Author: Thomas Wesson Barkley
Publisher: Saunders
ISBN:
Category : Medical
Languages : en
Pages : 980
Book Description
This book is a comprehensive, easy-access clinical reference for acute care nurse practitioners and other clinicians in acute care. It features guidelines for managing over 230 of the most common conditions experienced by adult patients in acute care. Using an outline format, the coverage of each condition includes an overview with defining terms, incidence/predisposing factors, subjective and physical exam findings, diagnostic tests, and management strategies. Comprehensive coverage--over 230 conditions covered Consistent outline format--each chapter includes an overview with defining terms, incidence/predisposing factors, subjective and physical exam findings, diagnostic tests, and management strategies In addition to conditions by body system, the book also includes coverage of nutritional considerations, fluid/electrolyte imbalances, shock, and trauma Convenient pocket-size
Practice Guidelines for Acute Care Nurse Practitioners
Author: Thomas Wesson Barkley
Publisher: Saunders
ISBN:
Category : Medical
Languages : en
Pages : 980
Book Description
This book is a comprehensive, easy-access clinical reference for acute care nurse practitioners and other clinicians in acute care. It features guidelines for managing over 230 of the most common conditions experienced by adult patients in acute care. Using an outline format, the coverage of each condition includes an overview with defining terms, incidence/predisposing factors, subjective and physical exam findings, diagnostic tests, and management strategies. Comprehensive coverage--over 230 conditions covered Consistent outline format--each chapter includes an overview with defining terms, incidence/predisposing factors, subjective and physical exam findings, diagnostic tests, and management strategies In addition to conditions by body system, the book also includes coverage of nutritional considerations, fluid/electrolyte imbalances, shock, and trauma Convenient pocket-size
Publisher: Saunders
ISBN:
Category : Medical
Languages : en
Pages : 980
Book Description
This book is a comprehensive, easy-access clinical reference for acute care nurse practitioners and other clinicians in acute care. It features guidelines for managing over 230 of the most common conditions experienced by adult patients in acute care. Using an outline format, the coverage of each condition includes an overview with defining terms, incidence/predisposing factors, subjective and physical exam findings, diagnostic tests, and management strategies. Comprehensive coverage--over 230 conditions covered Consistent outline format--each chapter includes an overview with defining terms, incidence/predisposing factors, subjective and physical exam findings, diagnostic tests, and management strategies In addition to conditions by body system, the book also includes coverage of nutritional considerations, fluid/electrolyte imbalances, shock, and trauma Convenient pocket-size
Practice Guidelines for Acute Care Nurse Practitioners - E-Book
Author: Thomas W. Barkley
Publisher: Elsevier Health Sciences
ISBN: 1416069216
Category : Medical
Languages : en
Pages : 1025
Book Description
PRACTICE GUIDELINES FOR ACUTE CARE NURSE PRACTITIONERS, 2nd Edition is the only comprehensive clinical reference tailored to the needs of advance practice nurses. With discussions of more than 230 of the most common conditions experienced by adult patients in acute care, this reference includes everything you need on a day-to-day basis. Plus, quick reference is easy with a spiral binding and content organized by body system. Each condition lists a concise outline of defining terms, incidence/predisposing factors, subject and physical examination findings, diagnostic tests, and management strategies so you can find everything you need to know quickly. Includes discussion of body systems, nutritional considerations, fluid/electrolyte imbalances, shock, trauma, gerontological concerns, professional issues, and trends in advanced practice. - Nursing guidelines for more than 230 of the most common conditions experienced by adult patients in acute care serve as an invaluable resource in the field. - Conditions are organized by body system for quick reference when treating patients. - Each condition lists defining terms, incidence/predisposing factors, subjective and physical examination findings, diagnostic tests, and management strategies to provide help every step of the way. - Coverage also includes discussion of body systems, nutritional considerations, fluid/electrolyte imbalances, shock, and trauma for a complete look at patient care and diagnosis. - An entire chapter dedicated to congestive heart failure gives you a deeper look at the disease. - Specific content, as well as online references, for diseases such as SARS and West Nile Virus give you the most current information available on these evolving diseases. - New chapters on admission, pre-op and post-op orders prepare you for every step of the patient treatment process. - Addition of ICD-9 codes within the chapters makes classifying diseases with ICD codes easy. - New content on Parkinson's disease, gout, testicular cancer, multiple sclerosis, bite management (including spider, snake, animal, and human) better prepare you for these situations. - Updated and expanded content reflects changes in current guidelines and evidence-based practice, an important part of working in the field. - Updated and expanded content on coronary artery disease and inclusion of the new JNC 7 national hypertension guidelines features more information on these common diseases. - Expanded and updated coverage of postmenopausal women and hormone replacement therapy.
