Full download Fundamentals of Nursing 2nd Edition Lauren Mctier file pdf all chapter on 2024

Fundamentals of Nursing 2nd Edition
Lauren Mctier
Visit to download the full and correct content document:
https://ebookmass.com/product/fundamentals-of-nursing-2nd-edition-lauren-mctier/
More products digital (pdf, epub, mobi) instant
download maybe you interests ...
Fundamentals of Nursing Patricia A. Potter
https://ebookmass.com/product/fundamentals-of-nursing-patricia-a-
potter/
Kozier & Erb’s Fundamentals of Nursing (Fundamentals of

Nursing (Kozier)) 10th Edition, (Ebook PDF)
https://ebookmass.com/product/kozier-erbs-fundamentals-of-
nursing-fundamentals-of-nursing-kozier-10th-edition-ebook-pdf/
(eBook PDF) Fundamentals of Nursing: Active Learning

for Collaborative Practice 2nd Edition
https://ebookmass.com/product/ebook-pdf-fundamentals-of-nursing-
active-learning-for-collaborative-practice-2nd-edition/
Fundamentals of Nursing Made Incredibly Easy!

(Incredibly Easy! Seriesu00ae) 2nd Edition, (Ebook PDF)
https://ebookmass.com/product/fundamentals-of-nursing-made-
incredibly-easy-incredibly-easy-series-2nd-edition-ebook-pdf/
Fundamentals of Nursing 10TH ED 2020 10th Edition Amy
M.
https://ebookmass.com/product/fundamentals-of-nursing-10th-
ed-2020-10th-edition-amy-m/
Oxford Handbook of Respiratory Nursing 2nd Edition

Terry Robinson
https://ebookmass.com/product/oxford-handbook-of-respiratory-
nursing-2nd-edition-terry-robinson/
Fundamentals of Canadian Nursing: Concepts, Process,

and Practice, 3rd Canadian Edition
https://ebookmass.com/product/fundamentals-of-canadian-nursing-
concepts-process-and-practice-3rd-canadian-edition/
Essentials of Nursing Law and Ethics 2nd Edition
https://ebookmass.com/product/essentials-of-nursing-law-and-
ethics-2nd-edition/
Fundamentals of Physical Geography 2nd Edition, (Ebook

PDF)
https://ebookmass.com/product/fundamentals-of-physical-
geography-2nd-edition-ebook-pdf/
fundamentals
of nursing
Australia & New Zealand..
2nd Edition..
Copyright 2020 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-200-202
Australia & New Zealand..
2nd Edition..
fundamentals
of nursing
DeLaune
Ladner
McTier
Tollefson
Lawrence
—
Australian and New Zealand Fundamentals of Nursing © 2020 Cengage Learning Australia Pty Limited
2nd Edition
Sue C. DeLaune Copyright Notice
Patricia K. Ladner This Work is copyright. No part of this Work may be reproduced, stored in a retrieval
Lauren McTier system, or transmitted in any form or by any means without prior written permission of
Joanne Tollefson the Publisher. Except as permitted under the Copyright Act 1968, for example any fair
Joanne Lawrence dealing for the purposes of private study, research, criticism or review, subject to
certain limitations. These limitations include: Restricting the copying to a maximum of
one chapter or 10% of this book, whichever is greater; providing an appropriate notice
Head of content management: Dorothy Chui and warning with the copies of the Work disseminated; taking all reasonable steps to
Senior content manager: Fiona Hammond, Michelle Aarons limit access to these copies to people authorised to receive these copies; ensuring
Content developer: James Cole you hold the appropriate Licences issued by the Copyright Agency Limited (“CAL”),
Project editor: Sutha Surenddar supply a remuneration notice to CAL and pay any required fees. For details of CAL
Editor: Sylvia Marson licences and remuneration notices please contact CAL at Level 11, 66 Goulburn
Proofreader: Craig MacKenzie Street, Sydney NSW 2000, Tel: (02) 9394 7600, Fax: (02) 9394 7601
Permissions/Photo researcher: Helen Mammides Email: info@copyright.com.au
Cover designer: Olga Lavecchia Website: www.copyright.com.au
Project designer: Nikita Bansal
Cover: Getty Images/ranplett For product information and technology assistance,
Cenveo Publisher Services in Australia call 1300 790 853;
in New Zealand call 0800 449 725
Any URLs contained in this publication were checked for currency during the
production process. Note, however, that the publisher cannot vouch for the ongoing For permission to use material from this text or product, please email
currency of URLs. aust.permissions@cengage.com
National Library of Australia Cataloguing-in-Publication Data

Acknowledgements Creator: DeLaune, Sue C., author.
Notice to the Reader Title: Australian and New Zealand fundamentals of nursing / Sue C. DeLaune,
Patricia K. Ladner, Lauren McTier, Joanne Tollefson, Joanne Lawrence (author).
Publisher does not warrant or guarantee any of the products described herein or Edition: 2nd edition
perform any independent analysis in connection with any of the product information ISBN: 9780170411417 (paperback)
contained herein. Publisher does not assume, and expressly disclaims, any obligation Notes: Includes index.
to obtain and include information other than that provided to it by the manufacturer. Other Creators/Contributors: Patricia K. Ladner, Lauren McTier, Joanne Tollefson,
The reader is expressly warned to consider and adopt all safety precautions that Joanne Lawrence (author).
might be indicated by the activities described herein and to avoid all potential
hazards.
Cengage Learning Australia
By following the instructions contained herein, the reader willingly assumes all risks in Level 7, 80 Dorcas Street
connection with such instructions. The publisher makes no representations or South Melbourne, Victoria Australia 3205
warranties of any kind, including but not limited to, the warranties of fitness for
particular purpose or merchantability, nor are any such representations implied with Cengage Learning New Zealand
respect to the material set forth herein, and the publisher takes no responsibility with Unit 4B Rosedale Office Park
respect to such material. The publisher shall not be liable for any special, 331 Rosedale Road, Albany, North Shore 0632, NZ
consequential, or exemplary damages resulting, in whole or part, from the readers’
use of, or reliance upon, this material. For learning solutions, visit cengage.com.au
Authorised adaptation of Fundamentals of Nursing 4th edition, by Sue C. DeLaune Printed in Singapore by 1010 Printing International Limited.
and Patricia K. Ladner © 2011 Cengage Learning (9781435480674) 1 2 3 4 5 6 7 23 22 21 20 19
v

CONTENTS
Guide to the text x UNIT 2

Guide to the online resources xiii NURSING PROCESS: THE STANDARD OF CARE 59
Prefacexv
Language and terminology xviii CHAPTER 4
About the authors xix Critical thinking, decision making and the nursing
Acknowledgementsxxii process 60
Introduction 61
Critical thinking 61
UNIT 1
Development of critical thinking skills 62
NURSING PERSPECTIVES: PAST, PRESENT The nursing process 64
AND FUTURE 1 Five steps of the nursing process 64
Critical thinking applied in nursing 69
CHAPTER 1
Chapter resources 70
Evolution of nursing education and theory 2
Introduction 3 CHAPTER 5
Evolution of nursing education in Australia and Assessment 72
New Zealand 3 Introduction 73
Trends in nursing education in Australia and Purpose of assessment 73
New Zealand 11 The three types of assessment 73
Theoretical foundations 14 Data collection 74
Scope of theories 16 The assessment interview 77
Evolution of nursing theory 16 Health history 78
Selected nursing theories 19 The physical examination 80
Chapter resources 25 Situational awareness 81
Verifying and organising data 82
CHAPTER 2
Interpreting and documenting data 84
Research and evidence-based practice 28
Data documentation 84
Introduction 29
Research: substantiating the science of nursing 29
Research process 30 CHAPTER 6
Research utilisation 34 Problem identification 96
Evidence-based practice 35 Introduction 97
Evidence reports 36 What is problem identification? 97
Trends in research and evidence-based practice 38 Importance of problem identification 98
Chapter resources 38 Components of problem identification 100
Clinical judgement in nursing: identifying problem
CHAPTER 3
statements 101
Health care delivery 41
Avoiding errors in the development and use of problem
Introduction 42
identification 103
Health care delivery: organisational frameworks 42
Health care team 43
Factors influencing the delivery of health care 44 CHAPTER 7
Responses to health care changes 46 Planning 107
Continuum of care 47 Introduction 108
Quality management in health care 50 Purpose of planning 108
Organisational structure for quality management 52 Process of planning 108
Nursing’s role in quality management 54 Establishing goals and expected outcomes 110
Trends in health care delivery 55 Components of goals and expected outcomes 111
Chapter resources 56 Problems frequently encountered in planning 112
vi Contents
Planning nursing interventions 113 Principles of effective documentation 190

Nursing care plan 116 Methods of documentation 194
Chapter resources 117 Computers in nursing 199
CHAPTER 8
Implementation 119
Introduction 120 UNIT 4
Purpose of implementation 120 PROMOTING HEALTH 205
Requirements for effective implementation 120
CHAPTER 13
Implementation activities 120
Delegation of tasks 122 Nursing, healing and caring 206
Nursing interventions 124 Introduction 207
Chapter resources 128 Nursing’s therapeutic value 207
Theoretical perspectives of caring 209
CHAPTER 9 Health care relationship 211
Evaluation 130 Caring and communication and characteristics
Introduction 131 of therapeutic nurses 214
Evaluation of care 131 Therapeutic value of the nursing process 217
Components of evaluation 131 Chapter resources 219
Methods of evaluation 132
CHAPTER 14
Evaluation and quality of care 133
Evaluation and accountability 135 Communication 222
Multidisciplinary collaboration in evaluation 135 Introduction 223
Chapter resources 137 The communication process 223
Modes of communication 227
Types of communication 230
UNIT 3 Barriers to therapeutic communication 234
PROFESSIONAL ACCOUNTABILITY 139 Communication roadblocks 235
Communication, critical thinking and nursing process 238
CHAPTER 10
Leadership and delegation 140
Professional nursing practice 141 Health and wellness promotion 244
Professional accountability 142 Introduction 245
Legislative accountability 144 Health, illness and wellness 245
Individual accountability 145 Health behaviours 247
Leadership in nursing 147 Health promotion 249
Power 151 The individual as a holistic being 252
Chapter resources 155 Needs and health 252
Promoting sexual health 254
CHAPTER 11
Legal and ethical responsibilities 158
Legal foundations of nursing 159 Family and community health 261
Legal responsibilities and roles of nurses 168 Introduction 262
Legislation affecting nursing practice 169 Family health 262
Ethical foundations of nursing 171 Characteristics of healthy families 262
Ethical principles 173 Family development theories 264
Ethical codes of practice 175 Threats to family integrity 265
Ethical dilemmas and ethical decision making 176 Community health and public health nursing 267
Chapter resources 179 Disaster preparedness 269
CHAPTER 12
Documentation and informatics 182 CHAPTER 17
Introduction 183 The life cycle 272
The role of informatics 183 Introduction 273
Documentation as communication 185 Fundamental concepts of growth and development 273
Contents vii
Factors influencing growth and development 274 Health of the First Australians 397
Theoretical perspectives of human development 275 Policies and practices impacting on First Australian
Holistic framework for nursing 281 health and wellbeing 398
Stages of the life cycle: the adult 281 Social determinants of health 399
Chapter resources 291 Chapter resources 400
CHAPTER 18 CHAPTER 23
Paediatric care 294 Rural and remote health 403
Introduction 295 Introduction 404
The prenatal period and the neonate 295 Characteristics of rural and remote communities 404
The infant 300 Determinants of health 407
The toddler and the preschool-aged child 304 Access to and use of health care 413
The school-age child and preadolescent 308 Providing sustainable health care 414
The adolescent 315 Role of the rural and remote nurse 418
Chapter resources 319 Health promotion 419
CHAPTER 19
The older adult 321 CHAPTER 24
Introduction 322 Health care education 425
Defining old age 322 Introduction 426
Changes associated with ageing 325 The importance of contemporary health education 426
Medications and the older adult 334 Barriers to learning 427
Abuse of the older adult 335 Professional responsibilities related to teaching 429
Nursing process and the older adult 337 Learning throughout the life cycle 429
Chapter resources 343 Teaching–learning and the nursing process 432
CHAPTER 20
Palliative care 347
Introduction 348 UNIT 5
Understanding palliative care 348 RESPONDING TO BASIC PSYCHOSOCIAL NEEDS 443
Palliative care approaches 350
CHAPTER 25
Disease trajectories 350
Working in palliative care 352 Self-concept 444
Provision of palliative care 352 Introduction 445
Psychosocial, spiritual and emotional concerns 361 Components of self-concept 445
The dying process 362 Development of self-concept 447
Chapter resources 364 Factors affecting self-concept 449
Nursing process and self-concept 450
CHAPTER 21 Chapter resources 455
Cultural diversity 368
CHAPTER 26
Introduction 369
Concepts of culture 369 Stress, anxiety, adaptation and change 458
Dominant values in Australia and New Zealand 370 Introduction 459
The indigenous peoples of Australia and New Zealand 371 Stress, anxiety and adaptation 459
Organising phenomena of culture 372 Responses to stress 459
Cultural disparities in health and health care delivery 378 Stress and illness 465
Transcultural nursing 382 Stress and change 466
Cultural competence and nursing process 383 Nursing process with anxious individuals 467
Chapter resources 386 Personal stress-management approaches for the nurse 472
CHAPTER 22
CHAPTER 27
Aboriginal and Torres Strait Islander health 389
Introduction 390 Spirituality 478
Introducing the First Australians 390 Introduction 479
Similarities and differences within and between Spirituality defined 479
Aboriginal Australians 392
viii Contents
Health and spirituality in Australian and New Zealand Post-assessment care of the person 617
indigenous cultures 483 Data documentation 619
Spirituality and aged care 484 Chapter resources 619
Nursing process and spirituality 485
CHAPTER 32
Safety, infection control and hygiene 623
CHAPTER 28 Introduction 624
Loss and grief 491 Creating a culture of safety for hospitalised people 624
Introduction 492 Safety for health care workers 629
Loss 492 Infection-control principles 631
Grief 493 Hygiene 638
Death 501 Assessment 640
Care after death 505 Problem identification and interventions 644
Nurse’s self-care 507 Outcome identification and planning 646
Chapter resources 508 Implementation 647
Evaluation 668
CHAPTER 29
Mental health 510
What is mental health? 511 Medication administration 674
The history of mental health care 512 Introduction 675
The recovery model of mental health care 513 Medication standards and legislation 675
Common mental disorders 514 Pharmacokinetics 676
Assessment of mental disorders 517 Medication nomenclature 678
Treatment of mental disorders 518 Medication action 678
Mental health promotion 520 Professional roles in medication administration 683
Specialising in mental health nursing 520 Systems of weight and measure 685
Working with culturally and linguistically diverse Medication dose calculations 685
populations in mental health 522 Safe medication administration 686
Chapter resources 523 Medication compliance and legal aspects of
administering medications 691
Assessment 693
UNIT 6
Problem identification and planning and outcome
RESPONDING TO BASIC PHYSIOLOGICAL NEEDS 525 identification 696
CHAPTER 30 Implementation 697
Vital signs 526 Evaluation 712
Introduction 527 Chapter resources 712
The physiological principles of oxygen delivery 527 CHAPTER 34
Recording of vital signs 529 Traditional and complementary therapies 715
Pulse 533 Introduction 716
Blood pressure 537 Historical influences on contemporary practices 717
Respirations 547 Allopathic medicine 719
Oxygen saturation 551 Contemporary trends in T&CM 720
Temperature 553 Holism and nursing practice 721
Level of consciousness 558 Complementary therapies and interventions 722
The nursing process and vital signs 559 Nursing and traditional and complementary medicine
Chapter resources 561 approaches 736
CHAPTER 31 Chapter resources 739
Physical assessment 564 CHAPTER 35
Introduction 565 Oxygenation 743
Purposes of physical examination 565 Introduction 744
Preparation for physical examination 566 Physiology of oxygenation 744
The person with bariatric issues 569 Factors affecting oxygenation 749
Assessment techniques 571 Assessment 754
Diagnostic testing 573 Problem identification 765
Physical assessment: areas to be assessed 583
Contents ix
Planning and outcomes 768 CHAPTER 40

