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Surgical Care: A Physiologic Approach to Clinical Management.
normal body structure and pathologicalconditions are displayed. The procedures included are in current orthopedic practice. The book does not discuss the requiredinstrumentation. This is a valuable resource for nurses who must instruct others about the procedure and a great aid for the new graduate and student nurse. I earnestly recommend acquiring this book for your library. I have already ordered mine. June Shibe, RN Marlton. NJ
Pearls for Nursing Practice: A Choice Collection of Tips, Hints, Timesavers, Improvisations, and Bright Ideas that Make Nursing Easier and Patients Happier. Nichols, ArleneOdom; Day, Joy. J B Lippincott Go, PO Box 7758, Philadelphia, Pa 19101, 1979, 215 pp, $8.75 paperback. As its title implies, this is a book to help nurses to “work smarter” and, in doing so, to make their patients happier. The authors collected their tips from the health care personnel at the Shands Teaching Hospital and Clinics and the J Hillis Miller Health Center at the University of Florida, Gainesville. Some are old tips that may have been forgottenor never learned, and many are as new as the techniques and equipment constantly being introduced into nursing practice. The authors warn the reader, however, that no book of helpful hints can function as a substitute for sound nursing judgment. The book is divided into three units. Unit one concerns “Pearls for Basic Needs” and includes chapters on mobility; comfort and hygiene; IV therapy, nutrition, and hydration; elimination; and psychosocial aspects. The psychosocial chapter covers pediatric and geriatric patients; the patient with visual, hearing, or language disorders; visitors; keeping patients informed; communicating with patients with various language and cultural backgrounds, and aids in meeting psychosocia1 needs. Unit twodeals with special problems such as medication administration, special therapeutic and diagnostic measures, physiological monitoring, infection control, and safety. The last unit provides ”Pearls for Nursing Management“ to help the nurse in managing
584
the clinical unit and in health education. There are tips concerning ordering supplies, procedures, policies, promoting organization, nursing rounds, reports and supervision, resources, collecting data, strategies for health teaching, and many others. There are many photos and diagrams to illustrate the step-by-step instructions. Introductory paragraphs at the beginning of each chapter are also interesting.Although you may find that you know many of the tips containedin this book, you may find yourself wondering why you aren’t using them and be inspired to do so. This is a good source book for nursing personnel, and it is one that procedure committees will find helpfulwhen reviewingor revising their nursing procedure manuals. Sister Kane, RHSJ, RN Cornwait, Ontario
Surgical Care: A Physiologic Approach to Clinical Management. Condon, Robert E; DeCosse, Jerome J. Lea & Febiger, 600 Washington Square, Philadelphia, Pa 19106, 1980, 456 pp, $37.50. This excellent medical textbook, which provides a comprehensive background on many surgical subjects, is the work of almost 50 contributors. They were asked to “develop their subjects in depth with a strong emphasis on the appropriate mix of biochemical, physiologic, pharmacologic, and biophysical principles that gird diagnosis and treatmsnt.” They were requested to “translate these principles into current methods of management” and “to focus on postoperative care because much of the challenge is in this domain.” The result is a book with much new information in pathophysiology, diagnosis, and treatment. Section I covers abdominal surgery. It includes stress and upper gastrointestinal hemorrhage after trauma or operation; delayed gastric emptying; fistulas and anastomotic leaks; biliary obstructions, leaks, and infections; pancreatitis; and ileostomies and colostomies. The cardiothoracic section is concerned with noncardiogenic pulmonary edema; phlebitis, thrombosis, and pulmonary embolism; and cardiac problems. The failed arterial graft, disorderly hemostasis, and transfu-
AORN Journal, October 1980, Vol32, N o 4
sion reactions are covered in the vascular and hematologic section. Section IV, on genitourinary surgery, deals with urinary obstruction and infection, oliguria and anuria, and immunologic rejection. A section on oncologic surgery includes indications for chemotherapy and for radiation therapy, and the section on sepsis contains valuable material on the choice and use of antibiotics. Malnutritionand alimentation, fluid and electrolyte problems, and acute postoperative hormonal insufficiency syndromes are covered in the metabolic and endocrine section. The final section covers airway problems, postoperative pain, drug competition and incompatibility, and psychiatric reactions associated with surgery.