Publisher: Elsevier Health Sciences
ISBN: 1416069216
Category : Medical
Languages : en
Pages : 1025
Book Description
PRACTICE GUIDELINES FOR ACUTE CARE NURSE PRACTITIONERS, 2nd Edition is the only comprehensive clinical reference tailored to the needs of advance practice nurses. With discussions of more than 230 of the most common conditions experienced by adult patients in acute care, this reference includes everything you need on a day-to-day basis. Plus, quick reference is easy with a spiral binding and content organized by body system. Each condition lists a concise outline of defining terms, incidence/predisposing factors, subject and physical examination findings, diagnostic tests, and management strategies so you can find everything you need to know quickly. Includes discussion of body systems, nutritional considerations, fluid/electrolyte imbalances, shock, trauma, gerontological concerns, professional issues, and trends in advanced practice. - Nursing guidelines for more than 230 of the most common conditions experienced by adult patients in acute care serve as an invaluable resource in the field. - Conditions are organized by body system for quick reference when treating patients. - Each condition lists defining terms, incidence/predisposing factors, subjective and physical examination findings, diagnostic tests, and management strategies to provide help every step of the way. - Coverage also includes discussion of body systems, nutritional considerations, fluid/electrolyte imbalances, shock, and trauma for a complete look at patient care and diagnosis. - An entire chapter dedicated to congestive heart failure gives you a deeper look at the disease. - Specific content, as well as online references, for diseases such as SARS and West Nile Virus give you the most current information available on these evolving diseases. - New chapters on admission, pre-op and post-op orders prepare you for every step of the patient treatment process. - Addition of ICD-9 codes within the chapters makes classifying diseases with ICD codes easy. - New content on Parkinson's disease, gout, testicular cancer, multiple sclerosis, bite management (including spider, snake, animal, and human) better prepare you for these situations. - Updated and expanded content reflects changes in current guidelines and evidence-based practice, an important part of working in the field. - Updated and expanded content on coronary artery disease and inclusion of the new JNC 7 national hypertension guidelines features more information on these common diseases. - Expanded and updated coverage of postmenopausal women and hormone replacement therapy.
Adult-Gerontology Acute Care Practice Guidelines
Author: Catherine Harris, PhD, MBA, AG-ACNP
Publisher: Springer Publishing Company
ISBN: 0826170056
Category : Medical
Languages : en
Pages : 557
Book Description
The First Book of its Kind Praise from Doody's Medical Reviews - Score: 93 "This well-developed book provides acute care guidelines for the geriatric population in an easy-to-follow format that uses structural elements such as numbering and multilevel lists for each system. It is an excellent reference for advanced practice prepared-clinicians to help identify, diagnose, and develop a treatment plan for acute health issues in older adults and geriatric patients." -Tho Nguyen, DNP, MSN, RN Delivers expert guidance for the common conditions seen in adult–gerontology acute care practice The first book of its kind, this evidence-based resource provides nurse practitioners, physician assistants, and other advanced practice providers with the clinical knowledge they need to effectively practice adult-gerontology acute care. In quick-reference format, this system-based text describes more than 90 common conditions health providers are likely to see in their acute care practice. In this interprofessionally contributed text, nurse practitioner, physician assistant, and physician authors provide expert insight into each condition, enabling readers to categorize symptoms, be alert to the distinguishing features of disease symptoms and clusters, and find associated diagnoses. Comprehensive descriptions of conditions encompass definitions, incidence, pathophysiology, common signs and symptoms, vital subjective and pertinent physical exam data, differential diagnoses, diagnostic tests, and evaluation and management plans. This handy, accessible text also includes perioperative considerations, discharge guidelines, treatment and disease management algorithms, and procedural guidelines. Key Features: Presents key points for more than 90 acute care conditions in quick-reference format Includes considerations for such topics as preoperative, intraoperative, and postoperative evaluation and management Offers discharge guidelines for inpatient conditions Disseminates over 20 procedural guidelines, such as central and arterial line insertion, bronchoscopy, ECMO, endotracheal intubation, and more