Implementation 768 Skin integrity and wound healing 956
Evaluation 779 Introduction 957
Chapter resources 779 Physiology of wound healing 957
CHAPTER 36
Factors affecting wound healing 959
Wound classification 962
Fluids and electrolytes 783
Wound assessment 963
Introduction 784
Problem identification 966
Physiology of fluid and acid-base balance 784
Planning and outcomes 967
Disturbances in electrolyte and acid-base balance 789
Implementation 968
Assessment 800
Pressure injuries 974
Implementation 808
Chapter resources 825 CHAPTER 41
CHAPTER 37
Sensation, perception and cognition 990
Introduction 991
Nutrition 828
Physiology of sensation, perception and cognition 991
Introduction 829
Factors affecting sensation, perception and cognition 997
Physiology of nutrition 829
Sensory, perceptual and cognitive alterations 998
Understanding nutrients 831
Assessment 999
Promoting proper nutrition 837
Factors affecting nutrition 840
Implementation 1004
Assessing nutrition 842
Evaluation 1009
Implementation 850
Evaluation 861 CHAPTER 42
Chapter resources 865 Elimination 1013
CHAPTER 38
Introduction 1014
Physiology of elimination 1014
Pain management, comfort and sleep 868
Factors affecting elimination 1017
Introduction 869
Assessment 1018
Pain 869
Problem identification: common alterations in elimination 1024
Physiology of pain 871
A person-centred pain assessment 876
Implementation 1030
Pharmacological pain management 884
Evaluation 1045
Non-pharmacological interventions 892
Evaluation 895
Rest and sleep 898 CHAPTER 43
Factors affecting rest and sleep 899 Perioperative nursing care 1048
Nursing interventions that promote comfort rest and sleep 902 Introduction 1049
Chapter resources 906 Surgical interventions 1049
CHAPTER 39
Preoperative phase 1052
Intraoperative phase 1068
Mobility 911
Postoperative phase 1074
Introduction 912
Overview of mobility 912
Physiology of mobility 914
Answers to review questions 1083
Physical activity 915
Glossary1086
Factors affecting mobility 923
Index1108
Physiological effects of mobility and immobility 925
Assessment 927
Implementation 935
Evaluation 951
x
266 P R O M O T I N G H E A LT H
Guide to the text
As you read this text you will find a number of features in
Strait Islander children overrepresented at eight times
the rate of non-Aboriginal and Torres Strait Islander
every chapter to enhance your study of nursing and help you 31
for being killed during intimate partner violence
CHAPTER (Cale et al., 2016; Powers & Kaukinen, 2012;
UNIT 0 4
children (Papalia et al., 2017; Sampson & Read, 2017). Spangaro et al., 2016). Some of the risk factors for
This number most likely does not reflect the total intimate partner abuse include young age, low
understand how the theory is applied in the real world.
number of children abused because underreporting income status, pregnancy, mental health problems,
is common. Young children are more vulnerable to
abuse than are older ones.
PHYSICAL ASSESSMENT
substance abuse by victims or perpetrators,
separated or divorced status, history of childhood
CHAPTER OPENING FEATURES
Many factors are related to child abuse and neglect. sexual or physical abuse, and being from either
These factors include stress, financial problems, inadequate an Aboriginal and Torres Strait Islander, Māori or
parenting skills, parental substance abuse, parental a culturally and linguistically diverse (CALD)
impulsivity, social isolation, and parents themselves being OUTCOMES
LEARNING background.
abused as children. Childaabuse Discuss the purposes of assessing a person throughout their health care.
results in physical1pain
Learning outcomes give you clear Nursing
2 Describe the preparation response
of the person requiredtoforfamily
performing violence
a physical examination.
and emotional damage that may last a lifetime. 3 Discuss the adaptation of skills to physically assess a person who is morbidly obese.
sense of what topics each chapter The best
4 Explain the techniques used intreatment for family
conducting a physical violence is prevention;
examination.
Older
will cover and adultyou
what abuseshould be
5 Describe common seeinvasive
Table and16-3.
non-invasive diagnostic procedures
Prevention is basedandon laboratory studies and
assessment and
relevant care of the person before, during and after diagnostic testing, including teaching guidelines.
discuss the
The mistreatment of older adults takes many forms, education;

6 Describe the physical examination therefore, all nurses
and the significance across
of assessment every
findings practice
obtained from a physical
able to do after reading the chapter.
including physical, psychological and sexual abuse examination of each of the and
setting following areas: headmust
specialty and neck,
bethorax and lungs,
vigilant forheart and vascular
signs of system,
breasts and axillae, abdomen, musculoskeletal, neurological, reproductive, rectum and anus.
and financial exploitation. In most cases, the 7 Outline the careviolence. Nursestheir
of the person following should
physicalbe especially vigilant for signs
examination.
8 Discuss the documentation of data obtained from a physical examination.
perpetrator is a family member, usually an adult child of abuse. In Australia, nurses are mandated to report if
or spouse. Factors associated with the abuse of older they believe there are reasonable grounds to suspect a
CLINICAL SKILLS
The Clinicaladults
Skills box increasing
include identifies age, low-income status, child is experiencing or is at risk of experiencing harm
The following procedures are to be found in CPS7:
functional
relevant clinical impairment
skills coveredand in impaired
the cognitive■■ability.
15 Mental status (Child
assessmentFamily Community Australia, 2017; Mathews
■■ 19 Focused neurological health history and physical
Older adults who have chronic illnesses are also atFocused cardiovascular
■■ 16 et al., 2017; Mathews
health history and & Walsh, 2014). In New Zealand,
assessment
Clinical Psychomotor Skills textbook,
increased risk. Social isolation is a serious problem physical assessment
nurses are required to report
■■ 21 Focused gastrointestinal health history and
incidences of children
■■ 18 Focused respiratory health history and physical abdominal physical assessment
sold separately.
that affects many elderly people, especially those assessment experiencing or at risk of ■harm according
■ 24 Focused to their
musculoskeletal health history and
with chronic illnesses (Cairns & Vreugdenhil, 2014; employing agency’s child protection policies
physical assessment and range(Jackson,
of motion exercises
Joosten, Dow, & Blakey, 2016). Lack of transportation, 2013; Oranga Tamariki Ministry for Vunerable
lack of employment and strained relationships with Children, 2015). When abuse is suspected, you
caregivers may lead to inadequate care, including should document your findings and report them in
maltreatment. See Chapter 19 for more discussion of accordance with the policies and procedures outlined
FEATURES WITHIN CHAPTERS
the maltreatment of older people. by your workplace setting. Your documentation
should include verbatim (subjective) statements
Spouse and partner abuse gathered from the victim as well as photographs and
Learn about Thethe importance
majority of evidence
of assaults by partnersand clinical atresearch
are directed in nursing
description of their with Evidence-Based
theTelephone
injuries. numbers of Practice
boxes which women. Women are
link research toalso at greater
nursing risk than men
practice. local shelters and crisis lines can also be given to the
EVIDENCE-BASED PRACTICE
Title of study Intimate Partner Violence profiles were identified that
Patterns of intimate partner violence victimization
564 among differed according to the variety, degree, and severity of
Australia and New Zealand female university students: An Intimate Partner Violence. Furthermore, the combination
initial examination of child maltreatment and self-reported of child maltreatment and self-reported depressive
depressive symptoms across profiles BK-CLA-DELAUNE_2E-180413-Chp31.indd symptoms
564 differed across profiles. The results highlighted 15/03/19 8:25 PM
AssEssmEnT 79
Authors 32differential n Upathways
R s i n G P Efrom R s P Echild
C T i v Emaltreatment
s : PA s T, P R Eto s Especific
nT And FUTURE
J. Cale, S. Tzoumakis, B. Leclerc and J. Breckenridge Intimate Partner Violence victimisation patterns. These
findings provide further evidence for the importance of
Abstract
ort of the event that short of breath – record this reaction). A person early intervention strategies to prevent Intimate Partner
The aim of this study was to examine the relationship
th care. The person’s may report an ‘allergy’ to a medication because they Violence,knowledge and specifically for evidence-based
for children who experience nursing practice. ■■ Trial and error: using unkno
UCNHIAT P0T1E R 0 5
between child abuse, depression, and patterns of intimate Qualitative research aims to understand how the situation of uncertainty
use it explains what is developed nausea after ingesting it, which you will abuse and neglect to help prevent subsequent victimisation
partner violence victimisation among female university participants
om their point of view. It recognise as a side effect that would not necessarily experiences in intimatederive meaning
relationship contexts. from their surroundings, ■■ Personal experience: gaining
students in Australia and New Zealand. Data were based and how their meaning influences their
PARTNERbehaviour. personally involved in an e
e the time of the onset of preclude administration of the medication in the CALE, J., TZOuMAKIS, S., LECLERC, B. & BRECKENRIdGE, J. (2016). PATTERNS OF INTIMATE VIOLENCE
on the Australia/New Zealand portion of the International VICTIMIZATION AMONG AuSTRALIA ANd NEW ZEALANd FEMALE uNIVERSITy STudENTS: AN INITIAL EXAMINATION
That is, qualitative researchers aim to gather an circumstance
ete symptom analysis. future. Sensitivity to a medication can also change OF CHILd MALTREATMENT ANd SELF-REPORTEd dEPRESSIVE SyMPTOMS ACROSS PROFILES. AUSTRALIAN & NEW
Dating Violence Study (2001–2005) (n = 293). Using in-depth understanding of human behaviour and the ■■ Role modelling and mentorsh
over time. Severe reactions may occur even though ZEALAND JOURNAL OF CRIMINOLOGY, dOI.ORG/10.1177/0004865816666615
alth status Identify important client

