Medical Surgical Keypoints

Lewis et al: Medical-Surgical Nursing: Assessment and Management of
Clinical Problems, 7th edition
Key Points
Chapter 1: Nursing Practice Today
 Nursing involves the (1) protection, promotion, and optimization of health and abilities;
(2) prevention of illness and injury; (3) alleviation of suffering through the diagnosis and
treatment of human response; and (4) advocacy in the care of individuals, families,
communities, and populations.
 Nurses offer skilled care to those recuperating from illness or injury, advocate for
patients’ rights, teach patients so that they can make informed decisions, support
patients at critical times, and help them navigate the increasingly complex health care
system.
 Certification in nursing specialties (e.g., ambulatory care, critical care, gerontologic,

pediatric, psychiatric and mental health, and community health nursing) is offered
through a variety of nursing organizations.
 Entry-level nurses with an associate or baccalaureate degree in nursing are prepared to

function as generalists. With additional preparation, nurses can assume roles such as
clinical nurse specialist and nurse practitioner.
 The exact roles (i.e., independent, dependent, collaborative) of the nurse are often
determined by state and agency policies. In most cases, the nurse’s role is one of
“interdependence and co-participation” with the patient and other health team members.
 Delegation of nursing interventions to licensed practical nurses/licensed vocational

nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP) is an important function
of the professional nurse.
 Healthy People 2010 is a broad-based program that involves government, private, public,
and nonprofit organizations in preventing disease and promoting health.
 Evidence-based practice (EBP) is the conscientious use of the best evidence (e.g.,
findings from research) in combination with clinician expertise and patient preferences
and values in clinical decision-making.
 Nursing informatics is a specialty that integrates nursing science, computer science, and
Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Key Points 1-2
information science in identifying, collecting, processing, and managing data and

information to support nursing practice, administration, education, and research.
 The five elements of the nursing process are assessment, diagnosis, planning,
implementation, and evaluation. Once begun, the nursing process is not only continuous
but it is also cyclic in nature.
 Standardized nursing terminologies can promote continuity of patient care and provide
data that can support the credibility of the profession.
 Nursing diagnoses describe health states that nurses can legally diagnose and treat.
A three-part nursing diagnosis statement includes the problem, etiology, and signs
and symptoms.
 Collaborative problems are potential or actual complications of disease or treatment

that nurses treat with other health care providers, most frequently physicians.
 The Nursing Outcomes Classification (NOC) is a research-based, standardized

language for nursing outcomes. It is used to evaluate the effects of nursing
interventions. NOC is a list of measures that describes patient outcomes influenced by
nursing interventions.
 The Nursing Interventions Classification (NIC) includes independent and collaborative

interventions that nurses carry out, or direct others to carry out, on behalf of patients.
 A nursing intervention is any treatment based on clinical judgment and knowledge

that a nurse performs to enhance patient outcomes.
 The setting of specific outcomes with outcome indicators is necessary for systematic
measurement of the patient’s progress.
 Outcomes may be developed by writing specific outcome statements or choosing

outcomes from the Nursing Outcomes Classification (NOC).
 The Nursing Interventions Classification (NIC) includes treatments (both physiologic and
psychosocial) that nurses perform in all settings and specialties.
 NIC and NOC provide a common language for communication among nurses and
facilitate computer collection of standardized nursing data.
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Lewis et al: Medical-Surgical Nursing: Assessment and Management of

Clinical Problems, 7th edition

Chapter 1: Nursing Practice Today

 Certification in nursing specialties (e.g., ambulatory care, critical care, gerontologic,

 Entry-level nurses with an associate or baccalaureate degree in nursing are prepared to

 Delegation of nursing interventions to licensed practical nurses/licensed vocational

Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

information science in identifying, collecting, processing, and managing data and

 Collaborative problems are potential or actual complications of disease or treatment

 The Nursing Outcomes Classification (NOC) is a research-based, standardized

 The Nursing Interventions Classification (NIC) includes independent and collaborative

 A nursing intervention is any treatment based on clinical judgment and knowledge

 Outcomes may be developed by writing specific outcome statements or choosing

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