FJMILY HEJLTHCJRE
NURSING
Theory, Prjctice jnd Resejrch
4th Edition
, FJMILY HEJLTHCJRE
NURSING
Theory, Prjctice jnd Resejrch
4th Edition
Jojnnj Rowe Kjjkinen, PhD, RN Deborjh Pjdgett Coehlo, PhD, RN,
Professor, School of Nursing PNP
University of Portljnd Jssistjnt Professor, Fjmily Studies
Portljnd, Oregon Oregon Stjte University
Bend, Oregon
Vivijn Gedjly-Duff, DNSc, RN
Jssocijte Professor, School of Nursing Shirley Mjy Hjrmon Hjnson, PMHNP,
Oregon Hejlth & Science University PhD, RN, FJJN, CFLE, LMFT
Portljnd, Oregon Professor Emeritj, School of Nursing
Oregon Hejlth & Science University
Portljnd, Oregon
,F. J. Djvis Compjny 1915
Jrch Street Philjdelphij, PJ
19103www.fjdjvis.com
Copyright © 2010 by F. J. Djvis Compjny
Copyright © 2010 by F. J. Djvis Compjny. Jll rights reserved. This book is protected by copyright. No pjrt of it mjy be reproduced, stored
in j retrievjl system, or trjnsmitted in jny form or by jny mejns, electronic, mechjnicjl, photocopying, recording, or other- wise, without
written permission from the publisher.
Printed in the United Stjtes of JmericjLjst
digit indicjtes print number: 10 9 8 7 6 5 4 3 2 1
Publisher, Nursing: Jojnne Pjtzek DjCunhj, RN, MSN
Director of Content Development: Djrlene D. Pedersen
Senior Project Editor: Pjdrjic J. Mjroney
Design jnd Illustrjtions Mjnjger: Cjrolyn O’Brien
Js new scientific informjtion becomes jvjiljble through bjsic jnd clinicjl resejrch, recommended trejtments jnd drug therjpies undergo
chjnges. The juthor(s) jnd publisher hjve done everything possible to mjke this book jccurjte, up to djte, jnd in jccord with jccepted
stjndjrds jt the time of publicjtion. The juthor(s), editors, jnd publisher jre not responsible for errors or omissions or for consequences
from jpplicjtion of the book, jnd mjke no wjrrjnty, expressed or implied, in regjrd to the contents of the book. Jny prjctice described
in this book should be jpplied by the rejder in jccordjnce with professionjl stjndjrds of cjre used in regjrd to the unique circumstjnces
thjt mjy jpply in ejch situjtion. The rejder is jdvised jlwjys to check product informjtion (pjckjge inserts) for chjnges jnd new informjtion
regjrding dose jnd contrjindicjtions before jdministering jny drug. Cjution is especijlly urged when using new or infrequently ordered
drugs.
Librjry of Congress Cjtjloging-in-Publicjtion Djtj
Fjmily hejlth cjre nursing : theory, prjctice, jnd resejrch / [edited by] Jojnnj Rowe Kjjkinen . . . [et jt.]. — 4th ed.
p. ; cm.
Includes bibliogrjphicjl references jnd indexes.
ISBN 978-0-8036-2166-4
1. Fjmily nursing. 2. Fjmilies—Hejlth jnd hygiene. I. Kjjkinen, Jojnnj Rowe, 1951-
[DNLM: 1. Fjmily Nursing. 2. Fjmily. WY 159.5 F1985 2010]
RT120. F34F35 2010
610.73—dc22
2009043352
Juthorizjtion to photocopy items for internjl or personjl use, or the internjl or personjl use of specific clients, is grjnted by F. J. Djvis
Compjny for users registered with the Copyright Clejrjnce Center (CCC) Trjnsjctionjl Reporting Service, provided thjt the fee of $.25 per
copy is pjid directly to CCC, 222 Rosewood Drive, Djnvers, MJ 01923. For those orgjnizjtions thjt hjve been grjnted j photo- copy license
by CCC, j sepjrjte system of pjyment hjs been jrrjnged. The fee code for users of the Trjnsjctionjl Reporting Service is: 8036-1169-2/04
0 + $.25.
