Fundamental Nursing Skills and Concepts 11th Edition Ebook PDF Version
Fundamental Nursing Skills and Concepts 11th Edition Ebook PDF Version
Fundamental Nursing Skills and Concepts 11th Edition Ebook PDF Version
Evelyn Simmons
Nursing Instructor
Florida State University
Tallahassee, Florida
Deborah Smith, ASN
Nursing Instructor
Oconee Fall Line Technical College
Dublin, Georgia
Deborah Stewart
Nursing Faculty
Cabell County Career Technology Center
Huntington, West Virginia
Lynne Sullivan, MS
Nursing Coordinator
Bristol Plymouth Regional Technical School
Taunton, Massachusetts
Words to Know. These key terms are listed at the beginning of each
chapter and set in boldface type within the text where they appear with or
near their definition. Additional technical terms are italicized throughout
the text. Words to Know and their definitions can also be found in the
glossary in alphabetical order.
Learning Objectives. These student-oriented objectives appear at the
beginning of each chapter to serve as guidelines for acquiring specific
information. They are now numbered so that the corresponding student
and instructors resources can be easily matched.
Nursing Process Focus. The focus on the Nursing Process continues to be
strong. The concepts and paradigm for the nursing process appear in
Chapter 2. The premise is that early familiarity with its components will
reinforce its use in the Skills and sample Nursing Care Plans throughout
the text. Each skill chapter has the most recent Applicable Nursing
Diagnoses that correlate with the types of problems recipients of the
respective skills may have.
Nursing Care Plans. Nursing Care Plans are now accompanied by a
representative photo of a client and a description of a clinical scenario.
This feature has been added to help students identify with a “real person”
and his or her subsequent individualized care. The diagnostic statements
contain three parts for actual diagnoses and two parts for potential
diagnoses. A double-column format lists interventions on one side and
corresponding rationales on the other. The evaluation step is reinforced by
evidence indicating expected outcome achievement.
Skills. The Skills continue to be clustered at the end of each chapter for
ease of access and to avoid interrupting the narrative and distancing
related tables and boxes to locations where they previously seemed out of
context. In addition, each illustration within the Skills has been closely
reviewed to ensure that it complies with Standard Precautions, infection
control guidelines from the Centers for Disease Control and Prevention.
Nursing Guidelines. These mini-procedures provide directions for
performing various kinds of nursing care, or suggestions for managing
client care problems. Illustrations have been relocated or added to the
nursing guidelines to facilitate visual learning.
Client and Family Teaching Boxes. These specially numbered boxes
found throughout the chapters highlight essential education points for
nurses to communicate to clients and their families.
Critical Thinking Exercises. Critical thinking questions appear at the end
of each chapter to facilitate application of the material, using clinical
situations or rhetorical questions.
NCLEX-PN Style Questions. NCLEX-Style questions help students apply
their acquired knowledge by answering items that reflect the formats
within the 2016 NCLEX-PN Test plan. In this edition, a test-taking
strategy has been included after each question. An effort has been made to
include many alternate format items to assist students with the types of
questions they will eventually encounter on their licensing examination. A
cognitive level and classification of the test item accompany each question
to demonstrate how the question correlates with the NCLEX-PN test plan.
Glossary. Found at the back of the book, this is a quick reference of
definitions for Words to Know that are used throughout the text. The
glossary provides the key terms in alphabetical order.
Bibliography. This is a comprehensive listing of references and suggested
readings, including general recommendations as well as unit-specific
citations, which provides a streamlined guide to current literature about
topics discussed in the text.
Detailed Table of Contents. Located at the beginning of the textbook, this
provides an outline of each unit’s and chapter’s subject matter.
USE WITH INTRODUCTORY MEDICAL–SURGICAL
NURSING
Fundamental Nursing Skills and Concepts may be adopted as a single text
for students in a nursing program. Additionally, the book may be adopted
with Introductory Medical–Surgical Nursing by Timby and Smith, as well
as Lippincott’s NCLEX-PN Review Book by Timby and Rupert. The
content, designs, features, and styles of these texts have been coordinated
closely to facilitate understanding and to present a consistent approach to
learning.