Latent Class health
Analysis, Low-,and safety
Moderate-,
the person has successfully taken the medication or
andissues and
High-level Consider reasons approaches
that govern such to respectful
behaviour. The care for clients
qualitative behaviours of an exemplar
fers to the person’s the appropriate response to critical situations
experienced only mild reactions to the medication in with the from diverse
method backgrounds
investigates the why withand the
how Respecting
of decision our ■■ Intuition: being guided by a
th. It may be useful to
SafetytheFirst
past. boxes. Differences making, not boxes. just what, where and when. cannot be logically explain
on a scale of 1 to 10 (with ■■ Reasoning: processing and o
or), together with their to reach conclusions
s. For example, you may SAFETY FIRST RESPECTING OUR DIFFERENCES ■■ Research: validating and refi
e following to represent knowledge and generating
alth: ‘Rates health a 7 on ASSESSMENT FOR ALLERGIES Experience of dialysis for people with Greek Carper (1978, 1992) descri
) because he must take BK-CLA-DELAUNE_2E-180413-Chp16.indd 266
It is essential that you explore possible allergies prior to backgrounds 15/03/19 10:42 AM
patterns of knowing:
to maintain mobility, administering any medications. Always ask if the person A study by Tranter (2016) used a descriptive qualitative ■■ Empirical: using research to
s upsets his stomach’. is allergic to the medication. Allergic reactions can be life- methodology to explore the factors that inform decisions of predict
threatening and can occur even with very low dosages people from Greek backgrounds regarding dialysis and to ■■ Ethical: extending knowled
isations and surgeries of medications or if the medication has been safely taken identify the enablers and barriers to choosing home dialysis and advocating
y previous experiences previously. for this group. An audit of dialysis patients in the renal ■■ Personal: encountering and
alisation are helpful service revealed that 20 per cent of hospital-based patients others
nditions. It is also were from a Greek background in comparison to 7 per cent ■■ Aesthetic: interpreting, eng
s to illness, since Current medications in the home dialysis group. Cultural norms are seen to guide clues to knowledge.
an impact on current CopyrightAll
2020 Cengagecurrently
medications Learning. All both
taken, Rights Reserved.
prescription May not be copied, scanned,
and the decisionsor duplicated,
of people from Greek in whole
backgrounds or inin part.
this WCN 02-200-202 Research undertaken by M
over-the-counter, are recorded by name, frequency older age group. Specific educational materials addressing (2008) identifies five discrete t
and dosage. Remind the person that this information home dialysis were developed and translated into Greek. used by nurses in medical war
l history
■■ Personal: encountering and focusing on self and
service revealed that 20 per cent of hospital-based patients others
were from a Greek background in comparison to 7 per cent ■■ Aesthetic: interpreting, engaging and envisioning
in the home dialysis group. Cultural norms are seen to guide clues to knowledge.
the decisions of people from Greek backgrounds in this G U I D E TO T H E TE X T xi
Research undertaken by Mantzoukas and Jasper
older age group. Specific educational materials addressing (2008) identifies five discrete types of knowledge
home dialysis were developed and translated into Greek. used by nurses in medical wards: personal practice,
These documents, coupled with a greater understanding theoretical, procedural, ward culture and reflexive.
of the findings related to Greek culture, were integrated by The authors suggest that reflexive knowledge is the
FEATURES WITHIN CHAPTERS staff in the Renal Options Clinic. This focused education,
taking into consideration cultural and social values, is
resulting knowledge base from which nurses appear to
work, and it integrates all other sources of knowledge
required to support patients in their decision making and 667
to enable them to respond to Sfuture A f E T Y, I N f E C T I O N C O N T R O L A N D H Y G I E N E
unique situations
Learn key information and to
confidence issues
perform in home nursing
therapies.with Review onand the basisrevise useful
of their previouslistsexperience
of important (p. 324). concepts
the Nursing Highlights R E s E A R C Hboxes.
And E vidEnCE-bAsEd PRACTiCE
Eyes
37 in nursing, The client
researchteaching
process is based andonthe nursing
sequential, process
interrelated
steps; see theofaccompanying NURSING CHECKLIST
Eyes are continually cleansed withbythe Nursing
the production Checklist‘Nursing boxes.checklist’.
CHAPTER 32
Increasingly used by nurse researchers is a
tears and the movement of eyelids over the eyes. EYE CARE FOR THE COMATOSE PERSON
mixed-method design which involves mixing
Eyelids should two be washed daily with a warm washcloth • Cleanse eyelids, eyelashes and eyebrows with warm
methodological approaches within the one study. The from the inner to outer canthus. Eyelashes function to washcloth at least every four hours. Clean from inner
NURSING HIGHLIGHTS prevent foreign material from entering NURSING the eyes and CHECKLIST to outer canthus.
two approaches used are typically quantitative and
CHAPTER 02
conjunctival sacs. Eyelashes and eyebrows should be • If eyes remain open and blink reflex is absent, liquid
qualitative, though they could be just oneasof these
DETERMINING EVIDENCE-BASED NURSING PRACTICEAn artificial eye (prosthetic) maySteps in the research process
washed necessary. tear solutions should be applied to prevent corneal
require daily drying and ulcerations.
(Morse, 2017), with the mixing coming from data Formulating a research question or problem
A nurse working on an intensive care unit notices that cleaning. The eye must be removed•from the • Eyes can be closed and covered with polyethylene
eview collection and analysis or the interpretation eye socket and phases
washed. Some artificial • Defining
eyes are the purposemoisture of thecovers
study(e.g., cling wrap) or a protective shield
Clostridium difficile infection has become prevalent
of the study. The main assumption underpinning permanently implanted. People who are unconscious
• Reviewing relevant literature to protect against corneal abrasion. The eye patch or a
among surgical patients in the hospital and is interestedfor a time have special eye care needs since they lack a protective shield should be removed at least every four
mixed-methods research is that using quantitative and • Developing a conceptual framework (structure that
Evidence in finding out if there is a reliable screening tool to assess blink reflex. These people require frequent instillations hours to assess eyes and provide eye care.
qualitative approaches in the same study results
of lubricants in
or eyedrops to prevent corneal links global
abrasions.concepts together to form a unified whole)
the risk of infection so that preventative measures can be The accompanying ‘Nursing checklist’ describes eye
complementary strengths. Furthermore, the limitations • Developing research objectives, questions and
taken. care for the comatose person. Anyone who can insert, remove and manage the care
Recommendations of one approach may be corrected or balanced by the hypotheses
1 Step 1. Review and critique research reports related of their lenses will require minimal assistance from
other approach (Richardson-Tench et al., 2018). See CPS7, Clinical Skill 78: Caring for a person who is
• Defining research thevariables
nurse. If the person is unable to assist with lens
to the use of screening tools for risk of infection in unconscious
care and also has corrective eyeglasses, suggest that
There are multiple ways in which nurses establish • Selecting a research design (overall planduring used hospitalisation.
to
ed for information, analysis of scientific surgical patients. he or she wear the eyeglasses
mmendations for practice the sources and the realm of knowledge Contactconcerning
lenses conduct the research) There are two types of contact lenses: hard and soft.
2 Step 2. Based on the critique of the literature on theThe nursing history should indicate whether the
nursing, human responses, diagnoses and treatments. Defining Each type requires different cleaning and care. During
the population, sample and setting
results of the use of screening tools in identifying person wears contact lenses, and the• routine care emergency situations, the nurse removes the lenses
and analysis of the systematic Gray, Grove & Sutherland (2017) describe how nursing Conducting a pilot
at risk of surgical infections and associated and level of assistance is recorded •
on the care plan. andstudy
places them in the appropriate solution.
e what the research has historically acquired knowledge: • Collecting data
recommendations for preventative measures, identify
the level of evidence in order ■■ Traditions: basing practice on customs and past trends
the level and strength of the evidence: good, fair or NURSING CARE PLAN • Analysing data
ns to promote EBP. ■■ Authority: crediting another person as the source of • Communicating research findings, their implications
insufficient to support or reject a cause-and-effect
summary statement information PERSON AT RISK FOR INJURY and the limitations of the study
Interventions/rationales
t the evidence reports. The Follow an individual
interpretation ofperson’s
the association. case
■■ Borrowing: using knowledge from other
Case disciplines
presentation 1 Initiate the fall prevention protocol. This identifies and
3 Step 3. Make specific recommendations regarding Mr Simon, aged 75, is admitted to the hospital with coronary
data describes a review of and the process of planning to guide nursing care, practice reduces risk for injury.
the use of recommended preventative measures to heart disease (CHD). He has a family history of CHD. He 2 Reassess Mr Simon’s injury status every four hours. This
d unpublished research, identifying problems, performing smokes two packs of cigarettes a day, has diabetes mellitus, identifies changes and highlights the need to modify plan
reduce the risk of surgical infections based on the of care.
s, target populations that and is obese.
clinical interventions that
interventions critiqued and evaluating
research and the level and strength of the
Assessment
3 Place Mr Simon in a room as close as possible to the nurses’
evidence found in the research. station. This facilitates faster response time to his needs.
he strength of individual outcomes for that person with the • Weight gain of 3 kg in past month
AdAPTEd FROM POLiT, d.F. & bECK, C.T. (2017) NURSING RESEARCH GENERATING•AND Blood cholesterol 320 mg/dL
4 Place fall alert signs on Mr Simon’s door and the head of
his bed. The signs alert other health care workers to the
Nursing
lts (Benefield, 2002). The detailed BK-CLA-DELAUNE_2E-180413-Chp02.indd Care Plans and • High-density lipoproteins (HDL) 28 mg/dL
ASSESSING EVIDENCE FOR NURSING PRACTICE. (10TH Ed.), PHiLAdELPHiA, WOLTERs KLUWER.
32 risk status. 12/03/19 6:16 PM
he strength and quality • Blood pressure 186/116 mmHg
arch findings should be

associated visual Nursing Concept • Diminished visual acuity
5 Turn on the bed alarm. This helps monitor Mr Simon’s
status and facilitates a prompt response if he tries to get
• Decreased bladder tone
text of actual or potential Maps.Clinicians then implement the guidelines rather than S k i n i nand
T E gsyncope
RiT y And wound HE Aling 985 out of bed unassisted.
• Weakness
6 Monitor Mr Simon and the environment every two hours,
distilling the research findings and making decisions • Glasgow Coma Scale (GCS) score of 12
the evidence deems it and whenever a caregiver passes by his room. This
Problem identification: Risk for injury related to sensory
duct is a recommendation based on the evidence. The latter half of the 1990sdysfunction, weakness, and altered level of consciousness. provides information on status, progress and needs; it also
Mr Short is a 48-year-old man who was involved in a encourages a team approach to his care.
focused guideline or saw the development of motor hundreds of sets of clinical
vehicle accident. Three days after
Goal: Mr Simon will not be injured during the hospitalisation.
7 Instruct all caregivers to respond promptly to the call light.
CHAPTER 40
Intervention: Assess for risk of falls and use fall-prevention

P promotes quality care guidelines. abdominal surgery he develops fever, tenderness This ensures rapid response to Mr Simon’s needs.
around incision, and purulent drainage from the strategies.
Essentially, a clinicalwound. guideline will appear 8 Teach Mr Simon how to use the call light; reinforce the
ted to be effective; see The physician opens the incisionin
and hard
Expected outcome
orders normal saline irrigation and dressing teaching each time before leaving him alone. This ensures
ing highlights’ box for an copy as a sheet of paper in a changes procedures or clinical Mr Simon will be protected from injury during the
three times a day. that Mr Simon has the means and knowledge to call for
y utilise research findings to guidelines book or folder, or in electronic form on hospitalisation. a assistance if necessary.
to promote EBP. If practice database in a computer file. It Within is a helpful,

