Title Details

Ian Peate OBE FRCN is Editor in Chief of the British Journal of Nursing, Visiting Professor of Nursing, St George's University of London and Kingston University London, and Head of School at the School of Health Studies, Gibraltar.

Karen Wild, formerly Senior Lecturer in Nursing, Student Opportunity Lead and Admissions Lead at the School of Health and Society, University of Salford, UK.

Preface xiv

Acknowledgements xvi

About the Editors xvii

Contributors xviii

How to Use Your Textbook xxii

About the Companion Website xxiv

Unit 1 Contextualising the Art and Science of Nursing 1

1 Nursing: Past, Present and Future 2

Introduction 3

A Glance at the History of Nursing 4

The Beginnings of the NHS and Nursing 9

Early Nursing Research 10

Modernising Nursing Careers 12

Current Nurse Education 15

The Francis Report 16

The Quality Assurance Framework for Nursing and Midwifery 18

The NHS and Healthcare Reform 19

Conclusion 21

Key Points 22

Glossary 22

References 22

2 The Professional Nurse and Contemporary Healthcare 24

Introduction 25

Teaching and Learning in Practice 30

Theoretical Frameworks for Teaching and Learning 33

The Adult Learner 37

Revalidation and Continuing Professional Development 38

Leadership Styles and Theories 40

Evidence-based Practice 42

Change Management 44

Clinical Governance 45

Interprofessional Working 46

Working in Collaboration with Patients 46

Conclusion 47

Key Points 47

Glossary 48

References 48

3 Health Promotion 50

Introduction 51

Health Promotion 51

Interpersonal Skills for Nursing and Health Promotion 57

Motivational Interviewing and Brief Interventions 57

Models of Health Promotion 58

Frameworks for Supporting Health 59

The Contemporary Focus of Health Promotion 62

Travel Health 67

Conclusion 68

Key Points 69

Glossary 69

References 69

4 Public Health 71

Introduction 72

Setting the Scene for Public Health in the UK 72

Public Health England 76

Health Inequalities 76

Epidemiology and Public Health 80

Health Protection 81

Primary Care Nursing 82

District Nursing 82

Community Matrons 84

Health Visitor and School Health Advisor 85

Conclusion 88

Key Points 88

Glossary 88

References 89

Unit 2 The Elements of Care 91

5 Ethics, the Law and the Nurse 92

Introduction 93

Approaches to Ethics 95

Ethical Principles 97

Legal and Ethical Dilemmas in Nursing 98

Legal Perspectives 102

Accountability 106

Conclusion 109

Key Points 109

Glossary 109

References 110

6 The Nursing Process 111

Introduction 112

Defining Nursing 112

Organisational Models of Care 114

The Nursing Process 118

A Systematic Approach 119

Patient Goals 121

Nursing Goals: A Lost Art? 121

Writing the Care Plan 122

How Does ‘Intentional Rounding’ Fit In? 124

Compassion 125

Conclusion 126

Key Points 126

Glossary 126

References 127

7 Models of Nursing 129

Introduction 130

Nursing Theory 130

History and Principles 132

A Framework for Children’s Nursing 135

The Tidal Model in Mental Health Nursing 136

The Art and Science of Nursing 138

Patient-centred Care and Safety 140

Conclusion 142

Key Points 143

Glossary 143

References 143

Unit 3 The Principles of Care 147

8 The Principles of Safeguarding and Dignity 148

Introduction 149

What Is Safeguarding? 149

Principles of Safeguarding 149

What Is Abuse or Harm? 153

Safeguarding Is Everybody’s Business 155

Policy Framework for Safeguarding Adults 155

Responding to Disclosures 156

Key Stages of the Adult Safeguarding Process 157

Preventing the Abuse of Adults at Risk 160

What Is Dignity? 162

What Is Respect? 163

Thinking About and Understanding Dignity 163

Types of Dignity 165

Essence of Care 2010 168

Influencing Dignity in Care Practice 168

Conclusion 168

Key Points 169

Glossary 169

References 169

9 The Principles of Older People’s Care 171

Introduction 172

Attitudes and Stereotyping 172

Effective Communication 173

Patient-centred Care 175

The Older Person’s Nutritional Needs 178

Pressure Ulcer Prevention 182

Falls Prevention 183

After a Fall 185

Discharge Planning 186

Key Points 189

Glossary 189

References 189

10 The Principles of Caring for People with Learning Disabilities and/or Autism 193

Introduction 194

Definitions of Learning Disabilities 195

Autistic Spectrum Conditions Defined 196

Prevalence and Causes of Learning Disabilities 197

Classification of Learning Disability 197

Inequalities in Health Care 198

Attitudes Towards People with Learning Disabilities 199

Supporting Access to Services 199

Communication 203

Legal Aspects 205

Safeguarding 206

Conclusion 208

Key Points 208

Glossary 208

References 208

11 Principles of Caring for Children and Families 210

Introduction 211

The Key Stages in Relation to the Development of Infants, Children and Young People 211

