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Contents

Preface xi Acknowledgements xii Dedication xiv List of contributors xv 1 The human body (C. Meurier) 1 Section 1: Introduction 1 Anatomical terms 2 Levels of organisation of the body 4 Hierarchy of functions 5 The basic structure of cells 5 Homeostasis 8 Organ systems 11 Section 2: The integumentary system 11 Structure of the skin 12 Thermoregulation and the skin 14 Section 3: The musculoskeletal system 14 The human skeleton 14 Bone 14 Joints 15 Muscular tissue 16 Section 4: The nervous system 17 Structure and function of the nervous system 17 The central nervous system 19 The autonomic nervous system 22 Sensations 23 Somatic senses 23 Pain 23 Section 5: The special senses 24 The eye 24 The ear 26 Section 6: The endocrine system 28 Hormones 28 Negative and positive feedback mechanisms 28 Section 7: The respiratory system 28 The mechanism of breathing 31 The transport of oxygen 32 The transport of carbon dioxide 33 Section 8: The cardiovascular system 33 The blood 33 The heart 34 Blood vessels: arteries, capillaries and veins 37 Section 9: The lymphatic and immune system 38 Components 38 Functions 38 Section 10: The digestive system 40 Functions 40 Organs of the digestive system and their location 40 Section 11: The urinary system 43 The kidney and its functions 44 Section 12: The reproductive system 46 Female reproductive system 47 The male reproductive organs 49 2 Nursing assessment and care planning (J. Aldridge, A. Eshun and C. Meurier) 52 Introduction 52 Nursing assessment and the nursing process 53 Advantages of using a conceptual model in assessment 71 Key issues and developments 72 3 Concepts of health, illness and holism (C. Meurier) 76 Introduction 76 Being 'healthy' 77 Health beliefs and health behaviour 80 Illness, sickness and disease 82 Seeing the person as a whole 84 Assessment 87 4 Factors to consider when assessing patients (A. Crouch, G. Rumbold, M. Thompson and W. Turner) 95 Section 1: Introduction 95 Ethical aspects of assessment 95 Respect for persons - definition 96 Privacy 98 Confidentiality 99 Respect for dignity 101 Truthfulness 102 Section 2: The environment, health status, age and cognitive ability of the patient, learning disability and health assessment 103 Environment 104 Health status of the patient 105 The patient's age 106 Cognitive development and ability 108 The assessment of children 112 Section 3: Gender and health assessment 114 Trends and patterns of health and disease among men and women 115 Health issues and dilemmas for men and women 116 A health assessment approach: some practical aspects to consider 118 5 Communication skills for holistic health assessment (A. Crouch) 128 Introduction 128 Definition and classification 129 Factors that facilitate effective communication 131 Skills needed during holistic health assessment 132 Barriers to communication during holistic assessment 138 Record keeping 144 6 Physical assessment (C. Meurier, J. Brown and A. Crouch) 148 Section 1: Introduction 148 The purpose of physical assessment 150 Approach to physical assessment 150 Preparation for physical assessment 150 Techniques of physical assessment 151 The general survey and vital signs 154 Section 2: Physical assessment of the integumentary system 163 The skin 164 Assessment of nails 166 Assessment of hair 167 Section 3: Physical assessment of the respiratory system 168 Taking a health history 168 Physical examination 169 Section 4: Physical assessment of the cardiovascular system 171 Relevant health history 172 Risk factors for coronary heart disease 175 Physical examination 175 Section 5: Physical assessment of the nervous system 178 Relevant health history 178 Examination 178 Section 6: Physical assessment of the eyes, ears, nose and throat 187 The eyes 187 The ears 191 The mouth, nose, sinuses and throat 192 Section 7: Physical assessment of the digestive system 195 Relevant health history 196 Risk factors 196 Physical assessment 197 Section 8: Physical assessment of the urinary tract system 200 Assessment of the urinary system 201 Assessment of the prostate gland 204 Section 9: Physical assessment of the musculoskeletal system 205 The musculoskeletal system 205 Assessment 206 Section 10: Physical assessment of the female and male reproductive systems 210 Examination of the breast 210 Examination of the female genitalia 214 Assessment of the male reproductive system 224 Record keeping 228 7 Assessment of nutritional status (M. Ingham and J. O'Reilly) 234 Introduction 234 Purpose of nutritional assessment 235 Components of food 235 Nutritional requirements 245 Dietary guidelines 246 Assessing nutritional status 246 Dietary assessment 257 Nutritional interventions 259 8 Social assessment in healthcare (S. O'Brien) 264 Introduction 264 The purpose of social assessment 265 Health policy: assessing social needs 266 Nursing models, social influences and assessment 267 Nursing and interprofessional approaches to social assessment 268 The social assessment/analysis framework 271 The levels of social assessment 284 9 Psychological assessment (J. H. Parkes) 288 Introduction 288 What is psychological health? 289 Why conduct a psychological assessment? 290 What to assess 291 How to conduct the psychological assessment 299 Nurses' role in assessment 299 The assessment process 300 Accurate reporting and documentation 307 10 Cultural and spiritual health assessment (S. Allen and A. Crouch) 311 Cultural health assessment 311 Spirituality and spiritual needs 318 Glossary 331 Index 339

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