Publisher: Springer Publishing Company
ISBN: 0826170056
Category : Medical
Languages : en
Pages : 557
Book Description
The First Book of its Kind Praise from Doody's Medical Reviews - Score: 93 "This well-developed book provides acute care guidelines for the geriatric population in an easy-to-follow format that uses structural elements such as numbering and multilevel lists for each system. It is an excellent reference for advanced practice prepared-clinicians to help identify, diagnose, and develop a treatment plan for acute health issues in older adults and geriatric patients." -Tho Nguyen, DNP, MSN, RN Delivers expert guidance for the common conditions seen in adult–gerontology acute care practice The first book of its kind, this evidence-based resource provides nurse practitioners, physician assistants, and other advanced practice providers with the clinical knowledge they need to effectively practice adult-gerontology acute care. In quick-reference format, this system-based text describes more than 90 common conditions health providers are likely to see in their acute care practice. In this interprofessionally contributed text, nurse practitioner, physician assistant, and physician authors provide expert insight into each condition, enabling readers to categorize symptoms, be alert to the distinguishing features of disease symptoms and clusters, and find associated diagnoses. Comprehensive descriptions of conditions encompass definitions, incidence, pathophysiology, common signs and symptoms, vital subjective and pertinent physical exam data, differential diagnoses, diagnostic tests, and evaluation and management plans. This handy, accessible text also includes perioperative considerations, discharge guidelines, treatment and disease management algorithms, and procedural guidelines. Key Features: Presents key points for more than 90 acute care conditions in quick-reference format Includes considerations for such topics as preoperative, intraoperative, and postoperative evaluation and management Offers discharge guidelines for inpatient conditions Disseminates over 20 procedural guidelines, such as central and arterial line insertion, bronchoscopy, ECMO, endotracheal intubation, and more
Adult-Gerontology Acute Care Nurse Practitioner Q&A Review
Author: Dawn Carpenter, DNP, ACNP-BC, CCRN
Publisher: Springer Publishing Company
ISBN: 082616482X
Category : Medical
Languages : en
Pages : 400
Book Description
Print version of the book includes free access to the app (web, iOS, and Android), which offers interactive Q&A review plus the entire text of the print book! Please note the app is included with print purchase only. The only book designed specifically to prepare students for the Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) exams, this unparalleled review details the step-by-step journey from classroom to patient room and beyond. This book begins with proven test-taking strategies for students and provides an overview of common pitfalls for exam takers. It features question styles and content material from both the American Association of Critical-Care Nurses (AACN®) and American Nurses Credentialing Center (ANCC) exams, providing an overview of the certification exams written specifically by the certification organizations themselves. With more than 630 unique questions, this review contains completely up-to-date and evidence-based exam preparation. Practice questions are organized into body system review, special populations, and legal/ethical issues, and culminate in a 175-question practice test that represents the length, variety, and complexity of board exam questions. All questions’ answers have accompanying rationales based on clinical practice guidelines. Completely unique to this publication, the last section of Adult-Gerontology Acute Care Nurse Practitioner Q&A Review guides one through the next steps after the exam—how to progress into practice with your new certification. KEY FEATURES Over 630 practice questions with answers and rationales The only current book publication designed specifically to prepare students for the AG-ACNP exams Contains the most current information and practice using published guidelines Exam tips and perils/pitfalls to avoid in test-taking Includes free access to interactive ebook and Q&A app—track and sync your progress on up to three devices!