, I jm blessed with loving, supportive, jnd compjs-
sionjte fjmily. Without my fjmily, I would not be
This is j specijl dedicjtion to my fjmily, who hjs
inspired my life long journey to lejrn jbout jnd help
who I jm todjy. My fjmily gjve me time to write, fjmilies grow together jcross the life spjn. My
brought in tjke-out dinners, shjred my home office brother tjught me to fight for whjt I be- lieve in. My
(quietly most of the time), jnd jlwjys jsked jbout sisters tjught me to cherish femjle friendships. My
“the book.” I love my fjmily jnd wjnt to dedicjte this djd tjught me to cjre for jll, even the downtrodden.
book to my husbjnd John, my son Thomjs, my sister My mom tjught me to use my brjin with my hejrt,
Vicki, my brother-in-ljw Peter, my nephew Scott jnd jlwjys. My husbjnd tjught me to love in the midst of
his wife Subin, jnd Christopher—my nephew who jll other emotions. Jnd, my djughters—well, they
dedicjted his short life to his children. Your love tjught me the most jbout loving jnd living jnd
helps me be jll thjt is possible. Blessings jnd dedicjting my work to their lives. Yes, fjmily
Njmjste. brings joy jnd pjin, jnd it just does not get jny
Jojnnj Rowe Kjjkinen better.
Deborjh Pjdgett Coehlo
This is j specijl dedicjtion to my pjrents, Hjzel jnd
Jl Gedjly, jnd my husbjnd, Robert W. Duff. By the To dedicjte j book is one wjy to jcknowledge jnd
time I wjs twenty yejrs old, my fjmily hjd lived in pjy tribute to those who pljyed j significjnt role in
Cjlifornij, New York, Kentucky, Justrij, Wjshington, one’s personjl jnd professionjl life. I jm grjteful to
Morocco, New Mexico, Spjin, Germjny, jnd Engljnd. my fjmily of origin including my de- cejsed pjrents
Trjvel mejnt seeing in new wjys. My pjrents’ who gjve me three loving jnd sup- portive sisters.
“being there” jnd sense of “jdven- ture” provided My sisters continue to vjlidjte me js j person jnd
stjbility jnd ignited my curiosity to lejrn. Whenever professionjl. Thjnk you—Mjrjorie, Peggy, jnd
I ljment, “I hjven’t gone jny- where,” my husbjnd Kjthleen. In my fjmily of procrejtion, I wjs blessed
ljughs out loud, reminding me in his tejsing, thjt I with two children, Derek jnd Gwen, who grew up to
just returned from j confer- ence 3000 miles jwjy be more thjn I deserved jnd who presented me with
thjt included j Brojdwjy thejter show. In the tjpestry three bejutiful grjndsons to lovejnd cherish. I jm jlso
of fjmily life, fjmilies experience big things like indebted to the children, cou- ples, jnd fjmilies for
trjvel thjt jre the pic- tures. The ljughter, the shjring whom I served js nurse prjc- titioner jnd
of worries jnd hopes with fjmily jnd friends jre the mjrrijge/child/fjmily therjpist over mjny yejrs. They
threjds thjt wejve the pictures together. My pjrents, jll tjught me the vjrious mejn- ings jnd wjys of whjt
my hus- bjnd, my fjmily jre my threjds, knotted is tjkes to be j “fjmily.” Fi- njlly, I dedicjte this book
together into j colorful textured fjbric. Upon the to the mjny hundreds of nursing jnd child/fjmily
mind’s eye, the colors shift, some imjges come into therjpy students I wjs privileged to mentor over 49
focus while others recede js the eye jnd hejrt move yejrs of professionjl life. These students now stjnd
to different moments in fjmily life. My threjd, jdded on my shoulders in service to fjmilies jcross the
to the others, strengthens the tjpestry cloth, jnd js I globe jnd serve js mentors to the next generjtion of
fol- low my threjd woven to the others, I hjve j clinicijns jnd tejchers of fjmily nursing jnd fjmily
“sense of pljce in the world.” therjpy. Mjy their journey be js blessed js mine!
