Lewis: Medical-Surgical Nursing, 7th Edition: Comprehensive Glossary

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Lewis: Medical-Surgical Nursing, 7th Edition

Comprehensive Glossary
Term Definition Chapter
abortion the loss or termination of a pregnancy before the fetus has 54
developed to a state of viability; may be spontaneous or
induced.
absence (petit mal) seizure seizure characterized by a brief staring spell and a very brief 59
loss of consciousness that usually occurs only in children and
rarely continues beyond adolescence.
absolute hypovolemia a loss of intravascular fluid volume resulting from fluid loss 67
from the body through hemorrhage, gastrointestinal (GI) loss
(e.g., vomiting, diarrhea), fistula drainage, diabetes insipidus,
or diuresis.
absorption the passage of substances across and into tissues, such as 39
the passage of digested food molecules into internal cells or
the passage of liquids into kidney tubules.
absorption atelectasis alveolar collapse that occurs when high concentrations of 29
oxygen are given and oxygen replaces nitrogen in the alveoli;
if airway obstruction occurs, the oxygen is absorbed into the
bloodstream and the alveoli collapse.
acculturation the process of adopting the cultural traits or social patterns of 3
a different population group.
achalasia a condition of the esophagus characterized by spasm of the 42
lower esophageal (cardiac) sphincter and absence of
peristalsis of the lower two thirds of the esophagus.
acidosis process that adds acid or eliminates base from body fluids. 17
acoustic neuroma a benign tumor that occurs where the acoustic nerve (CN VIII) 22
enters the internal auditory canal or the temporal bone from
the brain.
acquired immunodeficiency end stage of chronic HIV infection; a syndrome involving a 15
syndrome (AIDS) defect in cell-mediated immunity that has a long incubation
period and is manifested by various opportunistic infections
and cancers.
acromegaly a condition caused by excessive secretion of growth hormone 50
characterized by an overgrowth of the bones and soft tissues.
actinic keratosis a slowly developing, localized thickening and scaling of the 24
outer layers of the skin consisting of hyperkeratotic papules
and plaques as a result of chronic, prolonged exposure to the
sun, also known as solar keratosis.
action potential an electrical impulse that is created by a change in polarity of 32
cells that results in muscle cell contraction or other activity.
active transport process in which molecules move across a membrane against 17
a concentration gradient.
acupressure therapeutic technique of applying digital pressure in a 8
specified way on designated points on the body to relieve
pain, produce analgesia, or regulate a body function.
acupuncture therapeutic technique involving the insertion of fine needles in 8
the path of qi flow underneath the skin surface to achieve pain
relief and improvement in body function.
acute arterial ischemia a sudden interruption in the arterial blood supply to tissue, an 38
organ, or an extremity that if left untreated can result in tissue
death.
acute bronchitis an inflammation of the lower respiratory tract that is usually 28
due to infection.
acute coronary syndrome condition that develops when the oxygen supply is prolonged 34
and not immediately reversible; encompasses the spectrum of
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unstable angina, non–ST-segment-elevation myocardial

infarction (NSTEMI), and ST-segment-elevation myocardial
infarction (STEMI).
acute HIV infections initial stage of HIV infection; occurs 1 to 3 weeks after infection 15
and is typically manifested by a flulike syndrome of fever,
swollen lymph glands, sore throat, headache, malaise,
nausea, muscle and joint pain, diarrhea, and/or a diffuse rash.
acute pancreatitis an acute inflammatory process of the pancreas caused by 44
autodigestion and marked by symptoms of acute abdomen
and escape of pancreatic enzymes into the pancreatic tissues.
acute renal failure clinical syndrome characterized by a rapid decline in renal 47
function with progressive azotemia and increasing levels of
serum creatinine.
acute respiratory distress a sudden and progressive form of acute respiratory failure in 68
syndrome (ARDS) which the alveolar-capillary membrane becomes damaged
and more permeable to intravascular fluid.
acute rheumatic fever an inflammatory disease of the heart associated with a 37
pharyngitis or upper respiratory infection caused by group A β-
hemolytic streptococci.
acute tubular necrosis a type of intrarenal acute renal failure affecting the renal 47
(ATN) tubules caused by renal ischemia and nephrotoxic injury.
addiction compulsive, uncontrollable dependence on a substance, habit, 12
or practice to such a degree that cessation causes severe
emotional, mental, or physiologic reactions.
addictive behaviors behaviors associated with maintaining an addiction. 12
adhesion a band of scar tissue between or around organs. 13
advance care planning measures taken to anticipate challenges that the patient and 11
family will face because of illness, medical treatment, and
other concerns.
advance directive written statements of a person's wishes if he or she is unable 11
to communicate these wishes.
advanced practice nurse nurse with a master's degree in nursing, advanced education 1
in pharmacology and physical assessment, and expertise in a
specialized area of practice; includes clinical nurse specialist,
nurse practitioner, nurse midwife, and nurse anesthetist.
adventitious sounds extra breath sounds that are not normally heard, such as 26
crackles, rhonchi, wheezes, and pleural friction rubs.
afterload the peripheral resistance against which the left ventricle must 32
pump.
ageism an attitude that discriminates, separates, stigmatizes, or 6
otherwise puts older adults at a disadvantage on the basis of
chronologic age.
age-related macular a progressive deterioration of the maculae of the retina; 22
degeneration divided into two forms: dry and wet.
airway obstruction a condition where the base of the tongue falls backward 20
against the soft palate and occludes the pharynx; most
pronounced in the supine position and in the patient who is
extremely sleepy after surgery.
aldosterone a potent mineralocorticoid secreted by the adrenal cortex that 48
maintains extracellular fluid volume.
alkalosis process that adds base or eliminates acid from body fluids. 17
allergic rhinitis the reaction of the nasal mucosa to a specific allergen. 27
alopecia partial or complete lack of hair resulting from normal aging, 23
endocrine disorder, drug reaction, anticancer medication, or
skin disease.
alveolar hypoventilation a generalized decrease in ventilation that results in an 68

