Davis's Diseases and Disorders, 7th Edition

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Davis’s Diseases and Disorders: A Nursing Therapeutics Manual. 7th Edition. © 2023 F.A. Davis

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Author

Marilyn Sawyer Sommers, PhD, RN, FAAN
Professor Emerita
University of Pennsylvania School of Nursing
Philadelphia, Pennsylvania

Consultants

Consultants for 7th Edition

Kaitlyn M. Shen, BS, PhDc
University of Pennsylvania
Philadelphia, Pennsylvania

Gloria Haile Coats, MSN, RN, FNP
Professor Emerta
Modesto Junior College, Modesto,California
Assistant Clinical Professor
California State University, Stanislaus, California

Taralyn McMullan, DNP, RN, CNS-BC
Associate Professor
University of South Alabama
Mobile, Alabama

Karyn I. Morgan, MSN, APRN-CNS
Professor Emerita
University of Akron
Akron, Ohio

Reviewers

Dr. Victoria Haynes, DNP, APRN, FNP-C
Tenured Professor of Nursing Coordinator of Diversity & Cultural Competency
MidAmerica Nazarene University
Olathe, Kansas

Hiba Wehbe-Alamah, PhD, RN, FNP-BC, CTN-A, FAAN
Professor, School of Nursing
Michigan Distinguished Professor
University of Michigan-Flint
Flint, Michigan

Dedication

With a loving eye on the future: To Abigail, Sophia, Joshua, Jonah, and Ari

With a grateful eye on the past: To Mother and Dad

MSS

Preface

The seventh edition of Davis’s Diseases and Disorders was revised during the year of an outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), more commonly known as COVID-19. The World Health Organization declared a global pandemic on March 11, 2020 (Majumder & Minko, 2021), and the revision of the book was completed during 2021 as infections waxed and waned across the world. Just as COVID-19 affected all of us with respect to our individual, family, and work lives, it also affected the revision of the book. First, it highlighted the fact that emerging infectious diseases may be our future way of life. They are outbreaks of previously unknown diseases that persist in an uncontrolled manner and respect no national boundaries. They threaten the health and safety of all people because prevention strategies, control recommendations, and care guidelines may not be immediately available when the disease appears (National Institute of Allergy and Infectious Diseases, 2018). Second, COVID-19 also brought to the forefront inequities and disparities in the risk of disease and healthcare delivery that people experience (see Emerging Infectious Diseases).

Health disparities are preventable differences in the burden of disease, injury, and violence, or in opportunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, income, and other population groups and communities (CDC, 2017; Healthy People, 2021). While health disparities have been an issue of concern for many years, COVID-19 brought these differences into high relief over a short period of time. The most persistent disparities in the incidence of COVID-19 occurred in Native Hawaiian and Pacific Islander, American Indian, Alaska Native, Hispanic, and Black persons as compared to non-Hispanic White persons (Van Dyke et al., 2021). The reasons for these discrepancies may include inequities in COVID-19 testing and the fact that Hispanic and Black persons are overrepresented in the essential workforce leading to higher risk for exposure. The U.S. Commission on Civil Rights (2021) reported that COVID-19 has had a disproportionate toll on Native American communities as well. They note that the Navajo Nation experienced one of the highest infection rates in the United States. Additionally, discrimination in healthcare and living in urban areas may increase risk for exposure. In contrast, people living in rural areas may have longer dis- tances to travel to receive healthcare from COVID-19 specialists and are less likely to receive medical care guided by standard guidelines than those at large medical centers. Because sexual and gender minority persons have been historically affected disproportionately by lack of health insurance, poverty, discrimination, mental health disorders, and substance use disorders as compared to nongender and sexual minority persons, COVID-19 presents additional burdens for them (O’Neill, 2020).