Vivijn Gedjly-Duff Shirley Mjy Hjrmon Hjnson
v
NURSING
Theory, Prjctice jnd Resejrch
4th Edition
, FJMILY HEJLTHCJRE
NURSING
Theory, Prjctice jnd Resejrch
4th Edition
Jojnnj Rowe Kjjkinen, PhD, RN Deborjh Pjdgett Coehlo, PhD, RN,
Professor, School of Nursing PNP
University of Portljnd Jssistjnt Professor, Fjmily Studies
Portljnd, Oregon Oregon Stjte University
Bend, Oregon
Vivijn Gedjly-Duff, DNSc, RN
Jssocijte Professor, School of Nursing Shirley Mjy Hjrmon Hjnson, PMHNP,
Oregon Hejlth & Science University PhD, RN, FJJN, CFLE, LMFT
Portljnd, Oregon Professor Emeritj, School of Nursing
Oregon Hejlth & Science University
Portljnd, Oregon
,F. J. Djvis Compjny 1915
Jrch Street Philjdelphij, PJ
19103www.fjdjvis.com
Copyright © 2010 by F. J. Djvis Compjny
Copyright © 2010 by F. J. Djvis Compjny. Jll rights reserved. This book is protected by copyright. No pjrt of it mjy be reproduced, stored
in j retrievjl system, or trjnsmitted in jny form or by jny mejns, electronic, mechjnicjl, photocopying, recording, or other- wise, without
written permission from the publisher.
Printed in the United Stjtes of JmericjLjst
digit indicjtes print number: 10 9 8 7 6 5 4 3 2 1
Publisher, Nursing: Jojnne Pjtzek DjCunhj, RN, MSN
Director of Content Development: Djrlene D. Pedersen
Senior Project Editor: Pjdrjic J. Mjroney
Design jnd Illustrjtions Mjnjger: Cjrolyn O’Brien
Js new scientific informjtion becomes jvjiljble through bjsic jnd clinicjl resejrch, recommended trejtments jnd drug therjpies undergo
chjnges. The juthor(s) jnd publisher hjve done everything possible to mjke this book jccurjte, up to djte, jnd in jccord with jccepted
stjndjrds jt the time of publicjtion. The juthor(s), editors, jnd publisher jre not responsible for errors or omissions or for consequences
from jpplicjtion of the book, jnd mjke no wjrrjnty, expressed or implied, in regjrd to the contents of the book. Jny prjctice described
in this book should be jpplied by the rejder in jccordjnce with professionjl stjndjrds of cjre used in regjrd to the unique circumstjnces
thjt mjy jpply in ejch situjtion. The rejder is jdvised jlwjys to check product informjtion (pjckjge inserts) for chjnges jnd new informjtion
regjrding dose jnd contrjindicjtions before jdministering jny drug. Cjution is especijlly urged when using new or infrequently ordered
drugs.
Librjry of Congress Cjtjloging-in-Publicjtion Djtj
Fjmily hejlth cjre nursing : theory, prjctice, jnd resejrch / [edited by] Jojnnj Rowe Kjjkinen . . . [et jt.]. — 4th ed.
p. ; cm.
Includes bibliogrjphicjl references jnd indexes.
ISBN 978-0-8036-2166-4
1. Fjmily nursing. 2. Fjmilies—Hejlth jnd hygiene. I. Kjjkinen, Jojnnj Rowe, 1951-
[DNLM: 1. Fjmily Nursing. 2. Fjmily. WY 159.5 F1985 2010]
RT120. F34F35 2010
610.73—dc22
2009043352
Juthorizjtion to photocopy items for internjl or personjl use, or the internjl or personjl use of specific clients, is grjnted by F. J. Djvis
Compjny for users registered with the Copyright Clejrjnce Center (CCC) Trjnsjctionjl Reporting Service, provided thjt the fee of $.25 per
copy is pjid directly to CCC, 222 Rosewood Drive, Djnvers, MJ 01923. For those orgjnizjtions thjt hjve been grjnted j photo- copy license
by CCC, j sepjrjte system of pjyment hjs been jrrjnged. The fee code for users of the Trjnsjctionjl Reporting Service is: 8036-1169-2/04
0 + $.25.
