Fundamentals of Nursing

Fundamentals of Nursing aligns with the outcomes and competencies of a nursing fundamentals course. It is designed to provide students with the foundational knowledge and practical expertise essential for delivering holistic and patient-centered care. The authors emphasize the application of clinical judgment across diverse healthcare environments, ensuring readiness to deliver high-quality, compassionate care in an inclusive and supportive manner. Composed of 43 chapters, Fundamentals of Nursing offers an in-depth exploration of the roles and responsibilities of the nursing profession, the healthcare environment, and the application of critical thinking and evidence-based practice.

Fundamentals of Nursing features a variety of engaging and informative resources designed to prepare students for real-world clinical environments. By simulating patient interactions, students develop critical communication skills essential for effective nursing care. Insights from practicing nurses provide real-world perspectives, helping bridge the gap between theory and practice. The offering builds student confidence and competence through its focus on Quality and Safety Education for Nurses (QSEN), inclusion of robust unfolding case studies, and integration of NCLEX practice.

Senior Contributing Authors
- Christy Bowen, Chamberlain University
- Lindsay Draper, University of North Carolina at Greensboro
- Heather Moore, Xavier University

Preface

Unit 1 Foundation of Nursing and the Healthcare Environment

Chapter 1 Introduction to the Nursing Profession: Evolution, Theories, and Practice
o Introduction
o 1.1 Evolution of Nursing and Nursing Practice
o 1.2 Nursing Education Programs
o 1.3 Nursing as a Profession
o 1.4 History and Evolution of Nursing Theories
o 1.5 Selected Nursing Theorist
o 1.6 Application of Theories in Nursing Practice
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 2 Communication
o Introduction
o 2.1 Types of Communication
o 2.2 Models of Communication
o 2.3 Effective Communication
o 2.4 Therapeutic Communication
o 2.5 Barriers to Communication
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 3 Healthcare Delivery Systems
o Introduction
o 3.1 Levels of Care
o 3.2 Organizational Frameworks and Structure
o 3.3 Barriers to Healthcare Access
o 3.4 Culture
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 4 Health, Wellness, and Community-Based Health Care
o Introduction
o 4.1 Defining Health and Wellness
o 4.2 Models of Health
o 4.3 Health Promotion and Illness Prevention
o 4.4 Community-Based Health Care
o 4.5 Community-Based Healthcare Initiatives
o 4.6 Population Health
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 5 Cultural Competence
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 Promoting Individualized Care
o Introduction
o 6.1 Patient-Centered and Holistic Health Care
o 6.2 Foundations for Providing Person-Centered Care
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

Unit 2 Fundamental Aspects to Nursing Care

Chapter 7 Vital Signs
o Introduction
o 7.1 Indicators of Physiologic Functioning
o 7.2 How to Perform Vital Signs
o 7.3 Teaching Patients to Perform Vital Signs
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 8 Admission, Transfer, and Discharge
o Introduction
o 8.1 Patient Admission
o 8.2 Patient Transfer
o 8.3 Patient Discharge
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 9 Safety and Security
o Introduction
o 9.1 Safety: Individual and Environmental
o 9.2 Safety: Violence
o 9.3 Security: Privacy and 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 10 Infection Control and Prevention
o Introduction
o 10.1 Infection Cycle
o 10.2 Asepsis and PPE
o 10.3 Sterile Technique
o 10.4 Infection Control and Patient Safety
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 11 Medication Administration
o Introduction
o 11.1 Medication Orders
o 11.2 Fundamental Principles of Medication Administration
o 11.3 The Medication Administration Process
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 The Process of Nursing Care

Chapter 12 Assessment: Recognizing Cues
o Introduction
o 12.1 The Nurse’s Role in Assessment
o 12.2 Types of Assessment
o 12.3 Collection of Assessment Data
o 12.4 Cognitive Process for Analyzing Assessment Data
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 Diagnosis and Planning: Analyzing, Prioritizing, and Generating Solutions
o Introduction
o 13.1 Evolution of Nursing Diagnosis
o 13.2 Focus of Nursing Diagnosis
o 13.3 Categories of Nursing Diagnosis
o 13.4 Focus of the Planning Phase
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 Implementation and Evaluation: Taking Action, Evaluating Outcomes, and Documentation
o Introduction
o 14.1 The Nurse’s Role in Implementation
o 14.2 Types of Interventions
o 14.3 The Nurse’s Role in Evaluation
o 14.4 Evaluation Methods
o 14.5 Guidelines for Effective Documentation
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 Complex Thinking in Nursing Care

Chapter 15 Evidence-Based Research, Quality Improvement, and Collaborative Practice
o Introduction
o 15.1 Evidence-Based Research
o 15.2 Evidence-Based Clinical Decisions
o 15.3 Quality Improvement in Nursing
o 15.4 Nursing Standards of Delegation
o 15.5 Collaborative Practice
o 15.6 Interprofessional Approach to Health 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 16 Legal and Ethical Considerations
o Introduction
o 16.1 Value Considerations of Care
o 16.2 Ethics in Nursing Practice
o 16.3 Legal Dimensions of Care
o 16.4 Advocacy in Nursing Practice
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 17 Patient and Family Education
o Introduction
o 17.1 Informed Decision Making and Self-Care
o 17.2 Methods and Approaches to Learning and Teaching
o 17.3 The Nurse’s Role in Patient and Family Education
o 17.4 Evaluation of Teaching and Learning
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 Leadership and Management in Nursing
o Introduction
o 18.1 Concepts of Leadership in Nursing
o 18.2 Concepts of Management in Nursing
o 18.3 Implementing Leadership and Management into Nursing Practice
o 18.4 Certifications for Nurse Leaders and Managers
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 5 Physiological Aspects of Nursing Care