increase in the PaCO2 and a consequent decrease in PaO2.
Alzheimer's disease (AD) a chronic, progressive, degenerative disease of the brain. 60
amblyopia reduced vision in an eye that is not corrected by refraction and 22
does not have an obvious pathologic or structural cause.
ambulatory care health services provided on an outpatient basis to those who 7
visit a hospital or other health care facility and depart after
treatment on the same day.
ambulatory surgery same-day or outpatient surgery. 7, 18
amenorrhea absence of menstruation. 51
amyotrophic lateral a rare progressive neurologic disorder characterized by loss of 59
sclerosis (ALS) motor neurons and by weakness and atrophy of the muscles
of the hands, forearms, and legs, spreading to involve most of
the body and face.
analgesic ceiling a dose wherein no additional analgesia is produced regardless 10
of further dose increases.
anaphylactic shock an acute and life-threatening hypersensitivity (allergic) reaction 67
to a sensitizing substance, such as a drug, chemical, vaccine,
food, or insect venom.
andropause a decline in androgen secretion that occurs in most males 55
because of aging.
anemia a manifestation of a pathologic process characterized by a 31
reduction below normal in the number of erythrocytes, quantity
of hemoglobin, and/or the volume of packed red cells
(hematocrit) in the blood.
anergy immunodeficient condition characterized by lack of or 14
diminished reaction to an antigen or group of antigens.
anesthesia care provider one who administers anesthesia. 19
(ACP)
anesthesiology branch of medicine that is concerned with the relief of pain and 19
with the administration of medication to relax muscles and
obliterate consciousness during surgery.
aneurysm congenital or acquired weakness of the arterial wall resulting 38
in dilation and ballooning of the vessel.
angina chest pain that is the clinical manifestation of reversible 34
myocardial ischemia.
angiopathy blood vessel disease. 49
anions negatively charged ions. 17
ankylosing spondylitis a chronic inflammatory disease that primarily affects the axial 65
skeleton, including the sacroiliac joints, intervertebral disk
spaces, and costovertebral articulations.
ankylosis stiffness or fixation of a joint usually resulting from destruction 62
of articular cartilage and subchondral bone.
anorexia nervosa a disorder characterized by a prolonged refusal to eat, 40
resulting in emaciation, amenorrhea, emotional disturbance
concerning body image, and fear of becoming obese.
anterior cord syndrome damage to the anterior spinal artery usually resulting from 61
injury causing acute compression of the anterior portion of the
spinal cord; manifestations include motor paralysis and loss of
pain and temperature sensation below the level of injury.
antidiuretic hormone a hormone released from the posterior pituitary gland that 48
regulates fluid volume by stimulating reabsorption of water in
the renal tubules.
antigen a substance, usually a protein, that the body recognizes as 14
foreign and that can evoke an immune response.
α-antitrypsin a serum protein produced by the liver normally found in the 29