TEACHING–LEARNING PACKAGE
The 11th edition of Fundamental Nursing Skills and Concepts features a
compelling and comprehensive complement of additional resources to
help students learn and instructors teach.
STUDENT WORKBOOK
The Workbook for Fundamental Nursing Skills and Concepts, 11th edition,
is available for purchase and provides an engaging review of important
material. Featuring images from the text, review exercises, application
activities, and more NCLEX-PN practice questions, the Workbook
complements this textbook and provides dynamic reinforcement of
everything students need to learn from it. Answers to the exercises in the
Workbook are available to instructors through .
Acknowledgments
I
t is my belief that this text and its ancillary package will facilitate
learning and produce safe, effective practitioners, capable of
providing quality care for diverse clients in a variety of settings.
Thanks go to the following people at Lippincott Williams & Wilkins
for their help in preparing this book and for supporting the revision and
new ideas and organization of the text material:
UNIT 1
Exploring Contemporary Nursing
1 Nursing Foundations
2 Nursing Process
UNIT 2
Integrating Basic Concepts
3 Laws and Ethics
4 Health and Illness
5 Homeostasis, Adaptation, and Stress
6 Culture and Ethnicity
UNIT 3
Fostering Communication
7 The Nurse–Client Relationship
8 Client Teaching
9 Recording and Reporting
UNIT 4
Performing Basic Client Care
10 Asepsis
11 Admission, Discharge, Transfer, and Referrals
12 Vital Signs
13 Physical Assessment
14 Special Examinations and Tests
UNIT 5
Assisting With Basic Needs
15 Nutrition
16 Fluid and Chemical Balance
17 Hygiene
18 Comfort, Rest, and Sleep
19 Safety
20 Pain Management
21 Oxygenation
22 Infection Control
UNIT 6
Assisting the Inactive Client
23 Body Mechanics, Positioning, and Moving
24 Fitness and Therapeutic Exercise
25 Mechanical Immobilization
26 Ambulatory Aids
UNIT 7
The Surgical Client
27 Perioperative Care
28 Wound Care
29 Gastrointestinal Intubation
UNIT 8
Promoting Elimination
30 Urinary Elimination
31 Bowel Elimination
UNIT 9
Medication Administration
32 Oral Medications
33 Topical and Inhalant Medications
34 Parenteral Medications
35 Intravenous Medications
UNIT 10
Intervening in Emergency Situations
36 Airway Management
37 Resuscitation
UNIT 11
Caring for the Terminally Ill
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DANCE ON STILTS AT THE GIRLS’ UNYAGO, NIUCHI
I see increasing reason to believe that the view formed some time
back as to the origin of the Makonde bush is the correct one. I have
no doubt that it is not a natural product, but the result of human
occupation. Those parts of the high country where man—as a very
slight amount of practice enables the eye to perceive at once—has not
yet penetrated with axe and hoe, are still occupied by a splendid
timber forest quite able to sustain a comparison with our mixed
forests in Germany. But wherever man has once built his hut or tilled
his field, this horrible bush springs up. Every phase of this process
may be seen in the course of a couple of hours’ walk along the main
road. From the bush to right or left, one hears the sound of the axe—
not from one spot only, but from several directions at once. A few
steps further on, we can see what is taking place. The brush has been
cut down and piled up in heaps to the height of a yard or more,
between which the trunks of the large trees stand up like the last
pillars of a magnificent ruined building. These, too, present a
melancholy spectacle: the destructive Makonde have ringed them—
cut a broad strip of bark all round to ensure their dying off—and also
piled up pyramids of brush round them. Father and son, mother and
son-in-law, are chopping away perseveringly in the background—too
busy, almost, to look round at the white stranger, who usually excites
so much interest. If you pass by the same place a week later, the piles
of brushwood have disappeared and a thick layer of ashes has taken
the place of the green forest. The large trees stretch their
smouldering trunks and branches in dumb accusation to heaven—if
they have not already fallen and been more or less reduced to ashes,
perhaps only showing as a white stripe on the dark ground.