1 week Mr Short’s
practical
EVALUATION
or a specific problem, you and sequential guide for clinicians wound will regarding
be free of infection how to Fall prevention protocol implemented. Mr Simon discharged on third day of hospitalisation free from injury.
as evidenced by:
nt evidence in studies, go about a clinical procedure safely Absence and effectively. For
of fever
ASSESSMENT DATA
alyses, and assess the quality example,
Temperaturea38°Cclinical guideline Absence may of redness, exudates
be about caring for
Normal WCC count
Nursing Interventions and Rationales
a person with confusion, or undertaking the care of

Pulse 110
Respirations 20
acquire and appraise a person receiving chemotherapy.
BP 130/70 1 Assess and document If clinicians accept
BK-CLA-DELAUNE_2E-180413-Chp32.indd
the wound for
667 16/03/19 11:30 AM
Incision – red, tender to touch,

difficulty in recalling it well-prepared
yellow purulent drainage and well-researched clinical
presence of redness, pain, guidelines,
exudate
with every dressing change.
This situation has led to the Labsresearch-based
– WCC elevated information within
Exudate indicatesthem
infection.can find
cal practice guidelines or its way into practice.
Assessment data 2
Assess VS q4h.
. One example of clinical
clues indicate guidelines developed
VS reflect Mr Short's overall condition.
elines, which are 1
from research are those by the Day Surgery Special
Problem identification 1:
matic reviews, give specific Interest
Impaired SkinGroup
Integrity (Victoria) (DSSIG).
3
Assess The guidelines
WCC count. Mr Short should be free
dence-based decision were related to presence
developed from theWBC counts show progression of infection.
results of three systematic of infection, with no
of contaminants. evidence of fever,
Successful
17, p. 28). Clinical practice reviews carried out by researchers at La Trobe implementation redness, or exudates.
WCC and VS should be
prise a set of statements University
The expected and the DSSIG (Pearson,
Within 1–2
Richardson
weeks, Mr Shot’s
& of nursing care
within normal range
outcome is... is indicated by...
ition or patient problem. Cairns, 2004; Pearson et al., 2004a;
wound will exhibit Pearson et al.,
signs of healing within 1 week.
as evidenced by: The wound should exhibit
ommittee of experts who 2004b). Presence of granulation tissue beefy, red granulation
Wound being closed and tissue, and the wound
Nursing Interventions and Rationales
to formulas for practice. without drainage edges should be

Key:
contracting 1 week after
Case Scenario admission.
1 Irrigate the wound and change the
Assessment Data
dressing tid utilising sterile technique.
Problem identification Promotes clean environment, which
Prioritised as 1, 2, etc. encourages wound healing.
Expected Outcome
2 Ensure good handwashing before and
Interventions and after all dressing changes.
Rationales
Limits exposure of incision
Evaluation to pathogens.
12/03/19 6:16 PM
CONCEPT MAP
The person with impaired skin integrity
from the inner to outer canthus. Eyelashes function to washcloth at least
prevent foreign material from entering the eyes and to outer canthus.
conjunctival sacs. Eyelashes and eyebrows should be • If eyes remain open
xii G U I D E TO T H E TE X T washed as necessary. tear solutions shou
An artificial eye (prosthetic) may require daily drying and ulcerati
cleaning. The eye must be removed from the • Eyes can be closed
eye socket and washed. Some artificial eyes are moisture covers (e.
permanently implanted. People who are unconscious to protect against c
for a time have special eye care needs since they lack a protective shield sh
ICONS blink reflex. These people require frequent instillations
of lubricants or eyedrops to prevent corneal abrasions.
hours to assess eye
The accompanying ‘Nursing checklist’ describes eye

Link theory to key clinical skills with the Clinical Skills icon throughout care for the comatose person. Anyone who can inse
of their lenses will req
the chapters. These CPS icons direct you to corresponding clinical skills See CPS7, Clinical Skill 78: Caring for a person who is the nurse. If the perso
unconscious
in more detail in Clinical Psychomotor Skills 7th edition textbook by care and also has corr
he or she wear the eye
Joanne Tollefson and Elspeth Hillman. Contact lenses There are two types o
The nursing history should indicate whether the Each type requires dif
E v o l U T I o Nperson
o f N Uwears
R s I N gcontact lenses, and the routine care
E d U C AT IoN ANd THEoRy 25 emergency situations,
and level of assistance is recorded on the care plan. and places them in th
END OF CHAPTER FEATURES
NURSING CARE PLAN
CHAPTER RESOURCES
At the end of each chapter you’ll find several tools to help you to review,
E v o l U Tpractise
I o N o f N U Rand
s I N gextend
E d U C ATyour knowledge
IoN AN d THEoRy 25
CHAPTER 01 CHAPTER 01
of the key learning outcomes. PERSON AT RISK FOR INJURY Interventions/rationale
Case presentation 1 Initiate the fall preve
• TheSUMMARY
Summary section highlights the important concepts covered in the Mr chapter and
Simon, aged links
75, is back
admitted to theto the with coronary
hospital reduces risk for injur
CHAPTER RESOURCES heart disease (CHD). He has a family history of CHD. He 2 Reassess Mr Simon’
learning outcomes.
■■ Nursing is an art and a science in which people are assisted ■■ The complexity of theoretical
smokes two frameworks are categorised
packs of cigarettes a day, has diabetes mellitus, identifies changes an
of care.
in learning to care for themselves whenever possible and as grand-theory, middle-range
and is obese. theory, and micro-range
3 Place Mr Simon in a r
cared for when they are unable to meet their own needs. theory. Grand theories, or conceptual models, focus on
Assessment
SUMMARY • Weight gaindiscipline.
of 3 kg in past month
station. This facilitates
The professionalisation of nursing has been influenced by phenomenon of concern to the Middle-range 4 Place fall alert signs
• Blood cholesterol 320 mg/dL
■■ key issues such as: the status of women, the development
Nursing is an art and a science in which people are assisted theories provide a bridge
The complexity of theoretical from grand
frameworks theories to effectively his bed. The signs al
lipoproteinsare categorised
■ ■
• High-density (HDL) 28 mg/dL
of learning
the biomedical risk status.
in to caremodel, employment
for themselves opportunities,
whenever possibleclass
and describe and explain
as grand-theory, • specific
middle-range nursing
theory,
Blood pressure phenomenon.
andmmHg
186/116 micro-range Micro-
5 Turn on the bed alarm
structures and religion.
cared for when they areNew Zealand
unable was
to meet theown
their firstneeds.
nation to range
theory.theories view•phenomena
Grand theories, or conceptual
Diminished in theacuity
visual everyday
models, practice
focus on of status and facilitates
register
The nurses.
professionalisation of nursing has been influenced by nurse–patient
phenomenon ofinteractions.
• Decreased
concern bladder toneMiddle-range
to the discipline. out of bed unassisted
■■ As the nursing profession continues to evolve and respond • Weakness
■■ The work of early nursing and focused
theories syncope on the traditional
key issues such as: the status of women, the development theories provide a bridge from grand theories to effectively 6 Monitor Mr Simon an
• Glasgow Coma Scale (GCS) score of 12
to the
of the biomedical
challenges model,
within the health care
employment system, nurses
opportunities, will
class tasks of nursing.
describe Challenged
and explain specific tonursing
create phenomenon.
synergy between Micro-the and whenever a care
Problem identification: Risk for injury related to sensory
remain responsive to societal needs. was the first nation to art andtheories
scienceview
of nursing, nursing theories havepractice
developed. provides information
structures and religion. New Zealand range phenomena
dysfunction, in the
weakness, everyday
and altered of
level of consciousness.
■■ Concepts are abstract vehicles of thought and are the
encourages a team a
register nurses. Nursing theorists
nurse–patient such
Goal:as
interactions.MrPeplau,
Simon will Henderson,
not be injured Orlanda,
during the hospitalisation.
7 Instruct all caregiver
■■ building blocksprofession
As the nursing of theory, while propositions
continues to evolveare
andrelational
respond ■■ Rogers
The workandof Orem, toIntervention:
nametheories
early nursing a few, have
Assess forcreated
focusedrisk on philosophies,
of falls
the and use fall-prevention
traditional This ensures rapid re
statements that link concepts together. strategies.
to the challenges within the health careTheories are an will
system, nurses frameworks, models
tasks of nursing. and theories
Challenged to createto achieve
synergy this synergy.
between the 8 Teach Mr Simon how
organised, coherenttoand systematic Expected outcome
remain responsive societal needs.articulation of a set of Contemporary
art and sciencenursing philosophy
of nursing, nursingembraces
theories havecaring and
developed. teaching each time b
Mr Simon will be protected from injury during the that Mr Simon has th
statementsare
■■ Concepts related to significant
abstract vehicles ofquestions. Nursing
thought and are theuses nurturance with increasing
Nursing theorists such prominence
as Peplau, in recent
Henderson, nursing
Orlanda,
hospitalisation.
• Review questions
theories from give
other you the
disciplines in opportunity
conjunction withto
building blocks of theory, while propositions are relational
test
nursing your knowledge
theories. and consolidate your learning.
Rogers and Orem, to name a few, have created philosophies,
assistance if necess
Answers
theorytotoreview
statements enhance questions
knowledge,
that link can beTheories
found
understanding
concepts together. andat the
an back of the
practice.
are book. models and theories to achieve this synergy.
frameworks, EVALUATION
organised, coherent and systematic articulation of a set of Contemporary nursing
Fall philosophy embraces
prevention protocol caring Mr
implemented. andSimon discharged on third day of hospitalisation fr
statements related to significant questions. Nursing uses nurturance with increasing prominence in recent nursing
REVIEW QUESTIONS
theories from other disciplines in conjunction with nursing theories.
theory to
1 Since theenhance knowledge,
formalisation understanding
of nursing, andFlorence
notably with practice. c providers, standards, models and patients.
Nightingale, sociopolitical influences on the role of nursing d the person, environment, health
BK-CLA-DELAUNE_2E-180413-Chp32.indd 667 and nursing.
have included (select all that apply): e theory, health, environment, person.
REVIEW QUESTIONS
a the cost of living for sick people. 6 A micro-range theory:
b thethe
1 Since roleformalisation
of women inof society.
nursing, notably with Florence ac is composed
providers, of concepts
standards, representing
models and patients.global and
c technological
Nightingale, advancesinfluences
sociopolitical improvingon health outcomes.
the role of nursing d complex
the person, phenomena.
environment, health and nursing.
d access
have included to clean
(select water, hygiene
all that apply):and employment. be is the most
theory, concrete
health, and narrow
environment, person.of theories that
a registration
e the cost of living and professionalisation
for sick people. of nurses. establishes theory:
6 A micro-range nursing care guidelines.
2 b In thethe19th
role century,
of women theinAnglican
society. High Church nuns: ca describes,
is composed explains and predicts
of concepts complex
representing situations
global and
began trainingadvances
a technological
c nurses at improving
St Thomas’healthHospital.
outcomes. and directs
complex interventions.
phenomena.
introduced
b access
d university-based
to clean water, hygiene nursing education.
and employment. db provides
is the most anconcrete
overall framework
and narrow forofstructuring broad,
theories that
26 N U Re set
g PupE Rtheir
s P E Ctraining
cs I Nregistration and school
s T, Pat
R Ethe
T I v Eprofessionalisation
s : PA s E NSydney
T of d Hospital.
A Nnurses.
fUTURE abstract
establishes ideas.
nursing care guidelines.
• Spotlight on Critical Thinking ofquestions challenge
in England. you to reflect
ec answers onquestions
and discuss complex issueswithout
in
2 d In thewere19ththecentury,
dominant themodel
Anglican nursing reform
High Church nuns: describes, explains about nursing
and predicts phenomena
complex situations
relationae todeveloped
nursing.
began training the first
nursesnursing
at St theories.
Thomas’ Hospital. covering
and directs theinterventions.
full range of concern to the discipline.
3 Which was theuniversity-based
b introduced first country to enact nursing legislation to register
education. 7 An organised,
d provides ancoherent set of concepts
overall framework and their broad,
for structuring
nurses? relationship to each other that is proposed to explain a given
SPOTLIGHT ON CRITICAL THINKING
c set up their training school at the Sydney Hospital. abstract ideas.
d Australia
a were the dominant model of nursing reform in England. phenomenon best defines
e answers questions which
about of thephenomena
nursing following options?
without
bhasNew
It e beenZealand
developed argued the that
first nursing
nursing history
theories. has been presented a A
6 Many concept
covering
nursesthe full‘they
state rangewantof concern to the discipline.
to help people’ as a
3 fromcWhichBritain
was the
a feminist first country to enact legislation to register
perspective. bAn A
7 reason proposition
organised, coherent
for entering set of concepts
the nursing profession.and Explain
their how
United
1 dnurses?
How could States
this have impacted the role of men in the nursesA theory
crelationship
mightto‘help’
eachpeople
other that
whoisare
proposed
unwelltousing
explain
onea given
Germany
ea nursing
Australia and midwifery profession? A discipline
dphenomenon
nursing theoristbest defines
from which of the following options?
the following:
4 2 Nursing education
New Zealand
b Explain how this could withinimply
Australia
that and NewisZealand
‘caring’ a female ■ea A paradigm
AGrand
conceptnursing theory
included
Britain(select all those that apply):
c trait? 8 ■Why are nursing theories
b AMiddle-range
proposition theory important to the profession?
ad home
United visit
Statesnurses.
3 Explain why you think nursing history, until recently, has ■(Select
c A all
theory that apply.)
Micro-range theory
the
be excludedapprenticeship
Germany groups of nurses model. from its history. ad To
Consider guide
A discipline
the nursing
theories practicein this chapter.
discussed
4 Nursing unlicensed
cNursing education workers.within Australia and
history is reflecting a more comprehensive under- New Zealand be To
A promote
paradigm problem
7 State why a particular theory identification
might appeal to you. What
standing tertiary
dincluded education.
of(select
nursing allpractice
those thatandapply):
nursing participants. It is cWhy Toare
8 influenced guide nursing
nursing
your research
theories
decision? important to the profession?
now diploma
ea ahomemorevisit education.
nurses.
complex area of study. isTo
8 Itd(Select develop
all thatathat
suggested language
apply.)you both forincorporate
nurses an
5 4 Nursing’s
b the
Why do metaparadigm
apprenticeship
you think, from includes:
model.
a historical perspective, that it is ea ToTo define
guide
acknowledgement professional
nursing of nursing
practice
cultural practice
diversity and maintain
c concepts,totheory,
a important
unlicensed workers.
represent health
theand environment.
nursing profession within the b To promote
cultural safety in problem identification
your nursing practice.
b health, person,
tertiaryofeducation.
d context environment
society as a whole? and nursing. ac To guidewhat
Explain nursingeach research
term means.
xiii