While these issues are specific to COVID-19, investigation into the healthcare literature demonstrates the particular need to highlight health disparities in multiple conditions such as Heart Failure and Cerebral Concussion. For this reason, a new section titled Health Disparities and Sexual/Gender Minority Health has been added in all entries to reflect the importance of differences in health risks and outcomes across populations. The term sexual/ gender minority health describes the unique healthcare needs of persons including but not limited to those who identify as lesbian, gay, bisexual, transgender, or queer, all of whom face unique stigma and discrimination in the healthcare setting. The section titled Global Health Considerations has been updated to reflect a global society where many families migrate to, travel to, and live on multiple continents. This section acknowledges that the health of world populations becomes as important as the health of a neighborhood. Human papillomavirus and Trichomonas vaginalis infections are threatening the health of a generation of young people. In addition to infectious diseases, cardiovascular disease, lung disease, poor nutrition, violence, and injury cause death and disability around the world. By cultivating a global perspective, students and practicing nurses can prepare themselves for the next decades of healthcare. In the section titled Evidence-Based Practice and Health Policy, specific research studies or policy briefs have been chosen that relate to each entry and provide current information to guide nursing practice. The cited studies were selected because of their timeliness, relationship to nursing practice, and introduction of innovative therapies to improve health. I am indebted to Kaitlyn Shen, a geneticist at the University of Pennsylvania, who worked with me to update and expand the Genetic Considerations sections. As the volume of material about the genetic basis of disease proliferates, and as our understanding increases about how genetic and environmental factors relate to health and disease, this content has become essential to nursing practice.

Each entry begins with the Diagnosis Related Group (DRG) category. DRGs were initiated by the Health Care Financing Administration to serve as an organizing framework to group related conditions and to stabilize reimbursements. Because they provide a convenient standard to evaluate hospital care, DRGs are used by institutions and disciplines to measure utilization and to allocate resources. DRGs are included to indicate the expected norms in average length of hospital stay for each entry (Mean LOS). In addition, entries begin with the background information on epidemiology and physiology, causation, and considerations including genetics, gender, race/ethnicity, life span, health disparities, gender/minority health, and global health. I recognize that race, ethnicity, and gender are social and political constructs. Just as there are many races, there are also many genders, and categorizing people into groups, including a gender binary of male and female, does not represent the individuals for whom we provide care. I have tried to consider issues of race, ethnicity, and gender without stereotyping, but rather to inform nursing care. I will continue to work toward a goal of health equity in coming editions. Each entry follows the nursing process, with assessment information incorporated in the History and Physical Assessment sections, Psychosocial Assessment, and Diagnostic Highlights. These detailed, specific sections provide the foundation needed to perform a comprehensive assessment of the patient’s condition so that a Primary Nursing Diagnosis can be formulated that is appropriate to the patient’s specific needs (Butcher et al., 2018; Herdman et al., 2021; Moorhead et al., 2018). The Planning and Implementation section is divided into Collaborative and Independent interventions. The intent of the Collaborative section is to detail the goals of a multidisciplinary plan of care to manage the condition or disease. As in the first six editions, there is an expanded section on Pharmacologic Highlights that explores commonly used drugs, along with their doses, mechanisms of action, and rationales for use. The Independent section focuses on independent nursing interventions that demonstrate the core of the art and science of nursing. Each entry then finishes with Evidence-Based Practice and Health Policy, Documentation Guidelines, and Discharge and Home Healthcare Guidelines to help nurses evaluate the outcomes of care and to prepare hospitalized patients for discharge.

As with each preceding edition, the team at F. A. Davis has made the revision of the book much easier, and I am grateful to Rob Allen, Terri Allen, and Amy Romano for their patience, support, and assistance. I am also particularly grateful to Gloria Coats, Taralyn McMullan, and Karyn Morgan, who made important contributions to the revision of the seventh edition. The entire reason to revise this book is to provide practicing nurses a concise yet current and scientifically sound text to guide the professional practice of nursing. The provision of nursing care in the 21st century presents us with overwhelming challenges, and yet nursing is the discipline of choice for millions of practitioners. I hope this book honors the science of nursing and makes it easier to practice the art of nursing.

MARILYN (LYNN) S. SOMMERS

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