This work of destruction is carried out by the Makonde alike on the
virgin forest and on the bush which has sprung up on sites already
cultivated and deserted. In the second case they are saved the trouble
of burning the large trees, these being entirely absent in the
secondary bush.
After burning this piece of forest ground and loosening it with the
hoe, the native sows his corn and plants his vegetables. All over the
country, he goes in for bed-culture, which requires, and, in fact,
receives, the most careful attention. Weeds are nowhere tolerated in
the south of German East Africa. The crops may fail on the plains,
where droughts are frequent, but never on the plateau with its
abundant rains and heavy dews. Its fortunate inhabitants even have
the satisfaction of seeing the proud Wayao and Wamakua working
for them as labourers, driven by hunger to serve where they were
accustomed to rule.
But the light, sandy soil is soon exhausted, and would yield no
harvest the second year if cultivated twice running. This fact has
been familiar to the native for ages; consequently he provides in
time, and, while his crop is growing, prepares the next plot with axe
and firebrand. Next year he plants this with his various crops and
lets the first piece lie fallow. For a short time it remains waste and
desolate; then nature steps in to repair the destruction wrought by
man; a thousand new growths spring out of the exhausted soil, and
even the old stumps put forth fresh shoots. Next year the new growth
is up to one’s knees, and in a few years more it is that terrible,
impenetrable bush, which maintains its position till the black
occupier of the land has made the round of all the available sites and
come back to his starting point.
The Makonde are, body and soul, so to speak, one with this bush.
According to my Yao informants, indeed, their name means nothing
else but “bush people.” Their own tradition says that they have been
settled up here for a very long time, but to my surprise they laid great
stress on an original immigration. Their old homes were in the
south-east, near Mikindani and the mouth of the Rovuma, whence
their peaceful forefathers were driven by the continual raids of the
Sakalavas from Madagascar and the warlike Shirazis[47] of the coast,
to take refuge on the almost inaccessible plateau. I have studied
African ethnology for twenty years, but the fact that changes of
population in this apparently quiet and peaceable corner of the earth
could have been occasioned by outside enterprises taking place on
the high seas, was completely new to me. It is, no doubt, however,
correct.
The charming tribal legend of the Makonde—besides informing us
of other interesting matters—explains why they have to live in the
thickest of the bush and a long way from the edge of the plateau,
instead of making their permanent homes beside the purling brooks
and springs of the low country.
“The place where the tribe originated is Mahuta, on the southern
side of the plateau towards the Rovuma, where of old time there was
nothing but thick bush. Out of this bush came a man who never
washed himself or shaved his head, and who ate and drank but little.
He went out and made a human figure from the wood of a tree
growing in the open country, which he took home to his abode in the
bush and there set it upright. In the night this image came to life and
was a woman. The man and woman went down together to the
Rovuma to wash themselves. Here the woman gave birth to a still-
born child. They left that place and passed over the high land into the
valley of the Mbemkuru, where the woman had another child, which
was also born dead. Then they returned to the high bush country of
Mahuta, where the third child was born, which lived and grew up. In
course of time, the couple had many more children, and called
themselves Wamatanda. These were the ancestral stock of the
Makonde, also called Wamakonde,[48] i.e., aborigines. Their
forefather, the man from the bush, gave his children the command to
bury their dead upright, in memory of the mother of their race who
was cut out of wood and awoke to life when standing upright. He also
warned them against settling in the valleys and near large streams,
for sickness and death dwelt there. They were to make it a rule to
have their huts at least an hour’s walk from the nearest watering-
place; then their children would thrive and escape illness.”
The explanation of the name Makonde given by my informants is
somewhat different from that contained in the above legend, which I
extract from a little book (small, but packed with information), by
Pater Adams, entitled Lindi und sein Hinterland. Otherwise, my
results agree exactly with the statements of the legend. Washing?