Guide to the online resources

FOR THE INSTRUCTOR
Cengage is pleased to provide you with a selection of resources

that will help you to prepare your lectures and assessments,
when you choose this textbook for your course.
Log in or request an account to access instructor resources
at cengage.com.au/instructors for Australia or
cengage.co.nz/instructors for New Zealand.
MINDTAP
Premium online teaching and learning tools are available on the MindTap platform – the personalised
eLearning solution.
MindTap is a flexible and easy-to-use platform that helps build student confidence and gives you a clear picture
of their progress. We partner with you to ease the transition to digital – we’re with you every step of the way.
The Cengage Mobile App puts your course directly into students’ hands with course materials available on their
smartphone or tablet. Students can read on the go, complete practice quizzes or participate in interactive real-
time activities.
MindTap for DeLaune Fundamentals of Nursing in Australia and New Zealand 2nd edition is full of innovative
resources to support critical thinking, and help your students move from memorisation to mastery! Includes:
• DeLaune Fundamentals of Nursing in Australia and New Zealand 2nd edition eBook
• Media quizzes
• Videos and animations
• Heart and Lung sounds
• Polling and revision quizzing
• Advanced diagnostic testing extension material
• Nursing procedures and more!
MindTap is a premium purchasable eLearning tool. Contact your Cengage
learning consultant to find out how MindTap can transform your course.
INSTRUCTOR’S MANUAL
The Instructor’s Manual includes:
• instructional strategies • links to useful online resources
• resource aids • solutions to end of chapter review and spotlight on
• evaluation strategies critical thinking questions.
COGNERO TEST BANK POWERED BY MINDTAP

A bank of questions has been developed in conjunction with the text for creating quizzes, tests and exams for
your students. Create multiple test versions in an instant and deliver tests from your LMS, your classroom, or
wherever you want using Cognero. Cognero test generator is a flexible online system that allows you to import,
edit, and manipulate content from the text’s test bank or elsewhere, including your own favourite test questions.
xiv G U I D E TO T H E ON L I NE R ESO U R C ES
POWERPOINT™ PRESENTATIONS
Use the chapter-by-chapter PowerPoint presentations to enhance your lecture presentations and to reinforce
the key principles of your subject, or for student handouts.
ARTWORK FROM THE TEXT

Add the digital files of graphs, pictures and flowcharts into your course management system, use them within
student handouts, or copy them into lecture presentations. Printable versions of the Concept Maps from the
book are also provided.
FOR THE STUDENT
New, print versions of this textbook come with bonus online

study tools on the Search Me! Nursing platform.
Access for 24 months from your first login.
MINDTAP
MindTap is the next-level online learning tool that helps you get better grades!
MindTap gives you the resources you need to study – all in one place and available when you need them. In the
MindTap Reader, you can make notes, highlight text and even find a definition directly from the page.
If your instructor has chosen MindTap for your subject this semester, log in to MindTap to:
• Get better grades
• Save time and get organised
• Connect with your instructor and peers
• Study when and where you want, online and mobile
• Complete assessment tasks as set by your instructor
When your instructor creates a course using MindTap, they will let you know
your course key so you can access the content. Please purchase MindTap
only when directed by your instructor. Course length is set by your
instructor.
xv

PREFACE
We are very excited to share this second edition of CONCEPTUAL APPROACH

Australian and New Zealand Fundamentals of Nursing
with you! We hope this text will encourage you to This edition presents in-depth material in a clear,
develop an inquiring stance based on the joy of concise manner using language that is easy to read,
discovery and a love of learning. by linking related concepts. Nursing knowledge
Nursing is facing new challenges in delivering is formulated on the basic concepts of scientific
quality care to vulnerable peoples in a variety of and discipline-specific theory, health and health
settings. These settings are rapidly expanding and promotion, the environment, holism, health care
challenge all nurses to think creatively in applying teaching, spirituality, research and evidence-based
best practices based on current research. This edition practice, and the continuum of care. Emphasis is
presents the most current advances in nursing placed on cultural diversity, care of the older adult,
care, nursing education and research relative to the and ethical and legal principles.
demands of delivering care across a continuum of The nursing process provides a consistent approach
settings. Multiple theories of nursing are embraced, for presenting information. Assessment tools specific
and nursing’s elements of theory metaparadigm – to selected topics are presented to assist you with
human beings, environment, health and nursing – pertinent data collection. Critical thinking and
are threaded throughout this text. The organisation reflective reasoning skills are integrated throughout
of units and chapters is sequential; however, every the text. The safe and appropriate use of technology
effort has been made to allow for the varying needs has been incorporated throughout the text to reflect
of diverse curricula and students. Each chapter may contemporary nursing practice.
be used independently of the others according to the The conceptual approach used as an organisational
specific curriculum design. framework for this Australian and New Zealand
This comprehensive edition addresses fundamental edition falls into four categories:
1 Individuals are viewed as holistic beings with
concepts to help prepare novice graduate nurses to
apply an understanding of human behaviour to issues multiple needs and strengths, and the abilities
encountered in clinical settings. Physiological and to meet those needs. Holism implies that
psychosocial responses of both an individual and their individuals are treated as whole entities rather
nurse are addressed in a holistic manner. Integrative than fragmented parts or problems. Each person
modalities are presented in an environment is a complex entity who is influenced by cultural
that encourages the individual to participate in values, including spiritual beliefs and practices.
determining their own care. Every person has the right to be treated with
Skills and procedures have been relegated to dignity and respect regardless of race, ethnicity,
another text: J. Tollefson and E. Hillman’s Clinical age, religion, socioeconomic status or health
Psychomotor Skills: Assessment Tools for Nursing status. Traditional terms for people who are being
Students (seventh edition), published by Cengage treated for their health care such as ‘patient’ or
in 2018. This was done to decrease the size of ‘client’ are avoided as these terms do not reflect the
this textbook and permit more discussion of the conceptual value of the individual.
2 Environment is a complex interrelationship of
individual skills. Using contemporary clinical
information based on sound theoretical concepts, internal and external variables. Internal variables
and scientific evidence, the skills in the latest edition include one’s self-concept, self-efficacy, cognitive
of Tollefson and Hillman both supplement and development and psychological traits. The external
complement the material in this text. Therapeutic environment affects an individual’s health
nursing interventions reflect the current Registered status by facilitating or hindering the person’s
Nurse Standards of Practice (2016) and emphasise achievement of needs.
3 Health is viewed as a dynamic force that occurs
safety, communication skills, clinical reasoning
and interdisciplinary collaboration in delivering on a continuum ranging from wellness to
nursing care. You will be referred to the appropriate death. An individual’s actions and choices effect
procedure within the text. changes in their health status. Individuals who
are experiencing illness have strengths that may
xvi Preface
improve their health status. On the other hand, ■■ Cultural diversity is defined as individual
individuals who are experiencing a high degree of differences among people resulting from racial,
health generally have areas that can be improved. ethnic, religious and cultural variables.
4 Nursing is an active, interpersonal, professional ■■ Continuum of care is viewed as a process for
practice that seeks to improve the health status providing health care services in order to ensure
of individuals. Nursing’s focus is person-centred consistent care across practice settings.
and communicates a caring intent. Caring and ■■ Community, as both an aggregate focus for
compassion are demonstrated through nursing health care and as the setting for the delivery of
interventions. Nursing is a professional practice care, is evidenced in Chapter 16 and is threaded
based on scientific knowledge and is delivered in throughout the text.
an artful manner. ■■ Holism recognises the body–mind connection
Other important conceptual threads used to and views the person as a whole rather than as
direct the development of this book include the fragmented parts.
following: ■■ Spirituality encompasses the relationship with
■■ Health promotion encourages individuals to oneself, a sense of connection with others, and a
engage in behaviours and lifestyles that facilitate relationship with a higher power or divine source.
wellness. It is discussed in depth in Chapter 27.
■■ Standards of practice are discussed, with ■■ Caring, a universal value that directs nursing
information from national and specialty practice, is incorporated throughout the text, and
organisations (both from Australia and New is described in depth in Chapter 13.
Zealand) incorporated into each chapter as ■■ Alternative and complementary modalities
appropriate. are treatment approaches that can be used in
■■ Critical thinking is an essential skill for conjunction with conventional medical therapies.
blending science with the art of nursing. Chapter 34 is dedicated to this integrative approach,
■■ Evidence-based practice derived from scientific and related information featuring integrative
research is emphasised across chapters. concepts is included throughout the text.
ORGANISATION
This textbook provides you with a bridge that presents theory are provided showing the incorporation of theory into the
to support clinical practice. The intent of the authors is to nursing process. The concept of evidence-based practice
help you become a proficient critical thinker who is able is emphasised along with research utilisation. Quality is
to use the nursing process with diverse individuals in a discussed from the perspective of health care delivery and
variety of settings. Research-based knowledge that reflects the continuum of care.
contemporary practice is presented in a reader-friendly, •• Unit 2: Nursing process: the standard of care discusses
practical manner. recognised competencies and standards of care
Features that challenge you to use critical-thinking skills established by Australian and New Zealand nursing
are incorporated into each chapter, and critical-thinking registration bodies, the Australian Nursing and Midwifery
questions appear at the end of each chapter. Critical Federation, and nursing specialty organisations. Each stage
information is highlighted throughout the text in a format that of the nursing process is discussed, with an emphasis on
is easily accessed and understood. Similar concepts have critical thinking.
been grouped together to encourage you to learn through •• Unit 3: Professional accountability describes the
association; this method of presentation also prevents the nurse’s responsibilities to the individual in their care, the
duplication of content. community and the profession. Nursing leadership is
Australian and New Zealand Fundamentals of Nursing discussed in Chapter 10. Chapter 11 combines legal and
presents 43 chapters organised in six units: ethical aspects of nursing practice to reflect the interfacing
•• Unit 1: Nursing’s perspectives: past, present and future of these concepts. An in-depth discussion of informatics
provides a comprehensive discussion of nursing’s appears in Chapter 12, which focuses on documentation.
evolution as a profession and its contributions to health •• Unit 4: Promoting health was created to integrate
care based on standards of practice. The theoretical information on health promotion, consumer demand
frameworks for guiding professional practice and the and facilitating empowerment for the person seeking
significance of incorporating research into nursing practice health care. Chapter 13 provides nursing theoretical
are emphasised. Chapters are reflective of the parallel perspectives on caring. Chapter 15 emphasises the
evolution of nursing and nursing education. Examples nurse’s role in empowering the person seeking health
Preface xvii
care to assume more personal accountability for their •• Unit 6: Responding to basic physiological needs discusses
own health-related behaviours. Chapter 16 addresses the aspects of nursing care that are common to every area of
health needs of families and communities. nursing practice. Concepts such as safety and infection
•• Unit 5: Responding to basic psychosocial needs stresses control, medication administration, assessment of the
the importance of the holistic nature of nursing. Spirituality person, their comfort, mobility, fluid and electrolyte balance,
is spotlighted in order to emphasise its impact on oxygenation, skin integrity, nutrition and elimination are all
individuals’ health. described within the nursing process framework.
NEW TO THE SECOND AUSTRALIAN Additional features include the following:

■■ At the end of every chapter, a set of ‘Review
AND NEW ZEALAND EDITION questions’ is presented. For this second edition,
All the material has been settled into an Australian the rigour of the Review questions have been
and New Zealand context, using culturally appropriate increased. The answers and rationales are located
and relevant examples, Australian and New Zealand in the Instructor’s Manual.
government and non-government organisation ■■ ‘Spotlight on critical thinking’ at the end of the
information, research, legal and ethical material and chapter focuses attention on issues relating to the
laws, evidence-based practice information, and ratified caring, compassion, legal, ethical and professional
nursing standards. All chapters have been extensively components of nursing practice.
rewritten to reflect contemporary Australian and New ■■ ‘Safety first’ identifies critical health and safety
Zealand nursing practice. situations and highlights strategies for the
Contributions for specific chapters were sought appropriate nursing response and management.
from Australian and New Zealand nurses who are ■■ ‘Evidence-based practice’ emphasises the
expert in their fields. importance of clinical research by linking theory
Some chapters were condensed, and some to practice. We have added an additional Evidence-
expanded. Specifically, the pre-existing chapters on based practice box to most chapters in this second
nursing theory and nursing education were folded into edition.
Chapter 1, and the life cycle material is now presented ■■ ‘Respecting our differences’ challenges you to
over Chapters 17 and 18, giving more prominence to consider approaches to respectful and appropriate
the topic of nursing children. care for populations of people who may differ in a
Additional chapters were written: variety of ways, including culture, gender, age and
■■ Chapter 20: Palliative care, presents material to developmental level.
help you understand and assist the person who is ■■ ‘Nursing highlights’ provide key information on
nearing the end of their life. nursing practice.
■■ Chapter 21: Cultural diversity, although not ■■ ‘Nursing checklists’ are provided to assist you with
new, has been extensively adapted to reflect the the revision of information.
contemporary societies of Australia and New
Zealand.
■■ Chapter 22: Aboriginal and Torres Strait Islander
EXTENSIVE TEACHING/LEARNING
health, addresses the problems and solutions that PACKAGE
are specific to Indigenous Australians. The complete supplements package was developed to
■■ Chapter 23: Rural and remote health, looks at the
achieve two goals:
unique circumstances that face people who live in 1 to assist you in learning the essential skills and
the regional, rural and remote areas of Australia. competencies needed to secure a career in nursing
■■ Chapter 29: Mental health, presents some of
2 to assist your instructors in planning and
the issues that beginning nurses can expect to implementing their programs for the most efficient
encounter in their practice. use of time and other resources.
xviii
LANGUAGE AND TERMINOLOGY
ABORIGINAL AND TORRES STRAIT antidiscrimination that are made at the national
level in New Zealand. In Australia legislation exists
ISLANDER PEOPLES at Commonwealth, state and territory levels, which
This textbook has a full chapter on health issues make it an offence to discriminate against a person
pertaining to Aboriginal and Torres Strait Islander because of their race, ethnicity, culture or religion.
peoples, as well as integrated material throughout
the book relating to issues, events, policies
and groups. We have sought to use inclusive,
NURSING DIAGNOSIS
appropriate and non-discriminatory terminology Fry (1953) first used the term ‘nursing diagnosis’,
throughout, and for this purpose we have followed but it was not until 1974, after the first meeting of
the published guidelines provided by NSW Health the North American Nursing Diagnosis Association
in Communicating Positively: A Guide to Appropriate (NANDA), that nursing diagnosis was added as a
Aboriginal Terminology. separate and distinct step in the nursing process.
Prior to this, nursing diagnosis had been included as
a natural conclusion to the first step in the nursing
CULTURAL SAFETY IN NEW ZEALAND process – assessment.
New Zealand has a bicultural society by legislation. While the notion of nursing diagnosis is imperative
This diversity creates a vibrant, rich background for the Australian and New Zealand nursing context,
to daily living. Issues may arise when people of a the specific language used by NANDA and the term
different culture, ethnicity or religion interact and do ‘nursing diagnosis’ are not widely used in clinical
not understand each other. These misunderstandings practice. In the Australian and New Zealand setting,
can result in insult, feelings of isolation and inequality the term ‘nursing diagnosis’ is routinely replaced with
of service. Culturally unsafe practices are those ‘problem identification’, the term we have chosen
that ‘diminish, demean or disempower the cultural to use in this text. The exact language used to name
identity and well-being of an individual’ (NCNZ, the problem is not as important as ensuring that all
2012, p. 9). This definition is supported by laws on problems are identified in a systematic way.
xix

ABOUT THE AUTHORS
Lauren McTier is an Associate Professor and James Cook University in northern Queensland.
Associate Head of School, Teaching and Learning An experienced clinician (15 years of rural nursing,
in the School of Nursing and Midwifery at Deakin women’s health, medical, surgical and mental health
University. She commenced her nursing career over care) in Canada, Australia and Nigeria, she turned to
20 years ago with a Bachelor of Nursing and has education and taught in hospital and tertiary courses
subsequently gained formal qualifications in Critical for the next 30 years in all capacities, from clinical
Care Nursing, Education, Statistics and Research. facilitator to Principal Nurse Educator in hospital
Lauren leads teaching and learning in the nursing programs, Lecturer and Senior Lecturer at James
and midwifery programs at Deakin University. She Cook University. She was privileged to work with
is passionate about ensuring every student has the Fijian nurses at the Fiji School of Nursing to create an
knowledge, skills and attributes to provide quality and international-level nursing curriculum for the nurses
safe nursing care for individuals and their families. of the South Pacific. She has written a well-accepted
clinical psychomotor skills text, now in its seventh
Joanne Lawrence works in private practice as edition. Joanne has been honoured with two National
a neurological continence and wound clinical Awards for Outstanding Contributions to Student
consultant. Originally hospital-trained, she has since Learning (Carrick Award, 2007; Australian Teaching
completed a Bachelor of Applied Science (Nursing) and Learning Council Award, 2008). She is now retired
from the University of Sydney, a Master of Arts from formal teaching but continues to engage in
(Research) from Macquarie University and a PhD nursing via researching, writing and editing nursing
(Medicine) from the University of Sydney. Joanne’s texts.
PhD explored the neurological presentation of bowel
and bladder dysfunctions experienced by people with Sue Carter DeLaune earned a Bachelor of Science
Parkinson’s disease. In 2012, Joanne was recognised by in nursing from Northwestern State University,
the Australian Rehabilitation Nurses Association with Natchitoches, Louisiana, and a master’s degree in
an award for Excellence in Clinical Nursing Research. nursing from Louisiana State University Medical
Joanne has worked as a registered nurse since 1981, Center, New Orleans. She has taught nursing in
with most of her clinical experience focusing on diploma, associate degree and baccalaureate schools of
people who have either an acquired or congenital nursing as well as in RN degree-completion programs.
neurological condition. With over 35 years of experience as an educator,
Joanne has an extensive educational track record clinician and administrator, Sue has taught the
working in large private health care organisations fundamentals of nursing, psychiatric–mental health
and tertiary settings, where she taught undergraduate nursing, professionalism and nursing leadership in a
and postgraduate students of nursing. Joanne holds variety of programs. She also presents seminars and
a strong interest in health assessment and evidence- workshops across the country that assist nurses to
based clinical practice. Her research interests include: maintain competency in areas of communication,
the transition of research into clinical practice, leadership skills, patient education and stress
the provision of health care to vulnerable groups management.
of people, and neurological bowel and bladder Sue is a member of Sigma Theta Tau, the National
dysfunction. She is a Fellow of the Australian College League for Nursing, and the American Nurses
of Nursing and the President of the NSW and ACT Association. She has been recognised as one of the
Chapter of Continence Nurse Society Australia. ‘Great 100 Nurses’ by the New Orleans District Nurses
Association. Sue is a prolific author, having written
Joanne Tollefson earned her registered nurse several professional journal articles and textbook
certification in Canada and continued her studies chapters in the areas of nursing education and mental
throughout her career. She completed a Bachelor of health nursing.
General Studies from a Canadian University, and Currently, Sue is an Associate Professor and
a Master of Tropical Medicine, then a PhD, from RN-to-BSN Coordinator at William Carey University
Another random document with
no related content on Scribd:
pieces into the water. As he threw them, he called out, “Here are
Tskel’s ribs! Here is Tskel’s arm!” He threw the head; then ran with all
his might. When the old man’s sons saw the head and knew that
they had eaten their sister, they were so mad that they sent stone
knives, beaded blankets and skins of all kinds to lie on the trail in
front of Tskel. He had hard work to jump over them without getting
burned, but he didn’t touch or hit even one. When he got home
Skóŭks and little Tcûskai were mourning. Their hair was cut and
pitch was running over their faces. They sat with their heads down
and didn’t look up.
Tskel sat down by Tcûskai, and asked: “Why are you so dirty?”
Tcûskai jumped up, and cried out: “Are you here? I was just going to
look for you.”
Tskel said: “Heat some water. I am going to wash Skóŭks’ head, and
yours, too.”
After he had washed their heads, he wrapped a skin blanket around

them, and the next morning Skóŭks and Tcûskai had nice long hair.
Now Tskel moved off a little way from his old home. He made arrow
points and killed deer.
Kāhkaas was kin of Tskel and one day she came to visit him. Soon
Tcûskai ran in, and said: “I see lots of little tracks [300]around here.
Twist me some strings, Kāhkaas, so I can trap the things that make
the tracks.”
Tskel said to Kāhkaas: “Maybe they are the tracks of your children.
Where did you leave them?”
“I left them high on a tree off in the middle of the great water. My
children are safe.”
Kāhkaas twisted strings for Tcûskai and he set his trap. Soon he
came back bringing the five Kāhkaas boys in his trap. Kāhkaas was
terribly angry and sorry; she said: “Give them to me; I will go off in
the woods and roast and eat them.” (She went to bury them.)
Tcûskai watched Kāhkaas. Tskel knew that trouble would come, that
Kāhkaas would try and kill them. He lay down, he felt sorry.
Soon Tcûskai cried: “Get up, brother! A great elk is coming. I’ll go
and kill it.”
“Don’t go in front of it,” said Tskel. “Shoot it from behind!”
Tcûskai shot three times at the elk; each time he hit its horns. Then
the elk turned, caught him on her horns, and ran off to the
mountains. She ran a long way, then changed into Kāhkaas and
flew, with Tcûskai, to the tree on the island in the middle of the
ocean.
When the elk ran off with Tcûskai, Tskel fell on the ground and cried.
Then he jumped up and started off to find him. He went everywhere,
stopped at every house, and asked every person he met if they had
seen little Tcûskai. But nobody had seen him. At last he came to a
house where a sick woman lived; she was covered with sores. When
she saw Tskel, she called out, “Don’t come in here!” Tskel asked:
“Have you seen my brother?” “I haven’t seen anybody, I never go
anywhere, and nobody ever comes here. You can ask at the next
house.”
Tskel went on till he came to a rock house right on the trail. He

couldn’t see a door. He walked around the house, but couldn’t find
an opening. Then he called out: “Who lives here?” The rock
answered, “I live here!”—The house was a person.—Tskel asked:
“Have you seen my brother? Kāhkaas has carried him off.” “I go
nowhere, and nobody [301]comes here. I have no eyes, I can’t see.
You can ask at the next house. The people there see a great deal;
maybe they can tell you where your brother is.”
When Tskel got to the house, there were five persons inside and one
said to another: “Make room for that man to come in and sit down.” “I
can’t,” said that one. “I’m just finishing my work. You can make room
for him.” “I can’t, I’m just beginning my work.”—Some of the men
were braiding threads and others were twisting them.—When each
man had refused to make room for Tskel, it was just sunset. He went
into the house, gave the fire a kick, and sent it everywhere. It burned
up all the threads and ropes the men were making.
“I feel lonesome,” said he. “I can’t listen to your words; they make me
mad. I have lost my little brother; Kāhkaas has carried him off. Do
you know anything about him?—Sprinkle your threads with water
and roll them up; they will be whole again.—I have been everywhere
in the world, but I can’t find Tcûskai. I want to ask Súbbas if he can
tell me where he is. I can do everything, but I can’t find my brother. I
want you to go up to Súbbas’ house and ask him if he has seen
Tcûskai.”
Old man Kaltsik said: “We never go to Súbbas’ house. No one ever
goes there.”
Tskel said: “I will give you anything you want if you will go.” Tskel
teased a long time, and at last Kaltsik said: “I will go.”
He started just at daybreak. He traveled fast, going up all the time.

