Clinical Reasoning Cases in Nursing
SEVENTH EDITION
Mariann Harding, PhD, RN, CNE Associate Professor, Department of Nursing, Kent State University at Tuscarawas, New Philadelphia, Ohio
Julie S. Snyder, MSN, RN-BC Lecturer, School of Nursing, Regent University, Virginia Beach, Virginia
Table of Contents
Cover image
Inside Front Cover
Brief Contents
Title page
Copyright
Contributors
Reviewers
Introduction
What Is Clinical Reasoning?
What Is New in This Edition
The “How To” of Case Studies
Acknowledgments
1: Perfusion
Case Study 1
Case Study 2
Case Study 3
Case Study 4
Case Study 5
Case Study 6
Case Study 7
Case Study 8
Case Study 9
Case Study 10
Case Study 11
Case Study 12
Case Study 13
Case Study 14
Case Study 15
Case Study 16
Case Study 17
Case Study 18
Case Study 19
Case Study 20
Case Study 21
Case Study 22
2: Gas Exchange
Case Study 23
Case Study 24
Case Study 25
Case Study 26
Case Study 27
Case Study 28
Case Study 29
Case Study 30
Case Study 31
Case Study 32
Case Study 33
Case Study 34
Case Study 35
Case Study 36
Case Study 37
Case Study 38
Case Study 39
Case Study 40
3: Mobility
Case Study 41
Case Study 42
Case Study 43
Case Study 44
Case Study 45
Case Study 46
Case Study 47
Case Study 48
Case Study 49
Case Study 50
Case Study 51
Case Study 52
Case Study 53
Case Study 54
4: Digestion
Case Study 55
Case Study 56
Case Study 57
Case Study 58
Case Study 59
Case Study 60
Case Study 61
Case Study 62
Case Study 63
Case Study 64
Case Study 65
Case Study 66
5: Urinary Elimination
Case Study 67
Case Study 68
Case Study 69
Case Study 70
Case Study 71
Case Study 72
Case Study 73
Case Study 74
Case Study 75
6: Intracranial Regulation
Case Study 76
Case Study 77
Case Study 78
Case Study 79
Case Study 80
Case Study 81
Case Study 82
Case Study 83
Case Study 84
Case Study 85
Case Study 86
Case Study 87
Case Study 88
7: Metabolism and Glucose Regulation
Case Study 89
Case Study 90
Case Study 91
Case Study 92
Case Study 93
Case Study 94
Case Study 95
Case Study 96
Case Study 97
Case Study 98
Case Study 99
Case Study 100
8: Immunity
Case Study 101
Case Study 102
Case Study 103
Case Study 104
Case Study 105
Case Study 106
9: Cellular Regulation
Case Study 107
Case Study 108
Case Study 109
Case Study 110
Case Study 111
Case Study 112
Case Study 113
Case Study 114
Case Study 115
10: Tissue Integrity
Case Study 116
Case Study 117
Case Study 118
Case Study 119
11: Cognition
Case Study 120
Case Study 121
Case Study 122
12: Infection and Inflammation
Case Study 123
Case Study 124
Case Study 125
Case Study 126
Case Study 127
Case Study 128
Case Study 129
Case Study 130
13: Developmental
Case Study 131
Case Study 132
Case Study 133
Case Study 134
Case Study 135
Case Study 136
14: Reproductive
Case Study 137
Case Study 138
Case Study 139
Case Study 140
Case Study 141
Case Study 142
Case Study 143
15: Mood, Stress, and Addiction
Case Study 144
Case Study 145
Case Study 146
Case Study 147
Case Study 148
Case Study 149
Case Study 150
Inside Front Cover
Brief Contents Chapter 1 Perfusion, 1 Chapter 2 Gas Exchange, 99 Chapter 3 Mobility, 187 Chapter 4 Digestion, 247 Chapter 5 Urinary Elimination, 301 Chapter 6 Intracranial Regulation, 339 Chapter 7 Metabolism and Glucose Regulation, 401 Chapter 8 Immunity, 455 Chapter 9 Cellular Regulation, 483
Chapter 10 Tissue Integrity, 527 Chapter 11 Cognition, 547 Chapter 12 Infection and Inflammation, 561 Chapter 13 Developmental, 593 Chapter 14 Reproductive, 615 Chapter 15 Mood, Stress, and Addiction, 645
Copyright
CLINICAL REASONING CASES IN NURSING, SEVENTH EDITION ISBN: 978-0-323-52736-1
Copyright © 2020 by Elsevier, Inc. All rights reserved.
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Notice Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or property as a matter of products liability, negligence or
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Previous editions copyrighted 2016, 2013, 2009, 2005, 2001, 1996.