This book provides the information necessary to understandwhat can go wrong, how to prevent problems, how to recognize abnormal findings, and the rationale used in clinical management of complications. There are many good photographs, diagrams, and charts to clarify the text. A list of references follows each chapter, and the index is comprehensive. Although some parts of the text may be a bit difficult for nurses, there is so much valuable information that the book is highly recommended for nurses working in surgical units, ORs, and recovery rooms. The effort taken to obtain this book for the surgical units and departments will be worthwhile. Sister Kane, RSHJ, RN Cornwall, Ontario
Abdominal stab wounds may not need surgery The street fight victim is rushed to the hospital emergency room with a stab wound in the abdomen. Does the surgeon immediately operate to find the extent of damage and repair it? Only about half the time, in the approach followed at a New York City hospital. In some half of the abdominal stab wound cases, the preferred procedure is to wait. Admit the patient for careful observation and watch for signs that a vital organ is damaged and surgery is required, says Joseph R Wilder, MD, of the Hospital for Joint Diseases and Medical Center and Mt Sinai School of Medicine, New York. In the June 27 Journal of the American Medical Association, Dr Wilder reports surgery is often found unnecessary. No vital organ is seriously damaged, and the patient may be sent home after four or five days, he says. The New York surgeon points out that controversy still exists over the method of treatment of patients with stab wounds of the abdomen. Many surgeons continue to practice mandatory exploration in all such cases, he says. Dr Wilder details his experiences with more than 400 stab wounds in 20 years and concludes that surgery often is not needed. All patients with abdominal stab wounds
are treated as critically ill, regardless of their appearance, Dr Wilder says. Sometimes surgery is required immediately; sometimes it can be postponed for a short time. And sometimes it is not required. Careful observation of the patient and monitoring of vital functions are important in determining when to operate, he says. Even if the patient is intoxicated, it is not always necessary to operate immediately. “We believe that the results of our 20-year study of 403 stab wound patients justifies our confidence in continuing the policy of selective surgical intervention. The precipitous increase in the number of patients with stab wounds of the abdomen seen at our hospital is in keeping with the experience of most hospitals in the ghetto area,” Dr Wilder writes. Ninety-four percent of the stab wounds were homicidal, 4% were accidental, and 2% were suicidal. In more than half of the cases, injury was caused by known assailants, described as “friends.” In 90% of the cases, the weapon was a blade, and in 7% an ice pick. Other weapons included fence posts, broken glass, coat hangers, screwdrivers, and scissors. Eighty percent of the stab wound victims were addicts of heroin or similar drugs.
AORN Journal, October 1980,Vol32, No 4
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Pearls for Nursing Practice: A Choice Collection of Tips, Hints, Timesavers, Improvisations, and Bright Ideas that Make Nursing Easier and Patients Happier. Nichols, ArleneOdom; Day, Joy. J B Lippincott Go, PO Box 7758, Philadelphia, Pa 19101, 1979, 215 pp, $8.75 paperback. As its title implies, this is a book to help nurses to “work smarter” and, in doing so, to make their patients happier. The authors collected their tips from the health care personnel at the Shands Teaching Hospital and Clinics and the J Hillis Miller Health Center at the University of Florida, Gainesville. Some are old tips that may have been forgottenor never learned, and many are as new as the techniques and equipment constantly being introduced into nursing practice. The authors warn the reader, however, that no book of helpful hints can function as a substitute for sound nursing judgment. The book is divided into three units. Unit one concerns “Pearls for Basic Needs” and includes chapters on mobility; comfort and hygiene; IV therapy, nutrition, and hydration; elimination; and psychosocial aspects. The psychosocial chapter covers pediatric and geriatric patients; the patient with visual, hearing, or language disorders; visitors; keeping patients informed; communicating with patients with various language and cultural backgrounds, and aids in meeting psychosocia1 needs. Unit twodeals with special problems such as medication administration, special therapeutic and diagnostic measures, physiological monitoring, infection control, and safety. The last unit provides ”Pearls for Nursing Management“ to help the nurse in managing
584
the clinical unit and in health education. There are tips concerning ordering supplies, procedures, policies, promoting organization, nursing rounds, reports and supervision, resources, collecting data, strategies for health teaching, and many others. There are many photos and diagrams to illustrate the step-by-step instructions. Introductory paragraphs at the beginning of each chapter are also interesting.Although you may find that you know many of the tips containedin this book, you may find yourself wondering why you aren’t using them and be inspired to do so. This is a good source book for nursing personnel, and it is one that procedure committees will find helpfulwhen reviewingor revising their nursing procedure manuals. Sister Kane, RHSJ, RN Cornwait, Ontario