A Range of Communication Strategies 214

Some Common Physical and Mental Health Problems 218

Basic/Fundamental Care Needs 223

The Importance of Acting to Protect Infants, Children and Young People 227

Identifying Signs of Deterioration in General Health 229

Best Practice Relating to End of Life Care 232

Key Points 233

Glossary 233

References 234

12 The Principles of Caring for People with Mental Health Problems 236

Introduction 237

Policy Content 237

What Is Mental Disorder? 238

Settings for Mental Health Care 240

Recovery 241

Holism 241

Caring for Carers 242

Comprehensive Assessment in Mental Health 242

The Physical Health of People with Mental Health Problems 243

Risk Assessment and Management 244

Legal Context 246

Therapeutic Nursing Care 247

Conclusion 249

Key Points 249

Glossary 250

References 250

13 The Principles of Maternity Care 254

Introduction 255

The Role of the Midwife in Maternity Care 255

Overview of the Physiology of Pregnancy 255

Overview of Antenatal Care 256

Overview of Intranatal Care 260

Midwifery Care in Normal Labour 262

Unexpected and Rapid Deliveries 263

Initial Care of the Mother and Baby after Birth 263

Overview of Postnatal Care: Mother 264

Health and Advice in the Postnatal Period 265

Care of the Neonate after Birth 266

Infant Feeding 267

Conclusion 268

Key Points 268

Glossary 268

References 269

14 The Principles of Surgical Care 270

Introduction 271

The Classification of Surgery and Risk 271

The Phases of Surgery 272

Complications of Surgery 280

Further Care of the Surgical Patient 282

Discharge 284

Day-case Surgery 285

Conclusion 285

Key Points 285

Glossary 286

References 286

15 The Principles of Cancer Care 288

Introduction 289

Pathophysiology 290

Signs and Symptoms 291

Investigations and Diagnosis 292

Treatment of Cancer 293

Other Problems Resulting from All Cancer Therapies 303

Survivorship 303

End of Life Care 305

Conclusion 305

Key Points 305

Glossary 305

References 306

16 The Principles of Infection Control 307

Introduction 308

Development of Infection Control Practices 308

Preventing the Spread of Infection 309

Common Healthcare-associated Infections 314

Antimicrobial Resistance 319

Care and Treatment for People with Infectious

Diseases 319

Diagnostic Tests and Treatment 325

Technology and Infection Control 328

Conclusion 329

Key Points 329

Glossary 329

References 330

17 The Principles of Nutrition 332

Introduction 333

The Nutrients 333

A Healthy Diet 335

Physiology of the Alimentary System 335

Undernourishment and Malnutrition 338

Nutritional Support 340

Obesity 342

Diabetes and Nutrition 343

Nutrition and Mental Illness 344

Hydration 345

Nutrition and Wound Healing 345

Nutrition for the Person Who Is Dying 346

Hospital Nutrition Services 347

Conclusion 348

x Contents

Key Points 348

Glossary 348

References 348

18 The Principles of Skin Integrity 350

Introduction 351

Anatomy and Physiology of the Skin 351

Function of the Skin 354

Wound Healing (Figure 18.6) 355

Psycho-Socioeconomic Aspects of Wound Care 356

The Quality Agenda and Wound Management 357

Wound Care and Management 359

Nursing Management 370

Multiple Pathology and Wound Care 372

Conclusion 373

Key Points 373

Glossary 373

References 374

19 The Principles of Medicine Administration and Pharmacology 376

Introduction 377

Pharmacology 377

Person Group Directions 384

Changing Demography of the UK 386

Generic and Brand Names 386

Legislation and Policies Governing Drug Administration 386