Library of Congress Control Number: 2018954100
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Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 1
Contributors
Meghan Davis, MSN-Ed, CCRN, RN Registered Nurse, Virginia Beach, Virginia
Jatifha C. Felton, MSN-Ed, APRN, ACNCP-AG, CCRN Critical Care Nurse Practitioner, Chesapeake Regional Healthcare, Chesapeake, Virginia
Sherry D. Ferki, RN, MSN Adjunct Faculty, School of Nursing, Old Dominion University, Norfolk, Virginia
Joanna Van Sant, MSN, RN Clinical Nurse Manager–Oncology Unit, Sentara Northern Virginia Medical Center, Woodbridge, Virginia
Reviewers
Heidi Matarasso Bakerman, RN, BA Nursing, MscN Nursing Instructor, Nursing Vanier College, Montreal, Quebec, Canada
Beverly Banks, MSN, BSN, RN Full Time Faculty, Nursing, Alpena Community College, Alpena, Michigan
Mitzi L. Bass, MPH, MSN, RN Assistant Professor of Nursing, School of Nursing and Health Professions, Baltimore City Community College, Baltimore, Maryland
Michelle Bayard, BSN, RN Teacher, Faculty of Careers and Technology: Nursing Vanier College, Montreal, Quebec, Canada
Diana Lynne Burgess, MSN, RN Nursing Faculty—ADN Program, St. Petersburg College of Nursing, St. Petersburg, Florida
Lacey M. Campbell, MSN, RN Program Coordinator Accelerated LPN to RN Program, Texas County Technical College, Houston, Missouri
Diane Cohen, MSN, RN Professor—Nursing, MassBay Community College, Framingham, Massachusetts
Nicola Eynon-Brown, RN(EC), BNSc, MN, NP, CPNP- PC Professor, School of Baccalaureate Nursing, St. Lawrence College, Brockville, Ontario, Canada
Melissa Marie Fischer, MSN, RN ADN Nursing Faculty, Nursing, Blackhawk Technical College, Janesville, Wisconsin
Victoria A. Greenwood, MSN, MSEd, RN-BC Assistant Professor, Nursing, The Sage Colleges, Troy, New York
Rose A. Harding, MSN, RN Coordinator, Standardized Test
Evaluation Committee, JoAnne Gay Dishman School of Nursing, Lamar University, Beaumont, Texas
Antonea Jackson, PhD (c), MSN, RN CNE Clinical Assistant Professor, Nursing, Prairie View A&M University, Houston, Texas
Llynne C. Kiernan, DNP, MSN, RN-BC Assistant Professor of Nursing, Nursing, Norwich University, Northfield, Vermont
Tonie Metheny, MS, RN, CNE Clinical Instructor, Nursing, Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
Kathleen S. Murtaugh, MSN, RN, CNA Assistant Professor, Nursing, St. Elizabeth School of Nursing/University of Saint Francis, Lafayette, Indiana
Karen Noss, MSN, RN Professor, Nursing Department, Luzerne County Community College, Nanticoke, Pennsylvania
Alicia Powell, MSN, RNC Clinical Nurse Educator, Women’s Services, Chesapeake Regional Healthcare, Chesapeake, Virginia
Deborah J. Pumo, MS, RN, EdD Nursing Professor, Nursing Department, Illinois Valley Community College, Oglesby, Illinois
Sandra A. Ranck, MSN, RN Program Administrator, Auburn Practical Nursing Program, Auburn Career Center, Concord Township, Ohio
Cherie R. Rebar, PhD, MBA, RN, COI Professor of Nursing, Wittenberg University, Springfield, Ohio
Alicia N. Rose, ACNS-BC, PMHNP-BC, RN-BC, CSAC Psychiatric Nurse Practitioner, Meridian Psychotherapy, Virginia Beach, Virginia
Jane Tyerman, BA, RN, BScN, MScN, PhD Professor, Trent/Fleming School of Nursing, Trent University, Peterborough, Ontario, Canada
Introduction
To provide safe, quality care, nurses need to have well-developed clinical reasoning skills. As new graduates, you will make decisions and take actions of an increasingly sophisticated nature. You will encounter problems you have never seen or heard about during your classroom and clinical experiences. You will have to make complex decisions with little or no guidance and limited resources.
We want you to be exposed to as much as possible during your student days, but more importantly, we want you to learn to think. You cannot memorize your way out of any situation, but you can think your way out of any situation. We know that students often learn more and faster when they have the freedom to make mistakes. This book is designed to allow you to look at how to solve problems and find answers without the pressure of someone’s life hanging in the balance. We want you to do well. We want you to be the best. It is our wish for you to grow into confident, competent nursing professionals. We want you to be very, very good at what you do!