Hapana—there is no such thing. Why should they do so? As it is, the
supply of water scarcely suffices for cooking and drinking; other
people do not wash, so why should the Makonde distinguish himself
by such needless eccentricity? As for shaving the head, the short,
woolly crop scarcely needs it,[49] so the second ancestral precept is
likewise easy enough to follow. Beyond this, however, there is
nothing ridiculous in the ancestor’s advice. I have obtained from
various local artists a fairly large number of figures carved in wood,
ranging from fifteen to twenty-three inches in height, and
representing women belonging to the great group of the Mavia,
Makonde, and Matambwe tribes. The carving is remarkably well
done and renders the female type with great accuracy, especially the
keloid ornamentation, to be described later on. As to the object and
meaning of their works the sculptors either could or (more probably)
would tell me nothing, and I was forced to content myself with the
scanty information vouchsafed by one man, who said that the figures
were merely intended to represent the nembo—the artificial
deformations of pelele, ear-discs, and keloids. The legend recorded
by Pater Adams places these figures in a new light. They must surely
be more than mere dolls; and we may even venture to assume that
they are—though the majority of present-day Makonde are probably
unaware of the fact—representations of the tribal ancestress.
The references in the legend to the descent from Mahuta to the
Rovuma, and to a journey across the highlands into the Mbekuru
valley, undoubtedly indicate the previous history of the tribe, the
travels of the ancestral pair typifying the migrations of their
descendants. The descent to the neighbouring Rovuma valley, with
its extraordinary fertility and great abundance of game, is intelligible
at a glance—but the crossing of the Lukuledi depression, the ascent
to the Rondo Plateau and the descent to the Mbemkuru, also lie
within the bounds of probability, for all these districts have exactly
the same character as the extreme south. Now, however, comes a
point of especial interest for our bacteriological age. The primitive
Makonde did not enjoy their lives in the marshy river-valleys.
Disease raged among them, and many died. It was only after they
had returned to their original home near Mahuta, that the health
conditions of these people improved. We are very apt to think of the
African as a stupid person whose ignorance of nature is only equalled
by his fear of it, and who looks on all mishaps as caused by evil
spirits and malignant natural powers. It is much more correct to
assume in this case that the people very early learnt to distinguish
districts infested with malaria from those where it is absent.
This knowledge is crystallized in the
ancestral warning against settling in the
valleys and near the great waters, the
dwelling-places of disease and death. At the
same time, for security against the hostile
Mavia south of the Rovuma, it was enacted
that every settlement must be not less than a
certain distance from the southern edge of the
plateau. Such in fact is their mode of life at the
present day. It is not such a bad one, and
certainly they are both safer and more
comfortable than the Makua, the recent
intruders from the south, who have made USUAL METHOD OF
good their footing on the western edge of the CLOSING HUT-DOOR
plateau, extending over a fairly wide belt of
country. Neither Makua nor Makonde show in their dwellings
anything of the size and comeliness of the Yao houses in the plain,
especially at Masasi, Chingulungulu and Zuza’s. Jumbe Chauro, a
Makonde hamlet not far from Newala, on the road to Mahuta, is the
most important settlement of the tribe I have yet seen, and has fairly
spacious huts. But how slovenly is their construction compared with
the palatial residences of the elephant-hunters living in the plain.
The roofs are still more untidy than in the general run of huts during
the dry season, the walls show here and there the scanty beginnings
or the lamentable remains of the mud plastering, and the interior is a
veritable dog-kennel; dirt, dust and disorder everywhere. A few huts
only show any attempt at division into rooms, and this consists
merely of very roughly-made bamboo partitions. In one point alone
have I noticed any indication of progress—in the method of fastening
the door. Houses all over the south are secured in a simple but
ingenious manner. The door consists of a set of stout pieces of wood
or bamboo, tied with bark-string to two cross-pieces, and moving in
two grooves round one of the door-posts, so as to open inwards. If
the owner wishes to leave home, he takes two logs as thick as a man’s
upper arm and about a yard long. One of these is placed obliquely
against the middle of the door from the inside, so as to form an angle
of from 60° to 75° with the ground. He then places the second piece
horizontally across the first, pressing it downward with all his might.
It is kept in place by two strong posts planted in the ground a few
inches inside the door. This fastening is absolutely safe, but of course
cannot be applied to both doors at once, otherwise how could the
owner leave or enter his house? I have not yet succeeded in finding
out how the back door is fastened.