Publisher: Springer Publishing Company
ISBN: 082616482X
Category : Medical
Languages : en
Pages : 400
Book Description
Print version of the book includes free access to the app (web, iOS, and Android), which offers interactive Q&A review plus the entire text of the print book! Please note the app is included with print purchase only. The only book designed specifically to prepare students for the Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) exams, this unparalleled review details the step-by-step journey from classroom to patient room and beyond. This book begins with proven test-taking strategies for students and provides an overview of common pitfalls for exam takers. It features question styles and content material from both the American Association of Critical-Care Nurses (AACN®) and American Nurses Credentialing Center (ANCC) exams, providing an overview of the certification exams written specifically by the certification organizations themselves. With more than 630 unique questions, this review contains completely up-to-date and evidence-based exam preparation. Practice questions are organized into body system review, special populations, and legal/ethical issues, and culminate in a 175-question practice test that represents the length, variety, and complexity of board exam questions. All questions’ answers have accompanying rationales based on clinical practice guidelines. Completely unique to this publication, the last section of Adult-Gerontology Acute Care Nurse Practitioner Q&A Review guides one through the next steps after the exam—how to progress into practice with your new certification. KEY FEATURES Over 630 practice questions with answers and rationales The only current book publication designed specifically to prepare students for the AG-ACNP exams Contains the most current information and practice using published guidelines Exam tips and perils/pitfalls to avoid in test-taking Includes free access to interactive ebook and Q&A app—track and sync your progress on up to three devices!
Practice Considerations for Adult-Gerontology Acute Care Nurse Practitioners
Author: Thomas W. Barkley, Jr.
Publisher:
ISBN: 9781734319101
Category :
Languages : en
Pages :
Book Description
Publisher:
ISBN: 9781734319101
Category :
Languages : en
Pages :
Book Description
Critical Care
Author: Mary Wyckoff, PhD, APRN, BC,
Publisher: Springer Publishing Company
ISBN: 0826138276
Category : Medical
Languages : en
Pages : 581
Book Description
Named a 2013 Doody's Core Title! Winner of an AJN Book of the Year Award of 2009! "There is little doubt that every ACNP in practice or in training will want a copy of this reference in their lab coat pocket." --Ric Cuming, RN, MSN, EdD (c), CNOR, NEA-BC Chief Nursing Officer Jackson Memorial Hospital "Long overdue-This comprehensive critical care text will fill the void, especially for nurses advancing from BSN to Advanced Practice. The authors have covered all the basics and produced a text that provides a well-rounded knowledge base for critical care." -Jeanne H. Siegel, PhD, ARNP University of Miami School of Nursing and Health Studies This book defines what it means to be a nurse in critical care. With this text, Acute Care Nurse Practitioners (ACNPs) will learn what to expect in the critical care unit, and how to manage various complications with patients in acute and intensive care settings. Significant emphasis is given to the complex pathophysiology and appropriate management of common problems encountered in the critical care environment, including trauma, infections, and disease. One chapter is also dedicated to the medical, legal, and ethical aspects of critical care. Critical Care is thus the must-have reference for graduate students as well as for practicing ACPNs. Key topics include: The role of the ACPN in acute and critical care Pulmonary management Cardiac concepts in acute care settings Managing liver, kidney, and kidney pancreas transplant in the ICU Burn management Multisystem organ failure End-of-life and palliative care Family-centered care Winner of an AJN Book of the Year Award for 2009!
Publisher: Springer Publishing Company
ISBN: 0826138276
Category : Medical
Languages : en
Pages : 581
Book Description
Named a 2013 Doody's Core Title! Winner of an AJN Book of the Year Award of 2009! "There is little doubt that every ACNP in practice or in training will want a copy of this reference in their lab coat pocket." --Ric Cuming, RN, MSN, EdD (c), CNOR, NEA-BC Chief Nursing Officer Jackson Memorial Hospital "Long overdue-This comprehensive critical care text will fill the void, especially for nurses advancing from BSN to Advanced Practice. The authors have covered all the basics and produced a text that provides a well-rounded knowledge base for critical care." -Jeanne H. Siegel, PhD, ARNP University of Miami School of Nursing and Health Studies This book defines what it means to be a nurse in critical care. With this text, Acute Care Nurse Practitioners (ACNPs) will learn what to expect in the critical care unit, and how to manage various complications with patients in acute and intensive care settings. Significant emphasis is given to the complex pathophysiology and appropriate management of common problems encountered in the critical care environment, including trauma, infections, and disease. One chapter is also dedicated to the medical, legal, and ethical aspects of critical care. Critical Care is thus the must-have reference for graduate students as well as for practicing ACPNs. Key topics include: The role of the ACPN in acute and critical care Pulmonary management Cardiac concepts in acute care settings Managing liver, kidney, and kidney pancreas transplant in the ICU Burn management Multisystem organ failure End-of-life and palliative care Family-centered care Winner of an AJN Book of the Year Award for 2009!
