Clinical Nursing Skills

Clinical Nursing Skills is designed to equip nursing students with the practical knowledge and hands-on skills necessary to provide comprehensive patient care. The material emphasizes the application of clinical judgment in a variety of settings, ensuring that students are prepared to deliver high-quality care across different patient populations and clinical scenarios. The content utilizes concepts promoting the development of clinical judgment by building upon the systematic model developed by the National Council of State Boards of Nursing (NCSBN).

Clinical Nursing Skills provides detailed instructions on basic procedures such as hygiene, mobility, vital signs assessment, medication administration, and wound care. It also guides students through more complex skills, including intravenous therapy, catheterization, tracheostomy care, and emergency interventions. By integrating the Clinical Judgment Measurement Model, the material helps students recognize, analyze, prioritize, create, act, and evaluate outcomes in various clinical situations, fostering critical thinking and clinical decision making. By studying Clinical Nursing Skills, students will gain the confidence and competence needed to perform essential nursing tasks, make informed clinical decisions, and provide compassionate, patient-centered care, which will prepare students for success in their clinical rotations and future professional practice.

Senior Contributing Authors
• Christy Bowen, Chamberlain University

Contributing Authors
• Taranee Albert, Northwestern Medicine
• Mary Anne Bera
• Jessica Crockett, Baptist Health Care
• Lindsay L. Draper, University of North Carolina Greensboro
• Sandy Grimm, Nurse Educate
• Alissa Hershberger, University of Central Missouri
• Stephanie Hoffmann, Chamberlain University
• Czarina Hounsel, University of Texas at Arlington
• Lindsay Jusino, The University of West Florida
• Lori Kelly, Lipscomb University
• Heather Moore, Xavier University
• Amisha Parekh de Campos, University of Connecticut
• Margaret Riley, Nurse Educate
• Susan M. Rouse (Retired)
• Leigh A. Waldron, Western Governors University

Preface

Unit 1 Concepts of Comprehensive Clinical Care

Chapter 1 The Role of the Nurse in Comprehensive Care
o Introduction
o 1.1 Principles of Nursing Practice
o 1.2 Evidence-Based Practice
o 1.3 Nursing Process
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 Competency-Based Assessments
o References

Chapter 2 The Evolution of the Nurse's Role
o Introduction
o 2.1 Changing with Trends
o 2.2 Patient-Centered Care
o 2.3 Practice Standards
o 2.4 Collaborative Care
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 3 Patient Communication and Interviewing
o Introduction
o 3.1 Therapeutic Communication
o 3.2 Comprehensive Interview Practices
o 3.3 Patient Education and Teaching
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 Critical-Thinking Questions about Case Studies
 Competency-Based Assessments
o References

Chapter 4 Obtaining a Complete Health History
o Introduction
o 4.1 Foundations for a Complete Electronic Health Record: Accurate Health History
o 4.2 Data Collection and Documentation
o 4.3 Informatics
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 Critical-Thinking Questions about Case Studies
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 5 Cultural Competence and Assessment
o Introduction
o 5.1 Understanding Cultural Differences
o 5.2 Ethical Practice in Culture and Diversity
o 5.3 Cultural Practice in Nursing
o 5.4 Diversity, Equity, and Inclusion
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 Critical-Thinking Questions about Case Studies
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 6 Infection Prevention Techniques and Safety in the Clinical Setting
o Introduction
o 6.1 Infection Cycle
o 6.2 Asepsis and PPE
o 6.3 Sterile Technique
o 6.4 Infection Control and Patient Safety
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Unit 2 General Assessment and Special Considerations

Chapter 7 Hygiene
o Introduction
o 7.1 Hygiene Practices
o 7.2 Factors Influencing Personal Hygiene
o 7.3 Assisting with Hygiene and Health Promotion
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 Critical-Thinking Questions about Case Studies
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 8 Wound and Burn Assessment and Care
o Introduction
o 8.1 Wound Classification
o 8.2 Wound Assessment
o 8.3 Wound Management
o 8.4 Burn Injuries and Management
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 9 Activity Assessment and Management
o Introduction
o 9.1 Assessing Functional Ability
o 9.2 Assessing Mobility
o 9.3 Transferring Patients
o 9.4 Positioning in Bed
o 9.5 Limited Movement Devices
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 Critical-Thinking Questions about Case Studies
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 10 Specimen Collection and Lab Testing
o Introduction
o 10.1 Urine Specimen
o 10.2 Stool Collection
o 10.3 Sputum Collection
o 10.4 Blood Sampling
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Unit 3 Medication Management

