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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_2920_Библиотеки_им_академика_М_И_Перельмана
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P
S
IGNS
ROFESSIONALGUIDE TO
& S
S
IXTH EDITION
YMPTOMS
P
S
IGNS
ROFESSIONAL
& S
S
IXTH EDITION
YMPTOMS
G
UIDE TO
S
TAFF
Executive Publisher
Judith A. Schilling McCann, RN, MSN
Clinical Director
Joan M. Robinson, RN, MSN
Clinical Project Manager
Jennifer Meyering, RN, BSN, MS, CCRN
Art Director
Elaine Kasmer
Product Manager
Rosanne Hallowell
Marketing Manager
Kimberly Schonberger
Copy Editor
Amy Furman
Vendor Manager
Beth Martz
Composition Services
Aptara, Inc.
Manufacturing Manager
Beth J. Welsh
The clinical treatments described and recommended in
this publication are based on research and consultation
with nursing, medical, and legal authorities. To the best
of our knowledge, these procedures reflect currently accepted practice. Nevertheless, they can’t be considered
absolute and universal recommendations. For individual
applications, all recommendations must be considered
in light of the patient’s clinical condition and, before administration of new or infrequently used drugs, in light
of the latest package-insert information. The authors
and publisher disclaim any responsibility for any adverse effects resulting from the suggested procedures,
from any undetected errors, or from the reader’s misunderstanding of the text.
© 2011 by Lippincott Williams & Wilkins. All rights reserved. This book is protected by copyright. No part of it
may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means—electronic,
mechanical, photocopy, recording, or otherwise—without prior written permission of the publisher, except for
brief quotations embodied in critical articles and reviews and testing and evaluation materials provided by
publisher to instructors whose schools have adopted its
accompanying textbook. For information, write Lippincott Williams & Wilkins, 323 Norristown Road, Suite
200, Ambler, PA 19002-2756.
Printed in China
PGSS6E—010310
Library of Congress
Cataloging-in-Publication Data
Professional guide to signs & symptoms. — 6th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-60831-098-2 (alk. paper)
1. Symptoms—Handbooks, manuals, etc. I.
Lippincott Williams & Wilkins. II. Title:
Professional guide to signs and symptoms.
[DNLM: 1. Nursing Assessment—methods—
Handbooks. 2. Signs and Symptoms—Handbooks.
WY 49 P964 2011]
RC69.P77 2011
616⬘.047—dc22
2009033038
T
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ABLE OF
CONTENTS
Contributors and consultants vi
Foreword viii
S
IGNS
& S
YMPTOMS
A
PPENDICES
Selected signs & symptoms 724
Potential agents of bioterrorism 744
Adverse effects associated with herbs 746
Obtaining a health history 750
Guide to laboratory test results 752
Selected references 756
Index 757
(A–Z)
1
v
C
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ONTRIBUTORS
AND CONSULTANTS
Diane Dixon Abercrombie, MA, MMSc,
PhD Candidate, PA-C
Assistant Professor and Academic Coordinator
Department of Physician Assistant Studies
University of South Alabama
Mobile, Alabama
Marylee Bressie, RN, MSN, CCRN,
CCNS, CEN
Instructor
Spring Hill College Division of Nursing
Mobile, Alabama
Julie Carman, RN, MS
Instructor
University of Arkansas
Fort Smith, Arkansas
Laura M. Criddle, RN, PhD, CNS-BC, ONC,
CCRN, CCNS, CNRN, CEN, CFRN
Clinical Nurse
Oregon Health & Science University
Portland, Oregon
Shelton M. Hisley, RNC, PhD, WHNP-BC
Senior Associate
Coastline Writing Consultants
Assistant Professor (Retired)
University of North Carolina—Wilmington
School of Nursing
Wilmington, North Carolina
Julia Anne Isen, RN, MS, FNP-C
Assistant Clinical Professor
University of California
San Francisco, California
Internal Medicine
Uniformed Services University of the Health
Sciences
Bethesda, Maryland
Anna Lee Jarrett, PhD, ACNP/ACNS, BC
APN/Program Manager, Rapid Response Team
Central Arkansas Veterans Healthcare System
Little Rock, Arkansas
Cynthia Miculan, RN, MSN, ONC, CE-BC
Clinical Manager
The University Hospital
Cincinnati, Ohio
Steven Noakes, MPAS, PA-C
Division Officer, Acute Care Clinic
Marine Corps Recruit Depot
San Diego, California
Allen Phelps, MPAS, PA-C
Physician Assistant
Naval Medical Center
San Diego, California
Rexann G. Pickering, RN, BSN, MS, MSN,
PhD, CIM, CIP
Administrator, Human Protection–Research
Methodist Healthcare
Memphis, Tennessee
Roseanne Hanlon Rafter, RN, MSN,
GCNS, BC
Director of Nursing, Professional Practice
Chestnut Hill Hospital
Philadelphia, Pennsylvania
Sundaram V. Ramanan, MD, FRCP
Professor of Medicine
St. Francis Hospital—University of Connecticut