He reached Súbbas’ house in the middle of the sky before Súbbas
got there. He turned himself into a little clump of bushes, right on
Súbbas’ trail. When Súbbas came hurrying along, he stumbled
against the bushes, and said: “What is here? I never saw anything
on this trail before.”
Kaltsik took his own form, jumped up, and said, “I am here.”
“What are you here for?” asked Súbbas.
“Tskel has lost his brother, little Tcûskai, and he wants you to tell him
where he is.” [302]
“I can’t wait to talk,” said Súbbas. “I am always hurrying along; I only

stop here at midday. I’m afraid Lok will catch me.”
“Oh,” said Kaltsik, “you should tell Tskel where his brother is. I’m
sorry for him; he feels lonesome.”
“Come to-morrow,” said Súbbas, and he hurried along. It was night

when Kaltsik got down to the ground. The next morning he started
and before midday he turned himself into weeds and lay on Súbbas’
path. When Súbbas came rushing along, he said: “What is this? I
never saw anything on my trail before.” Kaltsik sprang up. “Why have
you come here?” asked Súbbas. “I have no time to spend talking.”
Kaltsik said: “Tskel will give you anything you want if you will tell him
where Tcûskai is. He has all kinds of things; beautiful beads—”
“I am brighter than beads. I don’t want beads!” said Súbbas, “but I

want a ring and a string of green shells to hang on my ears, and a
white blanket to cover me on bright days. Tell Tskel to send you up
to-morrow, if he has those things to give me.”
Súbbas went on and Kaltsik got back to earth just before dark. He
told Tskel what Súbbas wanted, and Tskel began to make the things.
He worked all night; in the morning they were ready, and Kaltsik took
them up to Súbbas. Súbbas was glad.—He still wears the ring.
People can see it just before a storm. (Circle around the sun. It is
called Wänämsäkätsaliyis.) They can see his green shells and his
white blanket, too.—When he had them all, he said: “This morning
when I was over that mountain in the east, I heard a man chopping
wood and off on an island I caught the smell of burning flesh. That
old man on the mountains has Tcûskai.”
When Tskel found out where his brother was, he turned himself into
an old woman, with a hump on her back, and went to the mountain.
When the man saw him, he said: “I think you are Tskel.”
Tskel said: “I’m not a man, I’m an old woman. I heard that you had
caught Tskel’s brother and were going to kill him; I want to see him.”
[303]
“I have him on an island; he’ll die soon. He killed all of my sons. Now
I am going to kill him. Help me with this wood.”
Tskel helped pack up a load of wood, then the old man bent over and
Tskel put the load on his back and gave him a cane to help himself
up by. “Bend,” said he to the cane. “Break and go into the old man’s
heart.”
The cane broke and one half of it struck the old man in the heart and
killed him. Tskel put the pieces together and the cane was whole
again.
The old man had told Tskel that he was so glad to have Tcûskai that
he danced all the time he was carrying wood to smoke him. Tskel
strapped the pack of wood on his own back and danced along with it
till he came to the canoe; then he danced in the canoe.
Old Kāhkaas had two servants, Kéis and Lok. Kéis guarded the
landing. When Tskel got out of the canoe, Kéis wanted to spring at
him, but Tskel said: “Don’t touch me. I am your master!” He said the
same to Lok, who was sitting by the smoke hole on top of the house,
and Lok let him go down the ladder into the house. As soon as he
was at the foot of the ladder, he saw Tcûskai hanging over the fire.
Old woman Kāhkaas was smoking him. He cut Tcûskai down and put
him under his arm. Then he caught Kāhkaas and tore her to pieces.
He threw the pieces off in different directions, and they became hills
and mountains. He took Tcûskai home and cured him.
After a time Tskel said to his brother: “We will go and hunt for
Wŏn.”—Wŏn was so large that he had to bend down to cut off the
branches of trees.—When Skóŭks gave them seeds to eat, Tskel
said: “If we don’t come back soon, you will know that we have killed
Wŏn.”
They hadn’t gone far when Tcûskai cried out: “I see a big deer!”
“Keep still,” said Tskel, “and go on till we see Wŏn.” In a little while
Tskel saw Wŏn, and, not far from him, a deer. He called to Tcûskai:
“Keep still! You mustn’t eat seed; if you do Wŏn will get away.” [304]
Tcûskai thought: “I wonder what Tskel is doing. I hope he will kill the
deer, too.” Tskel went between the two. Just as he was ready to
shoot Tcûskai thought: “I’m hungry, I’m going to eat a few of our
seeds. Tskel won’t miss them.”
That moment Tskel’s bow and bowstring broke. He knew that

Tcûskai had eaten seeds. Tcûskai was scared; he ran to a spring and
washed out his mouth, then came back to his brother. Tskel scolded.
Tcûskai said: “What makes you so mad? I didn’t eat any seed. Look
in my mouth,” and he opened it.
Tskel struck his brother. He had a deer’s head on; he took it off, put it
on Tcûskai’s head, and said: “Now go and hunt for Wŏn.”
“I can kill him easily,” said Tcûskai.

Tskel said: “You think that Wŏn runs on the ground. So he does, but
he runs in the air, too. He goes on all kinds of trees and he goes
back and forth in the sky. You will have to follow him around the
world before he will stop running.” When Tcûskai was ready to go,
Tskel said: “Take some seeds,” but it was too late. Tcûskai had
started.
Before Tcûskai had gone very far, he saw Wŏn and began to follow
him. He ran across rocky places, ran five times over the tops of pine
trees, and five times over the top of high grass, five times across
mole-hills, five times across the sky, and five times around the world,
then he ran east on the sky till he came near a village where Blaiwas
was chief.
Kékina and Gapni were Blaiwas’ servants; they were on top of the
house sunning themselves. Kékina said: “It sounds as if my cousin
were coming;” again he said: “It sounds like my brother, blowing on
his medicine stick. Tell the people to come out and look.”
When Gapni told them, Gäk said: “You can’t see much with your little
eyes; you are not like me. I can see all over the world.”
Blaiwas said: “Little Kékina never tells a lie; somebody must be

coming. Go and see who it is. Tell old man Moi to look; he can see
everything under the sky and in the whole world.” [305]
Moi said: “Somebody is coming. Tell the people to be ready to shoot

when I call out.”
The people made a ring, and when Wŏn came, he rushed inside of
it. Then every one shot at him; Kéis hit him in the foot, Näníhläs hit
him on the horns, Blaiwas hit him in the shoulder. At last they killed
him. When Wŏn was on the ground, Kéis jumped on one of his legs;
he wanted to get meat from the middle of it. (Tcûskai hadn’t come
yet.) People said to Kéis: “Get off; don’t make Tcûskai mad. He has
been following Wŏn for a long time.”
Tcûskai came slowly, for he was tired. When he got to the place, he
told Kéis to get off Wŏn and help to skin him. Kéis wouldn’t move.
Tcûskai pushed him away, but he jumped back; then Tcûskai threw
him off and told him he was in a hurry, for he had far to go. The third
time Kéis got on to Wŏn, Tcûskai threw him over a mountain, but he
was back in a minute. Tcûskai was so mad that he pounded Kéis’
head till he made it flat. That is why rattlesnakes have flat heads. He
cut off Wŏn’s foot that Kéis had hit with an arrow and threw it after
Kéis.
Gäk had shot Wŏn in the leg, and Tcûskai gave that leg to Gäk. And
so he divided Wŏn’s body among the people; then he took a large
piece on his back and started for home. When it was dark, he
camped in a woodpecker’s hole, in a tall tree.
Kéis was a great doctor. He was mad and he made it snow all night;
he thought he could kill Tcûskai in that way. But Tcûskai made a fire
in the woodpecker’s hole, and kept himself warm. He put a round
stone in the fire and heated it, and in the morning, when he started
for home, he rolled the hot stone along on the ground in front of him.
Where the stone went, the trail was dry. Everywhere else the snow
was so deep that only the tops of trees could be seen.
When Tcûskai got to the house, he went in quietly, didn’t make any
noise. Tskel and Skóŭks were mourning for him; they didn’t see him,
or hear him. He asked: “Why are you mourning? Did you think that I
was lost? Your heads don’t look nice; they don’t smell nice. Go and
wash them.” [306]
They were glad now. Skóŭks went out to get the meat Tcûskai had
brought; she couldn’t move it. Then Tskel went; he couldn’t raise it
from the ground.
“What is the matter?” asked Tcûskai. “I didn’t bring that meat with the
head strap; I used the chest strap.” He carried it into the house with
one hand; then he blew on it and made it small, but there was meat
enough to last all winter.
Tskel cut the meat in strips to dry; he worked all night, and finished
just as the sun came up. Then he took a piece of the fat, fastened it
on the top of Tcûskai’s head, and said, “This will always stay as it is
now; it is small, but all the people in the world could feed on it.” Then
he said: “You have lived long enough without a wife; you must look
for one.”
“Where can I find a wife?” asked Tcûskai.
“If you go to the place where they killed Wŏn, you will find a clearing
where women are digging roots. When you get to the edge of the
clearing, shoot an arrow. It will come down near a spring. You must
be at the spring by midday.”
Tcûskai walked and walked. After a while he came to the clearing

and saw women digging roots. Then he shot an arrow. When he got
to the spring his arrow was sticking up in the ground there. He sat
down, put his elbows on his knees, and his head on his hands. The
women went towards the spring, digging as they went.
Kówe saw Tcûskai first; she took off her cap and wanted to give him
water. He didn’t look up or move. She ran to the other women, and
said: “There is a nice-looking young man sitting by the spring. I gave
him some water, but he wouldn’t take it; maybe he will take it from
you.” The women crowded around Tcûskai; each offered him water,
but he wouldn’t take it. The chief’s daughter offered it but he didn’t
take it. Kaiutois’ daughter tried, but he wouldn’t look at her. Blaiwas’
daughter said to a woman: “Go and tell those Máidikdak girls to
come and try.” When the woman got to the girls, she said: “A nice-
looking young man is there by the spring. We have all offered him
water, but he won’t take it. Maybe he will take it from you.”
They went to the spring. The elder sister took off her cap, [307]filled it
with water, and gave it to Tcûskai; he drank half of the water. The
younger sister offered him the cap; he drank the other half of the
water. Blaiwas’ daughter saw the arrow; she tried to pull it up, but
couldn’t. Then each woman tried in turn. Some watered the ground
to soften it, but nobody could pull the arrow out. Then Blaiwas’
daughter said: “Let Máidikdak’s daughters try.”
The elder sister pulled the arrow half-way out; the younger pulled it
all the way out and put it in her basket. Then she went to dig roots.
Kówe saw the fat on Tcûskai’s head and wanted to loosen it, but she
couldn’t. She bit at the knots, but the women drove her away.
Blaiwas’ daughter said: “You mustn’t use your teeth. Whoever
loosens fat with their teeth will be Tusasás’ wife.” All the women tried
to take the fat off from Tcûskai’s head, but no one could do it. They
sent for Máidikdak’s daughters again. The elder one loosened it; the
younger took it off.
The women went home and Tcûskai was left alone. Kówe ran with all
her might, jumped, fell, puffed, at last got home. Then she said to her
mother: “Tcûskai drank from my cap; make a good place for him!”
Old Kówe was glad. She made ready a nice place for her son-in-law.
Each young woman told her mother the same thing, except
Máidikdak’s daughters; they didn’t say anything. Tusasás made
ready a place for his son-in-law.
He was so glad that he ran around and boasted, said: “Tcûskai drank
from my daughter’s cap; he is my son-in-law.”
When Tcûskai got to the village he stood in the middle of the road.
Blaiwas wanted to lead him into his house; so did all the other chiefs;
but he wouldn’t go. At last old Máidikdak asked him to come to her
house, and he went.
The next morning Blaiwas asked Tcûskai to run a foot race. All the
men were mad at Tcûskai and wanted to kill him. Every man in the
village ran against him. When Tcûskai started, he went under the
ground. He ran faster than anybody and got to the goal first. One
after another the runners [308]came till all were there; then they
turned and looked back to see where Tcûskai was. Tusasás said: “I
wonder when he will get here?” and he made fun of him. Then they
saw that Tcûskai was ahead of them.
When they were ready for the race back, Tcûskai said: “Go on! You
needn’t wait for me.” He ran under the ground. He came to the goal
first and won the race. The second man to come was Blaiwas, the
third was Wus. When Kûlta overtook Tusasás, he said: “Little
brother, stop and pull this sliver out of my foot with your teeth.”
Tusasás stopped, but he couldn’t get the sliver out; men had to
come and carry Kûlta home.
Blaiwas said: “Now we will hunt deer.” They drove the deer to the
mountain and left Tcûskai alone there. He sent one arrow and killed
all the deer on the mountain.
The next morning Máidikdak’s daughter had a little boy; he grew fast
and soon was running around.
After a time Tcûskai wanted to see his brother. When he got to