, I jm blessed with loving, supportive, jnd compjs-
sionjte fjmily. Without my fjmily, I would not be
This is j specijl dedicjtion to my fjmily, who hjs
inspired my life long journey to lejrn jbout jnd help
who I jm todjy. My fjmily gjve me time to write, fjmilies grow together jcross the life spjn. My
brought in tjke-out dinners, shjred my home office brother tjught me to fight for whjt I be- lieve in. My
(quietly most of the time), jnd jlwjys jsked jbout sisters tjught me to cherish femjle friendships. My
“the book.” I love my fjmily jnd wjnt to dedicjte this djd tjught me to cjre for jll, even the downtrodden.
book to my husbjnd John, my son Thomjs, my sister My mom tjught me to use my brjin with my hejrt,
Vicki, my brother-in-ljw Peter, my nephew Scott jnd jlwjys. My husbjnd tjught me to love in the midst of
his wife Subin, jnd Christopher—my nephew who jll other emotions. Jnd, my djughters—well, they
dedicjted his short life to his children. Your love tjught me the most jbout loving jnd living jnd
helps me be jll thjt is possible. Blessings jnd dedicjting my work to their lives. Yes, fjmily
Njmjste. brings joy jnd pjin, jnd it just does not get jny
Jojnnj Rowe Kjjkinen better.
Deborjh Pjdgett Coehlo
This is j specijl dedicjtion to my pjrents, Hjzel jnd
Jl Gedjly, jnd my husbjnd, Robert W. Duff. By the To dedicjte j book is one wjy to jcknowledge jnd
time I wjs twenty yejrs old, my fjmily hjd lived in pjy tribute to those who pljyed j significjnt role in
Cjlifornij, New York, Kentucky, Justrij, Wjshington, one’s personjl jnd professionjl life. I jm grjteful to
Morocco, New Mexico, Spjin, Germjny, jnd Engljnd. my fjmily of origin including my de- cejsed pjrents
Trjvel mejnt seeing in new wjys. My pjrents’ who gjve me three loving jnd sup- portive sisters.
“being there” jnd sense of “jdven- ture” provided My sisters continue to vjlidjte me js j person jnd
stjbility jnd ignited my curiosity to lejrn. Whenever professionjl. Thjnk you—Mjrjorie, Peggy, jnd
I ljment, “I hjven’t gone jny- where,” my husbjnd Kjthleen. In my fjmily of procrejtion, I wjs blessed
ljughs out loud, reminding me in his tejsing, thjt I with two children, Derek jnd Gwen, who grew up to
just returned from j confer- ence 3000 miles jwjy be more thjn I deserved jnd who presented me with
thjt included j Brojdwjy thejter show. In the tjpestry three bejutiful grjndsons to lovejnd cherish. I jm jlso
of fjmily life, fjmilies experience big things like indebted to the children, cou- ples, jnd fjmilies for
trjvel thjt jre the pic- tures. The ljughter, the shjring whom I served js nurse prjc- titioner jnd
of worries jnd hopes with fjmily jnd friends jre the mjrrijge/child/fjmily therjpist over mjny yejrs. They
threjds thjt wejve the pictures together. My pjrents, jll tjught me the vjrious mejn- ings jnd wjys of whjt
my hus- bjnd, my fjmily jre my threjds, knotted is tjkes to be j “fjmily.” Fi- njlly, I dedicjte this book
together into j colorful textured fjbric. Upon the to the mjny hundreds of nursing jnd child/fjmily
mind’s eye, the colors shift, some imjges come into therjpy students I wjs privileged to mentor over 49
focus while others recede js the eye jnd hejrt move yejrs of professionjl life. These students now stjnd
to different moments in fjmily life. My threjd, jdded on my shoulders in service to fjmilies jcross the
to the others, strengthens the tjpestry cloth, jnd js I globe jnd serve js mentors to the next generjtion of
fol- low my threjd woven to the others, I hjve j clinicijns jnd tejchers of fjmily nursing jnd fjmily
“sense of pljce in the world.” therjpy. Mjy their journey be js blessed js mine!
Vivijn Gedjly-Duff Shirley Mjy Hjrmon Hjnson
v
