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200Cancer of the Thyroid . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202Cancer of the Vagina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203Cancer of the Vulva . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204Cardiac Arrest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207Cardiomyopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213Cerebral Vascular Accident (Ischemic Stroke) . . . . . . . . 214Cholelithiasis (and Cholecystitis) . . . . . . . . . . . . . . . . . . 225Chronic Obstructive Pulmonary Disease (COPD) . . . . . 231Cirrhosis, Hepatic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235Constipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238Contact Dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240Coronary Atherosclerosis and CAD . . . . . . . . . . . . . . . . . 241