The first and second editions of this book were conceived to provide distilled, up-to-date information
to nursing students and staff nurses about many conditions and diagnoses encountered in
nursing practice. With the third edition, we have responded to the ever-changing health care
environment as well as to the recommendations of our readers and editors. We have held true to
our initial purpose in this third edition: to provide a ready source of information for nurses in a
time of short staffing, brief lengths of stay, and increasing patient acuity in the hospital, in nursing
homes, in rehabilitation centers, and in the home. We have also responded to the everincreasing
need for nurses to understand the scientific basis of their practice by augmenting the
pathophysiology sections that were in the past two editions.
Perhaps the most significant addition to the third edition is a section entitled Genetic Considerations.
Since the completion of the Human Genome Project in 2003, the health care disciplines
are beginning to understand the enormous significance of the human genome sequence,
which provides foundational information that shows us how genes and proteins work together to
promote human health. This section of the book assists practitioners to consider how the genetic
basis of disease is related to environmental factors in health and disease, and how disease susceptibility,
detection of illness, and drug response are related to people’s genetic make-up. We
are indebted to co-author Dr. Terry Beery for the development of the genetic information contained
in this edition.
As in the first edition, we have included relevant information about Gender and Life Span
Considerations, and have enhanced this section with information about racial and ethnic differences
in health and disease. As our society has an ever-increasing diversity, we have developed
this section so that practitioners have a basis from which to develop culturally competent care.
Each entry begins with the Diagnosis Related Group (DRG) category. DRGs were initiated
by the Health Care Financing Administration to serve as an organizing framework to grouprelated
conditions and to stabilize reimbursements. Because they provide a convenient standard
to evaluate hospital care, DRGs are used by institutions and disciplines to measure utilization
and to allocate resources. We have included DRGs to indicate the expected norms in average
length of stay for each entry. Each entry follows the nursing process, with assessment information
incorporated in the History and Physical Assessment sections, the Psychosocial Assessment,
and Diagnostic Highlights. Based on requests from our readers and reviewers, we have
supplemented information on diagnostic testing from earlier editions to provide normal and
abnormal values for the most important diagnostic tests. We have also added a section to explain
the rationale for the test. These detailed, specific sections provide the foundation needed to perform
a comprehensive assessment of the patient’s condition so that a Primary Nursing Diagnosis
can be formulated appropriate to the patient’s specific needs. The Planning and Implementation
section is divided into Collaborative and Independent interventions. The intent of
the Collaborative section is to detail the goals of a multidisciplinary plan of care to manage the
condition or disease. As in the second edition, there is an expanded section on Pharmacologic
Highlights that explores commonly used drugs, their doses, mechanisms of action, and rationales
for use. The Independent section focuses on independent nursing interventions that
demonstrate the core of the art and science of nursing. Each entry then finishes with Documentation
Guidelines and Discharge and Home Healthcare Guidelines to help nurses evaluate the
outcomes of care and to prepare hospitalized patients for discharge.
As with the first and second editions, the idea for the book originated with Joanne Patzek
DaCunha, Publisher at F.A. Davis. The authors salute her creativity, perseverance, enthusiasm,
and vision. More importantly, her gracious friendship and support enabled us to accomplish this
revision with a minimum of difficulty. We also owe a debt of gratitude to Jeff Sommers for his
assistance with manuscript development, editing, proofreading, and supportive cheerleading.
Finally we acknowledge with gratitude the hard work that a host of contributors made to the first
edition.
The entire reason to revise this book is to provide practicing nurses a concise and yet scientifically
sound text to guide the professional practice of nursing. The provision of nursing care in
the 21st century presents us with overwhelming challenges, and yet nursing is the discipline of
choice for millions of practitioners. We hope this book honors the science of nursing and makes
it easier to practice the art of nursing.