Cold Chain 388

Preparation of Drugs 388

Medical Abbreviations 392

Compliance, Concordance and Adherence 393

Some Common Drugs Used in Practice and Their Action 393

Drug Calculations 400

Conclusion 401

Key Points 402

Glossary 402

References 402

20 Care at the End of Life 404

Introduction 405

Where Do Our Ideas about Death and Dying Come From? 405

The Death of Personhood 406

Care at the End of Life 407

Advance Care Planning 412

Care in the Last few Days of Life 415

Communication 417

Breaking Bad News 421

Culture and Ethnicity 422

Grief, Loss and Bereavement 424

Who Cares for the Carers? 425

Conclusion 426

Key Points 427

Glossary 427

References 427

21 The Principles of Supporting Families and Carers in Practice 430

Introduction 431

Carers 431

Families 435

Opportunities for Family and Carer Involvement 438

Adaptability and Coping 441

The Impact of Caregiving 443

Interventions to Support Families and Carers 447

Conclusion 448

Key Points 449

Glossary 449

References 449

Unit 4 The Scientific Nature of Disease 453

22 The Cell 454

Introduction 455

The Chemical Level 456

The Genetic Level 459

The Cellular Level 474

The Tissue Level 476

Conclusion 478

Key Points 478

Glossary 478

References 479

23 Immunity, Inflammation and Infection 480

Introduction 481

Inflammation 481

An Introduction to the Classification of Microbes/Microorganisms 483

The Lymphatic System and Immunity 484

The Cells of Immunity 491

Chemical Proteins Involved in Immunity 494

Immunity in Action 496

Disorders of the Immune System 499

Immunodeficiency 502

Conclusion 503

Key Points 503

Glossary 503

References 503

24 Pain Management 504

Introduction 505

The Physiology of Pain 505

The Classification of Pain 508

Pain Theory 512

Pain Assessment 513

Pain Management 514

Nursing Management of Acute Pain 519

Nursing Management of Chronic Pain 522

Conclusion 524

Key Points 524

Glossary 525

References 526

25 Fluid and Electrolyte Imbalance, and Shock 528

Introduction 529

Fluid Balance 529

Electrolyte Imbalance 537

Shock 545

Conclusion 549

Key Points 549

Glossary 549

References 550

Unit 5 The Art and Science of Nursing Care 551

26 The Person with a Cardiovascular Disorder 552

Introduction 553

Anatomy and Physiology of the Heart 553

Anatomy and Physiology of the Blood Vessels 558

Assessing the Cardiovascular System 561

Disorders of the Cardiovascular System 563

Conclusion 575

Key Points 576

Glossary 576

References 576

27 The Person with a Haematological Disorder 578

Introduction 579

Composition of Blood 579

Red Blood Cells 579

Conditions Associated with the Red Cells 581

White Blood Cells and Lymphoid Tissue Disorders 590

The Lymphatic System 591

Conditions Associated with the White Blood Cells 591

Platelet and Haemostasis Disorders 599

Conclusion 602

Key Points 603

Glossary 603

References 603

28 The Person with a Respiratory

Disorder 605

Introduction 606

Anatomy and Physiology 606

Respiratory Disease 617

Respiratory Failure 617

Respiratory Tract Infection 621

Obstructive Lung Disorders 624

Restrictive Lung Disorders 628

Lung Cancer 629

Pleural Disorders 630

Interstitial Lung Disease (Diffuse Parenchymal Lung Disease) 631

Conclusion 631

Key Points 631

Glossary 631

References 633

29 The Person with a Gastrointestinal Disorder 635

Introduction 636

Anatomy and Physiology 636

Peptic Ulcer 644

Carcinoma of the Stomach 646

Hepatitis 648

Inflammatory Bowel Disease 651

Stomas 653