Chapter 19 Oxygenation and Perfusion
o Introduction
o 19.1 Respiratory System
o 19.2 Cardiovascular System
o 19.3 Factors Affecting Cardiopulmonary Function
o 19.4 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 20 Fluid, Electrolyte, and Acid-Base Balance
o Introduction
o 20.1 Fluid and Electrolyte Balances
o 20.2 Acid-Base Balances
o 20.3 The Nurse’s Role in Patient Care 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 21 Nutrition
o Introduction
o 21.1 Nutritional Concepts
o 21.2 Factors Affecting Nutrition
o 21.3 Specialized Diets
o 21.4 Nutritional 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 22 Activity
o Introduction
o 22.1 Importance of Activity, Movement, and Alignment
o 22.2 Factors Affecting Activity Level
o 22.3 Activities of Daily Living (ADLs)
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 23 Neuromuscular Function
o Introduction
o 23.1 Foundations of Neuromuscular Functioning
o 23.2 Factors Affecting Neuromuscular Functioning
o 23.3 Considerations for Care of Neuromuscular Impairment
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 Skin Integrity
o Introduction
o 24.1 Structures and Function of the Skin
o 24.2 Skin Integrity
o 24.3 Wound Classification
o 24.4 Wound Healing
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 Hygiene
o Introduction
o 25.1 Hygienic Practices
o 25.2 Factors Affecting Hygienic Practices
o 25.3 The Nurse’s Role in Hygiene
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 Urinary Elimination
o Introduction
o 26.1 Urinary System
o 26.2 Functions of the Urinary System
o 26.3 Factors Affecting Urinary Elimination
o 26.4 The Nurse’s Role in Urinary 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 27 Bowel Elimination
o Introduction
o 27.1 Gastrointestinal Tract Structures and Functions
o 27.2 Factors Affecting Bowel Elimination
o 27.3 Diagnostic Evaluation
o 27.4 Common Conditions Affecting Bowel Elimination
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 Sleep and Rest
o Introduction
o 28.1 Concepts of Sleep and Rest
o 28.2 Factors Affecting Sleep and Rest
o 28.3 Effects of Insufficient Sleep
o 28.4 Nursing Care to Promote Sleep and Rest
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 29 Sensory Alterations
o Introduction
o 29.1 Sensory Functioning
o 29.2 Impaired Sensory Function
o 29.3 Factors Affecting Sensory Function
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 30 Pain Assessment
o Introduction
o 30.1 The Pain Process
o 30.2 Responses to Pain
o 30.3 Factors Affecting Pain
o 30.4 Pain Assessment
o 30.5 Pain Management
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 31 Perioperative Nursing Care
o Introduction
o 31.1 Surgical Concepts
o 31.2 Preoperative Phase
o 31.3 Intraoperative Phase
o 31.4 Postoperative Phase
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 6 Psychosocial Aspects of Nursing Practice

Chapter 32 Self-Concept
o Introduction
o 32.1 Foundations of Self-Concept
o 32.2 Factors Affecting Self-Concept
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 33 Sexuality
o Introduction
o 33.1 Sexual Identity
o 33.2 Sexual Fulfillment
o 33.3 Factors Affecting Sexuality
o 33.4 The Nurse’s Role in Providing Care
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 34 Stress, Adaptation, and Homeostasis
o Introduction
o 34.1 Stress and Adaptation
o 34.2 Effects of Stress on Health and Wellness
o 34.3 Factors Affecting Stress and Adaptation
o 34.4 Adaptation Theories and Models
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 35 Spirituality
o Introduction
o 35.1 Dimensions of Spirituality
o 35.2 Applications of Spirituality to Health 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 36 Grief, Loss, Death, and Dying
o Introduction
o 36.1 Concepts of Grief and Loss
o 36.2 Concepts of Death and Dying
o 36.3 Factors That Affect Grief, Loss, Death, and Dying
o 36.4 Legal and Ethical Considerations
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

Unit 7 Health Promotion Across the Life Span

Chapter 37 Family Dynamics
o Introduction
o 37.1 Family Concepts
o 37.2 Family Framework
o 37.3 Family Dynamics Influence on Health Outcomes
o 37.4 The Nurse’s Role in Caring for the Family Unit
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 38 Growth and Development
o Introduction
o 38.1 Stages of Growth and Development
o 38.2 Specific Developmental Theories
o 38.3 Application to 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 39 Conception Through Adolescence
o Introduction
o 39.1 Growth and Development Stages
o 39.2 Theories Related to Growth and Development
o 39.3 Health Risks for Each Stage
o 39.4 The Nurse’s Role in Preventing Illness
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 40 Young and Middle-Aged Adults
o Introduction
o 40.1 Growth and Development Stages
o 40.2 Theories Related to Growth and Development
o 40.3 Health Risks for Young and Middle-Aged Adults
o 40.4 The Nurse’s Role in Preventing Illness
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 41 Older Adults
o Introduction
o 41.1 Growth and Development Stages
o 41.2 Theories Related to the Older Adult
o 41.3 Health Risks for Older Adults
o 41.4 The Nurse’s Role in Preventing Illness
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 42 Caring for Patients with Disability and Chronic Illness
o Introduction
o 42.1 Characteristics of Disability
o 42.2 Healthcare Approach to Disability
o 42.3 Chronic Disease and Chronic Illness
o 42.4 Healthcare Approach to Chronic Conditions
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 43 Clinical Judgment and Critical Thinking
o Introduction
o 43.1 Clinical Judgment Measure Model
o 43.2 Developing Critical Thinking
o 43.3 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
Appendix B Equivalents