Surgical Care: A Physiologic Approach to Clinical Management. Condon, Robert E; DeCosse, Jerome J. Lea & Febiger, 600 Washington Square, Philadelphia, Pa 19106, 1980, 456 pp, $37.50. This excellent medical textbook, which provides a comprehensive background on many surgical subjects, is the work of almost 50 contributors. They were asked to “develop their subjects in depth with a strong emphasis on the appropriate mix of biochemical, physiologic, pharmacologic, and biophysical principles that gird diagnosis and treatmsnt.” They were requested to “translate these principles into current methods of management” and “to focus on postoperative care because much of the challenge is in this domain.” The result is a book with much new information in pathophysiology, diagnosis, and treatment. Section I covers abdominal surgery. It includes stress and upper gastrointestinal hemorrhage after trauma or operation; delayed gastric emptying; fistulas and anastomotic leaks; biliary obstructions, leaks, and infections; pancreatitis; and ileostomies and colostomies. The cardiothoracic section is concerned with noncardiogenic pulmonary edema; phlebitis, thrombosis, and pulmonary embolism; and cardiac problems. The failed arterial graft, disorderly hemostasis, and transfu-
AORN Journal, October 1980, Vol32, N o 4
sion reactions are covered in the vascular and hematologic section. Section IV, on genitourinary surgery, deals with urinary obstruction and infection, oliguria and anuria, and immunologic rejection. A section on oncologic surgery includes indications for chemotherapy and for radiation therapy, and the section on sepsis contains valuable material on the choice and use of antibiotics. Malnutritionand alimentation, fluid and electrolyte problems, and acute postoperative hormonal insufficiency syndromes are covered in the metabolic and endocrine section. The final section covers airway problems, postoperative pain, drug competition and incompatibility, and psychiatric reactions associated with surgery.
This book provides the information necessary to understandwhat can go wrong, how to prevent problems, how to recognize abnormal findings, and the rationale used in clinical management of complications. There are many good photographs, diagrams, and charts to clarify the text. A list of references follows each chapter, and the index is comprehensive. Although some parts of the text may be a bit difficult for nurses, there is so much valuable information that the book is highly recommended for nurses working in surgical units, ORs, and recovery rooms. The effort taken to obtain this book for the surgical units and departments will be worthwhile. Sister Kane, RSHJ, RN Cornwall, Ontario
Abdominal stab wounds may not need surgery The street fight victim is rushed to the hospital emergency room with a stab wound in the abdomen. Does the surgeon immediately operate to find the extent of damage and repair it? Only about half the time, in the approach followed at a New York City hospital. In some half of the abdominal stab wound cases, the preferred procedure is to wait. Admit the patient for careful observation and watch for signs that a vital organ is damaged and surgery is required, says Joseph R Wilder, MD, of the Hospital for Joint Diseases and Medical Center and Mt Sinai School of Medicine, New York. In the June 27 Journal of the American Medical Association, Dr Wilder reports surgery is often found unnecessary. No vital organ is seriously damaged, and the patient may be sent home after four or five days, he says. The New York surgeon points out that controversy still exists over the method of treatment of patients with stab wounds of the abdomen. Many surgeons continue to practice mandatory exploration in all such cases, he says. Dr Wilder details his experiences with more than 400 stab wounds in 20 years and concludes that surgery often is not needed. All patients with abdominal stab wounds
are treated as critically ill, regardless of their appearance, Dr Wilder says. Sometimes surgery is required immediately; sometimes it can be postponed for a short time. And sometimes it is not required. Careful observation of the patient and monitoring of vital functions are important in determining when to operate, he says. Even if the patient is intoxicated, it is not always necessary to operate immediately. “We believe that the results of our 20-year study of 403 stab wound patients justifies our confidence in continuing the policy of selective surgical intervention. The precipitous increase in the number of patients with stab wounds of the abdomen seen at our hospital is in keeping with the experience of most hospitals in the ghetto area,” Dr Wilder writes. Ninety-four percent of the stab wounds were homicidal, 4% were accidental, and 2% were suicidal. In more than half of the cases, injury was caused by known assailants, described as “friends.” In 90% of the cases, the weapon was a blade, and in 7% an ice pick. Other weapons included fence posts, broken glass, coat hangers, screwdrivers, and scissors. Eighty percent of the stab wound victims were addicts of heroin or similar drugs.
AORN Journal, October 1980,Vol32, No 4
585