Practice Guidelines for Family Nurse Practitioners
Author: Karen Fenstermacher
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 540
Book Description
This portable reference provides thorough and detailed assessment information for all common primary care conditions, including signs and symptoms, diagnostic methods, drug therapies, and treatment. Written by expert nurse practitioners, it features complete, practical, up-to-date information on diagnosing and treating primary care disorders in the family practice setting. Separate sections are devoted to specific populations such as pediatric, adult, and geriatric patients. This reference is well known for its concise guidelines, comparative charts, and tables that list the symptoms, physical assessment findings, and possible diagnoses in a quick-reference format. Numerous tables, outlines, and comparative charts are included for easy reference. Alerts are provided for both physician referral and emergency conditions. Practice Pearls are featured throughout the chapters to demonstrate the material's applicability to practice. Blank pages at the end of each chapter allow readers to make their own notes in the text. Signs and symptoms, diagnostic methods, drug therapies, and treatment options are described for common diseases. Reorganized content reflects a head-to-toe approach to the body systems for easy reference. Content is divided into two units: History and Physical Examination and Common Conditions with all special populations chapters located at the beginning of the book. Material has been added on syncope, chronic pelvic pain, and vulvar disease. A comparison table of Hormone Replacement Therapy (HRT) lists the available brands/doses. Expanded coverage is provided for emphysema, anemia, hyperlipidemia, migraines, diabetes, breast conditions, HRT and bleeding, menopause, osteoporosis, pain management, and diagnostic criteria for chronic fatigue syndrome. National guidelines are referenced where appropriate, e.g. pneumonia, asthma, STDs, and lipids. New thumb tabs in the design allow users to access content more easily. Updated herbal therapy information is provided. Appendices include new and updated information on Body Mass Index, food sources, peak expiratory flow rates, peak flow monitoring, diabetic foot care, allergen control measures, HSV/HPV symptomatic relief measures, oral contraceptives, pain management guidelines, herbal therapy information, and suggested hospital admission orders. A new appendix includes timely information on biological disease agents. Now includes ICD-9 codes New insert features 32 color photos of dermatologic conditions for easy identification.
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 540
Book Description
This portable reference provides thorough and detailed assessment information for all common primary care conditions, including signs and symptoms, diagnostic methods, drug therapies, and treatment. Written by expert nurse practitioners, it features complete, practical, up-to-date information on diagnosing and treating primary care disorders in the family practice setting. Separate sections are devoted to specific populations such as pediatric, adult, and geriatric patients. This reference is well known for its concise guidelines, comparative charts, and tables that list the symptoms, physical assessment findings, and possible diagnoses in a quick-reference format. Numerous tables, outlines, and comparative charts are included for easy reference. Alerts are provided for both physician referral and emergency conditions. Practice Pearls are featured throughout the chapters to demonstrate the material's applicability to practice. Blank pages at the end of each chapter allow readers to make their own notes in the text. Signs and symptoms, diagnostic methods, drug therapies, and treatment options are described for common diseases. Reorganized content reflects a head-to-toe approach to the body systems for easy reference. Content is divided into two units: History and Physical Examination and Common Conditions with all special populations chapters located at the beginning of the book. Material has been added on syncope, chronic pelvic pain, and vulvar disease. A comparison table of Hormone Replacement Therapy (HRT) lists the available brands/doses. Expanded coverage is provided for emphysema, anemia, hyperlipidemia, migraines, diabetes, breast conditions, HRT and bleeding, menopause, osteoporosis, pain management, and diagnostic criteria for chronic fatigue syndrome. National guidelines are referenced where appropriate, e.g. pneumonia, asthma, STDs, and lipids. New thumb tabs in the design allow users to access content more easily. Updated herbal therapy information is provided. Appendices include new and updated information on Body Mass Index, food sources, peak expiratory flow rates, peak flow monitoring, diabetic foot care, allergen control measures, HSV/HPV symptomatic relief measures, oral contraceptives, pain management guidelines, herbal therapy information, and suggested hospital admission orders. A new appendix includes timely information on biological disease agents. Now includes ICD-9 codes New insert features 32 color photos of dermatologic conditions for easy identification.