Hartford, Connecticut
vi
Richard R. Roach, MD, FACP
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Assistant Professor of Internal Medicine
Michigan State University
Kalamazoo Center for Medical Studies
Kalamazoo, Michigan
Ora V. Robinson, RN, PhD
Assistant Professor
California State University
San Bernardino, California
Phillip Todd Smith, MHS, PA-C
Assistant Professor
Department of Physician Assistant Studies
University of South Alabama
Mobile, Alabama
Allison J. Terry, RN, MSN, PhD
Director, Center for Nursing
Alabama Board of Nursing
Montgomery, Alabama
Daniel T. Vetrosky, PhD, PA-C
Assistant Professor
University of South Alabama
Mobile, Alabama
Gail A. Viergutz, MS, ANP-C
Nurse Practitioner, Emergency Department and
Urgent Care
Ministry Corporation
St. Michael’s Hospital
Stevens Point, Wisconsin
CONTRIBUTORS AND CONSULTANTS
vii
F
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OREWORD
With continuing advances in medical technology, laboratory studies, and diagnostic testing,
clinical diagnosis and physical examination
skills are in danger of becoming a lost art. I
have seen too many students and novice practitioners become overly dependent on frequently
imperfect, unreliable, and expensive tests to diagnose the cause of their patients’ illnesses. The
sixth edition of Professional Guide to Signs &
Symptoms will help ensure that this doesn’t happen. This fully reviewed and updated edition
provides a comprehensive yet easy-tounderstand compilation of many important
signs and symptoms seen in clinical practice,
and can help guide initial interventions and the
appropriate use of laboratory and diagnostic
studies.
The scope and organization of this sixth edition make it a valuable reference for students,
nurses, and practitioners at all levels of training
and expertise. More than 500 clinical signs and
symptoms are arranged alphabetically and discussed in the body of the text. The new full-color
format is appealing and enables quick and easy
retrieval of relevant information. Easy-to-read
tables, charts, and illustrations make difficultto-grasp physiologic and clinical concepts understandable. Potentially obscure pathologic
signs are clearly explained and should become
more readily apparent to the astute clinical observer. New sections examining troublesome infectious diseases (methicillin-resistant Staphylo-
coccus aureus, vancomycin-resistant
enterococci, and vancomycin-resistant S.
aureus) and popcorn lung disease (diacetyl exposure) are included.
viii
Each sign and symptom is reviewed in a concise and standard format. Every entry begins
with a brief review of the sign or symptom and
is followed, where applicable, by a focused discussion of possible emergency interventions.
Relevant history and physical findings are then
reviewed and possible medical causes are discussed. Special considerations for caregivers
provide practical advice, and pointers for pediatric and elderly populations should be particularly helpful for those who care for patients at
either end of the age spectrum. Detailed differential diagnosis matrixes and flowcharts interspersed throughout the text aid patient assessment and diagnosis, while patient counseling
sections provide helpful recommendations for
patients and families once the diagnosis is established.
An additional 250 less frequently encountered selected signs and symptoms are briefly
reviewed in the first appendix. Updated sections
on the signs and symptoms of bioterrorism
agents and the adverse effects of herbal remedies are particularly timely. The guide to obtaining a patient history provides helpful tips for
conducting a medical interview, collecting primary clinical data, and performing a thorough
review of systems. The index is crossreferenced and thorough, and the inside-thecover listing of common signs and symptoms in
both English and Spanish make this sixth edition a valuable reference for students, nurses,
and practitioners living or traveling abroad.
I believe anyone who provides clinical care to
patients and who is interested in the focused
and appropriate use of medical technology,
diagnostic testing, and initial interventions will
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find this comprehensive text extremely valuable.
The standardized format with its easy-to-read
tables, charts, and illustrations make this sixth
edition an indispensable tool for the inquisitive
student, nurse, or clinical practitioner.
Charles W. Mackett III, MD, FAAFP
Associate Professor and Executive
Vice Chairman
Department of Family Medicine
University of Pittsburgh (Pa.) Medical Center
FOREWORD
ix
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