Chapter 11 Principles of Medication Administration
o Introduction
o 11.1 Rights of Medication Administration
o 11.2 Dosing
o 11.3 Documentation of Medication Administration
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 12 Medication Administration Procedures
o Introduction
o 12.1 Administering Oral Medications
o 12.2 Administering Parenteral Medications
o 12.3 Preparing Unit-Dose Packaged Medications
o 12.4 Administering Intradermal Injections
o 12.5 Administering Subcutaneous Injections
o 12.6 Administering Intramuscular Injections
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 13 Intravenous Administration
o Introduction
o 13.1 Principles of Intravenous Therapy
o 13.2 Intravenous Device Insertion
o 13.3 Intravenous Infusion
o 13.4 Blood Transfusions
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 14 Miscellaneous Medication Administration
o Introduction
o 14.1 Administering Eye Medications
o 14.2 Administering Ear Medications
o 14.3 Administering Nasal Medications
o 14.4 Administering Inhaled Medications
o 14.5 Administering Other Medications
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Unit 4 Health Assessment and Promotion

Chapter 15 General Survey, Anthropometric Measurement, and Vital Signs
o Introduction
o 15.1 Performing a General Survey
o 15.2 Common Types of Anthropometric Measurements
o 15.3 Vital Signs
o 15.4 Temperature
o 15.5 Heart Rate
o 15.6 Respiration
o 15.7 Blood Pressure
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 Critical-Thinking Questions about Case Studies
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 16 Pain Assessment
o Introduction
o 16.1 The Pain Process
o 16.2 Responses to Pain
o 16.3 Factors Affecting Pain
o 16.4 Pain Assessment
o 16.5 Pain Management
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 17 Nutrition Assessment
o Introduction
o 17.1 Nutritional Concepts
o 17.2 Factors Affecting Nutrition
o 17.3 Specialized Diets
o 17.4 Nutritional Assessment
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 Critical-Thinking Questions about Case Studies
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 18 Oxygenation and Perfusion
o Introduction
o 18.1 Respiratory System
o 18.2 Cardiovascular System
o 18.3 Factors Affecting Cardiopulmonary Function
o 18.4 Management of Impaired Cardiopulmonary Functioning
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 Critical-Thinking Questions about Case Studies
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 19 Fluids, Electrolytes, and Elimination
o Introduction
o 19.1 Fluid and Electrolytes
o 19.2 Nursing Assessment for Fluid and Electrolytes
o 19.3 Considerations for Fluid and Electrolyte Imbalances
o 19.4 Nursing Management of Elimination
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 Critical-Thinking Questions about Case Studies
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 20 Psychosocial Assessment
o Introduction
o 20.1 Mental Health Assessment
o 20.2 Substance Use Disorder Assessment
o 20.3 Abuse and Neglect Assessment
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 21 Assessment of the Integumentary System
o Introduction
o 21.1 Structure and Functions of the Skin
o 21.2 Factors Affecting Skin Integrity
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 22 Assessment of the Head and Neck
o Introduction
o 22.1 Head and Neck
o 22.2 Eyes
o 22.3 Ears
o 22.4 Mouth, Throat, Nose, and Sinuses
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 23 Assessment of the Thorax, Lungs, Breast, and Lymphatic System
o Introduction
o 23.1 Structure and Function
o 23.2 Physical Assessment of the Thorax
o 23.3 Breath Sounds and Lung Assessment
o 23.4 Breast and Lymphatic System
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 24 Assessment of the Cardiovascular and Peripheral Vascular System
o Introduction
o 24.1 Cardiovascular System
o 24.2 Peripheral Vascular System
o 24.3 Nursing Assessment
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 Critical-Thinking Questions about Case Studies
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 25 Assessment of the Musculoskeletal System
o Introduction
o 25.1 Structure and Function
o 25.2 Physical Assessment
o 25.3 Recognizing Common Musculoskeletal Disorders
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 26 Assessment of the Neurological System
o Introduction
o 26.1 Structure and Function
o 26.2 Physical Assessment
o 26.3 Recognizing Common Neurological Disorders
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 27 Assessment of the Abdomen
o Introduction
o 27.1 Structure and Function
o 27.2 Physical Assessment
o 27.3 Recognizing Common Abdominal Disorders
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 What Should the Nurse Do?
 Competency-Based Assessments
o References

Chapter 28 Clinical Judgment and Critical Thinking
o Introduction
o 28.1 Clinical Judgment Measurement Model
o 28.2 Developing Critical Thinking Skills
o 28.3 Unfolding Case Study Dissection
o Summary
o Key Terms
Assessments
 Review Questions
 Check Your Understanding Questions
 Reflection Questions
 Competency-Based Assessments
o References
Appendix A Adult Lab Values