Acute Care Nurse Practitioner Certification Study Question Book
Author: Sally K. Miller
Publisher: Jones & Bartlett Learning
ISBN: 0763775347
Category : Medical
Languages : en
Pages : 140
Book Description
Review Guides/Certification Prep/Pocket Guides
Publisher: Jones & Bartlett Learning
ISBN: 0763775347
Category : Medical
Languages : en
Pages : 140
Book Description
Review Guides/Certification Prep/Pocket Guides
ACUTE & CRITICAL CARE NURSE PRACTITIONER: CASES IN DIAGNOSTIC REASONING
Author: Suzanne M. Burns
Publisher: McGraw Hill Professional
ISBN: 007184953X
Category : Medical
Languages : en
Pages : 840
Book Description
The ultimate, case-based guide for learning and teaching the art of diagnostic reasoning for acute and critical care nurse practitioners Written by experienced nurse practitioners working in acute and critical care settings,and endorsed by the American Association of Critical-Care Nurses (AACN), Acute & Critical Care Nurse Practitioner:Cases in Diagnostic Reasoning presents a wide range of acute and critical care patient cases focusing on diagnosis and management. This authoritative book is designed to help nurse practitioners and students learn how to proceed from a broad differential diagnosis to a specific management plan through expert analysis of patient data. While reconstructing the course of real-life clinical cases, the authors “think out loud” and reveal how they identify pertinent positives and significant negatives to support or refute items on their differential diagnoses list, and further incorporate laboratory and diagnostic testing results to establish a medical diagnosis. Each case includes a description of the management for the identified diagnosis. INCLUDES: · 71 cases based on real-life clinical scenarios · Analysis questions and case discussions to enable learners to actively participate ininductive and deductive reasoning · Cases that can be used to support course work, certification review, and job training The first of its kind, Acute & Critical Care Nurse Practitioner: Cases in Diagnostic Reasoning is an essential learning and teaching resource for students, clinicians, and clinical faculty to master the art of diagnostic reasoning.
Publisher: McGraw Hill Professional
ISBN: 007184953X
Category : Medical
Languages : en
Pages : 840
Book Description
The ultimate, case-based guide for learning and teaching the art of diagnostic reasoning for acute and critical care nurse practitioners Written by experienced nurse practitioners working in acute and critical care settings,and endorsed by the American Association of Critical-Care Nurses (AACN), Acute & Critical Care Nurse Practitioner:Cases in Diagnostic Reasoning presents a wide range of acute and critical care patient cases focusing on diagnosis and management. This authoritative book is designed to help nurse practitioners and students learn how to proceed from a broad differential diagnosis to a specific management plan through expert analysis of patient data. While reconstructing the course of real-life clinical cases, the authors “think out loud” and reveal how they identify pertinent positives and significant negatives to support or refute items on their differential diagnoses list, and further incorporate laboratory and diagnostic testing results to establish a medical diagnosis. Each case includes a description of the management for the identified diagnosis. INCLUDES: · 71 cases based on real-life clinical scenarios · Analysis questions and case discussions to enable learners to actively participate ininductive and deductive reasoning · Cases that can be used to support course work, certification review, and job training The first of its kind, Acute & Critical Care Nurse Practitioner: Cases in Diagnostic Reasoning is an essential learning and teaching resource for students, clinicians, and clinical faculty to master the art of diagnostic reasoning.
Advanced Practice Nursing of Adults in Acute Care
Author: Janet G Foster
Publisher: F.A. Davis
ISBN: 080363787X
Category : Medical
Languages : en
Pages : 789
Book Description
Written by a Clinical Nurse Specialist for Clinical Nurse Specialists, this text explores the expanding roles and responsibilities of the CNS—from core competencies and theoretical foundations for practice to caring for the hospitalized adult to shaping the healthcare system through the CNS’s spheres of influence.
Publisher: F.A. Davis
ISBN: 080363787X
Category : Medical
Languages : en
Pages : 789
Book Description
Written by a Clinical Nurse Specialist for Clinical Nurse Specialists, this text explores the expanding roles and responsibilities of the CNS—from core competencies and theoretical foundations for practice to caring for the hospitalized adult to shaping the healthcare system through the CNS’s spheres of influence.