Gallbladder Disorders 657

Conclusion 660

Key Points 660

Glossary 660

References 660

30 The Person with a Urinary Disorder 662

Introduction 663

Anatomy and Physiology 663

Urinary Tract Infection 669

Renal Calculi 670

Bladder Cancer 672

Renal Tumour 675

Renal Failure 677

Acute Kidney Injury 677

Chronic Kidney Disease 680

Conclusion 683

Key Points 684

Glossary 684

References 684

31 The Woman with a Reproductive Disorder 686

Introduction 687

Anatomy and Physiology 687

Assessing the System 692

Abnormal Menstrual Bleeding 695

The Menopause 697

Disorders of the Female Reproductive System 699

Gynaecological Oncology 704

Female Genital Mutilation 711

Breast Disease 711

Breast Surgery 713

Conclusion 715

Key Points 715

Glossary 715

References 715

32 The Man with a Reproductive Disorder 717

Introduction 718

Anatomy and Physiology 718

Assessing the System 723

Testicular Disorders 728

Prostate Disease 731

Erectile Dysfunction 739

Circumcision 742

Conclusion 743

Key Points 743

Glossary 744

References 744

33 The Person with a Sexually Transmitted Infection 746

Introduction 747

Assessing the System 748

Features of STIs 755

Preventing STIs 756

Partner notification 756

Genital Warts 756

Gonorrhoea 758

Syphilis 762

Conclusion 765

Key Points 765

Glossary 765

References 766

34 The Person with an Endocrine Disorder 768

Introduction 769

Anatomy and Physiology of the Endocrine System 770

Anatomy and Physiology of the Individual Endocrine Glands 772

Assessing the Endocrine System 780

Hypopituitarism (Pituitary Insufficiency) 781

Disorders of the Thyroid Gland 783

Disorders of the Parathyroid Glands 787

Disorders of the Adrenal Glands 788

Diabetes Mellitus 791

Conclusion 794

Key Points 794

Glossary 794

References 795

35 The Person with a Neurological Disorder 797

Introduction 798

Anatomy and Physiology 798

Nursing Assessment of the Neurological System 811

The Unconscious Patient 819

The Patient with Raised Intracranial Pressure 822

Traumatic Brain Injury (Head Injury) 823

Stroke 827

Neurological Oncology 830

Infections of the CNS 832

Epilepsy 833

Headaches 836

Multiple Sclerosis 838

Parkinson’s Disease 841

Alzheimer’s Disease and Related Disorders 843

Peripheral Neuropathy 845

Conclusion 846

Key Points 846

Glossary 847

References 847

36 The Person with an Ear or Eye Disorder 850

Introduction 851

Anatomy and Physiology of the Ear 851

Assessing the Person with an Ear Problem 856

Common Conditions of the Ear 858

Anatomy and Physiology of the Eye 863

Assessing Vision 867

Common Conditions of the Eye 870

Cataract Surgery 873

Conclusion 876

Key Points 876

Glossary 876

References 877

37 The Person with a Musculoskeletal Disorder 879

Introduction 880

Anatomy and Physiology 880

Musculoskeletal Conditions 888

Assessing the Musculoskeletal System 891

Arthritis 892

Fractured Neck of Femur 897

Caring for People with Plaster Casts 903

Conclusion 904

Key Points 905

Glossary 905

References 907

38 The Person with a Skin Disorder 909

Introduction 910

Anatomy and Physiology 910

Assessment 910

Skin Infections: Viral, Bacterial and Fungal 915

Infestations 918

Acne 919

Rosacea 921

Psoriasis 922

Eczema 923

Skin Tumours 923

Vascular Disorders (Including Naevi) 925

Disorders of the Hair and Nails 926

Connective Tissue Disorders 928

Conclusion 929

Key Points 929

Glossary 929

References 930

Appendix A Reference Values in Venous Serum (Adults) 931

Appendix B List of Units 934

Index 935