Tskel’s house he found that Tskel had a boy larger than his own. The
two little boys were like brothers. Tskel asked Tcûskai to go to the
lake and get him reeds for arrows. “Get the kind of reeds that have
tear-drops on them,” said he. “Those are the best to make arrows.”
Tcûskai went, and looked in every place; when he couldn’t find reeds
with tear-drops on them, he put his fingers in his eyes and made
tears come; then he dropped them on the reeds. He shed so many
tears that his eyelids got swollen; he could hardly see.
When Tcûskai went to the lake, he went along the south side, for old
Sukas, a man-eater, who drew people in with his breath and
swallowed them, lived on the west side. Going home he made a
mistake; he thought the west was the south side,—he couldn’t see
well. Soon he met old Sukas.
Sukas said: “Come and wrestle with me, then you can go home.”
Tcûskai had to wrestle. About the middle of the afternoon he threw

the old man, but as he went down Tcûskai slipped and fell on him.
Sukas’ stomach was so big and flabby that [309]it covered Tcûskai up;
he couldn’t get out and he could scarcely breathe. He didn’t know
what to do. Then he heard Skóla say: “Somebody must scratch and
kick hard; that will kill the old man.”
Tcûskai began to kick and scratch, and in a little while he broke the
skin; the old man’s stomach shrank up. Tcûskai got up and ran
home.
Tskel asked: “Where are the reeds? Why were you gone so long?”
Tcûskai said: “I met old Sukas and wrestled with him.”
“I told you not to go that way,” said Tskel. He was cross and scolded.
That made Tcûskai mad.
The next morning Tcûskai made arrows for his boy and told him to
shoot Tskel’s boy while they were playing. He did, and Tskel’s boy
was two days getting well. Then Tcûskai put poison in an arrow and
told his son to shoot Tskel’s boy again. Tskel knew what his brother
was doing; he put poison in his son’s arrow and told him even if he
were dying, to kill Tcûskai’s boy.
The next day both boys were dead. Tcûskai and Tskel felt lonesome.
Tskel said: “I will go to Lamsewe and swim.”—When people lose
their friends and feel badly about it, they go and swim till they feel
better.—He told Tcûskai to go to another mountain, but he didn’t go;
he followed his brother.
When Tskel saw him, he was mad and he said: “You will be a person
no longer. You will look funny to people and they will laugh at you
when you run in and out of holes. They will think there are five or six
of you, but there will be only one.”
Tcûskai said: “You will no longer be a person, you will have no

power. In winter, when the water freezes, people will hunt for you in
the tula grass and will kill you.”
All this took place. Those two great powers turned into common little
minks and weasels, such as live now and are killed by hunters.
Tcûskai was always full of tricks. He taught his son to kill his cousin;
and that is why people of kin sometimes kill one another now. [310]
[Contents]
GÄK KILLS PAKOL
CHARACTERS
Gäk Crow Ndukis Hawk

Kiúks An Indian Doctor Pakol Deer
Kumal Pelican Wíle A Fawn
Moi Squirrel Wus Fox
Gäk was an old man and he was a doctor; his wife was young.
Off in the mountains there was a platform of rocks. Gäk lay on the
platform; he was sick. His medicines were the earth and the wind,
and he sang to them all the time, trying to get well.
One morning Gäk told his wife (Wíle) that he was going to die, and
asked her to call to her mother and father and aunts and uncles and
cousins, and tell them to come and see him for the last time.
Wíle stood on the rocks and called: “My mother, my father, my aunts
and uncles and cousins, come and see Gäk; he is going to die.”
Her father was away on the mountain, but he heard her and said:
“That sounds like my child’s voice.”
Right off Wíle saw hundreds of her people gathering and she called
to Gäk: “They are coming! They are coming!”
Gäk got up, turned around, and lay down so there was just room
enough for one person to sit on the edge of the rock. Then he said to
Wíle: “When they get here, have the fattest one, the one with the
black spot on his forehead, sit here by me. I am going to leave him
everything I have.”
When they were all standing around Gäk, he said to the one with the
spot on his forehead: “I want you to be the last man to bid me good-
by.” Then he covered up his head and [311]made a sound like
groaning. The Pakols waited a long time to see him die. At last they
began to say good-by. There was such a crowd that it was sundown
when they were through. Then Gäk told the fat Pakol, the one with
the spot on his forehead, to say good-by.
Just as Pakol was getting up to go, Gäk kicked him off the rock; he
fell over the precipice and was killed. Wíle and all the Pakols were so
scared that they ran away. Gäk went down among the rocks and
began to eat Pakol’s body.
The Pakols said: “The greatest one of us has been killed,” and they
mourned for him. (The Gäk people can never get enough to eat; they
feed themselves with both hands.)
Wus was no longer a person, but he could still talk. He came to the
ledge of rocks, looking for something to eat. He saw Gäk eating and
called out to him: “My brother, how did you get so much meat? How
did you get down there among the rocks?”
“I shut my eyes and jumped. Come down and eat with me.”
“I am afraid.”
“Go back a little way, shut your eyes, run to the edge, and jump.”
Wus said, “Eg! Eg!” and ran, but just as he got to the edge of the
rocks he opened his eyes and stopped. He did that three times.
Gäk scolded, and said: “You must do as I tell you. If you open your
eyes when you jump, you will get killed.”
Wus tried again, then he said: “Oh, my brother, throw me a piece of

meat.”
Gäk said: “If you want to eat, you must come down here.”
“Well, this time I will come!”
Wus jumped, but he caught on the bushes, and climbed back.
Gäk said: “It is getting dark. If you don’t come, you will have nothing
to eat.”
“I will come this time.”
Wus went over the rock like a feather, but when he was half-way
down, he opened his eyes; then he fell and was torn [312]to pieces.
His head, alive and with open eyes, was far away from the body.
Gäk felt badly; he and Wus had always been good friends. He said
to the head: “Wus, I thought you were the strongest person in the
world; now you are torn to pieces. You didn’t do as I told you to; you
opened your eyes.”
Gäk talked to his medicines, the earth and the wind, then he got his
red medicine basket, 1 picked up the pieces of Wus, joined them
together and stepped over the body three times. He covered the
body with the basket and told Wus to lie still, that the basket would
cure him, but he mustn’t get up till he came and took it off. Gäk went
back to eating.
At sundown Wus began to kick and to call: “I am well; come and take
the basket off!” He called many times. Each time Gäk said: “Lie still a
while longer; you needn’t be afraid. There is plenty of meat; we can’t
eat it in all night.” At last Gäk took the basket off.
After that Wus and Gäk lived together. The Pakols wanted to kill
Gäk, because he had killed their best man. All kinds of people hated
him, and wanted to kill him, but when any one got near him he
wasn’t Gäk; he turned into something and got away. One morning
two small men started to hunt for him; when he knew they were
coming, he turned himself into a bird and flew away.
Gäk had a blanket of bright rock (obsidian); he put the blanket

around him, turned into a man just like Ndukis, and sat down on a
high rock in sight of his enemies. He painted his face white, to make
them believe he was Ndukis. His enemies came and looked at him,
—a long line of people. All the people that walk, or crawl, or fly in the
world were there, and all had good eyes. Each man gave his
opinion, and each thought it was Ndukis.
Blaiwas said: “Nobody in the world can see plainer than I can; that is
Ndukis.” Old man Moi knew the man was Gäk, but he didn’t want to
say so. When they asked him what he [313]thought, he said: “You
have a wise old man here” (he meant Kumal); “if he doesn’t tell you
who that man is, I will.”
Gäk sat perfectly still on the rock. He knew that Kumal was wise, and
that he had a blanket made of five kinds of stone. Gäk’s blanket was
made of four kinds of stone.
When Kumal came up, the people gave him a place where he could
stand and look at the man on the rock. He looked a long time, then
said: “How could you be fooled? That is Gäk, the man who killed
Pakol. He has painted his face white and made himself look like
Ndukis, but don’t you see his large mouth?”
Gäk came down from the rock, took his own form, and began to fight
with the crowd. He killed every one who fought with him; some
wouldn’t fight, they ran away.
Gäk struck at Kumal’s throat, cut through the old man’s stone
blanket, and killed him; he tore his body to pieces, threw the pieces
in the water, and said: “You will no longer be a person. You will be a
fisher, and live in the water.” The other bodies Gäk turned to rocks,
then he went off to the mountains. Wus had been eating the bodies
of the men Gäk killed. When the bodies turned to stone, he followed
Gäk to the mountains. [314]
1 A medicine basket is made of tckula, a kind of willow, and is painted red. When
the basket is not a medicine, it is used as a sieve. The old Indian woman who
related this Gäk myth said: “The basket is a good medicine. If a man is wounded,
and the basket is put over him, he gets well.” ↑
[Contents]

Full download Fundamentals of Nursing 2nd Edition Lauren Mctier file pdf all chapter on 2024

Uploaded by

Copyright:

Available Formats

You might also like

Full download Fundamentals of Nursing 2nd Edition Lauren Mctier file pdf all chapter on 2024

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Full download Fundamentals of Nursing 2nd Edition Lauren Mctier file pdf all chapter on 2024

Uploaded by

Copyright:

Available Formats

Fundamentals of Nursing 2nd Edition

Fundamentals of Nursing Patricia A. Potter

Kozier & Erb’s Fundamentals of Nursing (Fundamentals of

(eBook PDF) Fundamentals of Nursing: Active Learning

Fundamentals of Nursing Made Incredibly Easy!

Oxford Handbook of Respiratory Nursing 2nd Edition

Fundamentals of Canadian Nursing: Concepts, Process,

Essentials of Nursing Law and Ethics 2nd Edition

Fundamentals of Physical Geography 2nd Edition, (Ebook

National Library of Australia Cataloguing-in-Publication Data

Guide to the text  x UNIT 2

Planning nursing interventions 113 Principles of effective documentation 190

Planning and outcomes 768 CHAPTER 40

The mistreatment of older adults takes many forms, education;

alth status Identify important client

arch findings should be

Intervention: Assess for risk of falls and use fall-prevention

to promote EBP. If practice database in a computer file. It Within is a helpful,

a person with confusion, or undertaking the care of

Incision – red, tender to touch,

to formulas for practice. without drainage edges should be

The accompanying ‘Nursing checklist’ describes eye

Guide to the online resources

Cengage is pleased to provide you with a selection of resources

COGNERO TEST BANK POWERED BY MINDTAP

ARTWORK FROM THE TEXT

FOR THE STUDENT

New, print versions of this textbook come with bonus online

We are very excited to share this second edition of CONCEPTUAL APPROACH

NEW TO THE SECOND AUSTRALIAN Additional features include the following:

LANGUAGE AND TERMINOLOGY

ABOUT THE AUTHORS

After he had washed their heads, he wrapped a skin blanket around

“Don’t go in front of it,” said Tskel. “Shoot it from behind!”

Tskel went on till he came to a rock house right on the trail. He

He started just at daybreak. He traveled fast, going up all the time.

“What are you here for?” asked Súbbas.

“I can’t wait to talk,” said Súbbas. “I am always hurrying along; I only

“Come to-morrow,” said Súbbas, and he hurried along. It was night

“I am brighter than beads. I don’t want beads!” said Súbbas, “but I

That moment Tskel’s bow and bowstring broke. He knew that

“I can kill him easily,” said Tcûskai.

Blaiwas said: “Little Kékina never tells a lie; somebody must be

Moi said: “Somebody is coming. Tell the people to be ready to shoot

“Where can I find a wife?” asked Tcûskai.

Tcûskai walked and walked. After a while he came to the clearing

After a time Tcûskai wanted to see his brother. When he got to

Tcûskai had to wrestle. About the middle of the afternoon he threw

Tcûskai said: “I met old Sukas and wrestled with him.”

Tcûskai said: “You will no longer be a person, you will have no

Gäk Crow Ndukis Hawk

Wus tried again, then he said: “Oh, my brother, throw me a piece of

“Well, this time I will come!”

Wus jumped, but he caught on the bushes, and climbed back.

“I will come this time.”

Gäk had a blanket of bright rock (obsidian); he put the blanket

You might also like

Guide to the text x UNIT 2