lungs that inhibits proteolytic enzymes of white cells from
lysing lung tissue; genetic deficiency of this protein can cause
emphysema.
aortic dissection the result of a tear in the intimal (innermost) lining of the 38
arterial wall that allows blood to enter between the intima and
media, thus creating a false lumen.
aortic stenosis a narrowing or stricture of the aortic valve resulting in 37
obstruction of the flow from the left ventricle to the aorta during
systole.
aortic valve regurgitation regurgitation that may be the result of primary disease of the 37
aortic valve leaflets, the aortic root, or both.
aphakia a condition in which the crystalline lens of the eye is absent, 22
usually because it has been surgically removed, as in the
treatment of cataracts.
aphasia an abnormal neurologic condition in which language function 58
is disordered or absent because of an injury to certain areas of
the cerebral cortex.
aplastic anemia a disease with a deficiency of all of the formed elements of 31
blood (specifically red blood cells, white blood cells, and
platelets), representing a failure of the cell-generating capacity
of bone marrow.
apnea an absence of spontaneous respirations. 27
apocrine sweat glands sweat glands that secrete a milky substance that becomes 23
odoriferous when altered by skin surface bacteria.
appendicitis an inflammation of the appendix that if undiagnosed, leads 43
rapidly to perforation and peritonitis.
aqueous humor a clear watery fluid that fills the anterior and posterior 21
chambers of the anterior cavity of the eye.
arterial blood pressure a measure of the pressure exerted by blood against the walls 32
of the arterial system, which depends on the heart's pumping
pressure, the resistance of the arterial walls, elasticity of
vessels, the blood volume, and its viscosity.
arthritis inflammation of a joint; most prevalent types are osteoarthritis, 65
rheumatoid arthritis, and gout.
arthrocentesis incision or puncture of joint capsule to obtain samples of 62
synovial fluid from within joint cavity or to remove excess fluid;
used for diagnostic purposes, to instill medications, and to
remove fluid from the joints to relieve pain.
arthrodesis the surgical fusion of a joint. 63
arthroplasty surgical reconstruction or replacement of a joint. 63
arthroscopy insertion of an arthroscope into a joint for visualization or 62
surgery.
Aschoff bodies tiny rounded or spindle-shaped nodules formed by a reaction 37
to myocardial inflammation with accompanying swelling and
fragmentation of collagen fibers.
ascites an abnormal intraperitoneal accumulation of a fluid containing 44
large amounts of protein and electrolytes as a result of portal
hypertension.
assessment collecting subjective and objective information about a patient; 1
forms the base for the plan of care.
assimilation the process in which a person or a group of people of a 3
different ethnic background becomes absorbed into a new
culture.
assist-control mechanical the ventilator delivery of a preset tidal volume at a preset 66

ventilation frequency; when the patient initiates a spontaneous breath, a
full tidal volume is delivered.
asterixis flapping tremor (liver flap) commonly affecting the arms and 44
hands that is a manifestation of hepatic encephalopathy.
asthma a chronic inflammatory lung disease that results in airflow 29
obstruction; characterized by recurring episodes of
paroxysmal dyspnea, wheezing on expiration and/or
inspiration caused by constriction of the bronchi, coughing,
and viscous mucoid bronchial secretions.
astigmatism an unevenness in the corneal or lenticular curvature, causing 21
horizontal and vertical rays to be focused at two different
points on the retina, which results in visual distortion.
asystole represents the total absence of ventricular electrical activity. 36
atelectasis an abnormal condition characterized by the collapse of alveoli, 20
preventing the respiratory exchange of carbon dioxide and
oxygen in a part of the lungs.
atherosclerosis formation of focal deposits of cholesterol and lipids known as 34
atheromas or plaque, primarily within the intimal wall of
arteries, that obstruct circulation.
atrial fibrillation a cardiac dysrhythmia characterized by a total disorganization 36
of atrial electrical activity without effective atrial contraction.
atrial flutter an atrial tachydysrhythmia identified by recurring, regular, 36
sawtooth-shaped flutter waves.
atrophy wasting of muscle, characterized by decreased circumference 62
and flabby appearance leading to decreased function and
tone.
atypical absence seizures a type of seizure characterized by a staring spell accompanied 59
by other signs and symptoms, including brief warnings,
peculiar behavior during the seizure, or confusion afterwards.
aura a sensation of light or warmth or other perception that may be 59
a warning of an attack of a migraine or an epileptic seizure.
auscultation the act of listening for sounds within the body to evaluate the 4
condition of the heart, blood vessels, lungs, pleura, intestines,
or other organs. Auscultation may be performed directly with
the unaided ear, but most commonly a stethoscope is used to
determine the frequency, intensity, duration, and quality of the
sounds.
autoimmunity an inappropriate immune reaction to self-proteins; the immune 14
system no longer differentiates self from nonself with respect
to these substances.
automated peritoneal dialysis machine that controls the fill, dwell, and drain phases, 47
dialysis (APD) and cycles four to eight exchanges per night with 1 to 2 hours
per exchange.
automatic external defibrillator that has rhythm detection capability and the ability 36
defibrillator to advise the operator to deliver a shock using hands-free
defibrillator pads.
automaticity a property of specialized cells of the heart found in the 36
sinoatrial (SA) node, parts of the atria, the atrioventricular (AV)
node, and the His-Purkinje system, that are able to discharge
spontaneously.
autonomic dysreflexia a dysreflexia that is a result of impaired function of the 61
autonomic nervous system caused by simultaneous
sympathetic and parasympathetic activity; occurs in patients
with paraplegia and tetraplegia; characterized by symptoms of
hypertension, bradycardia, severe headaches, pallor below
and flushing above the cord lesions.
autonomic nervous system the nervous system, which is part of the peripheral nervous 56
system, that governs involuntary functions of cardiac muscle,
smooth muscle, and glands.
azotemia an accumulation of nitrogenous waste products, such as blood 47
urea nitrogen (BUN) and creatinine.
bacteria small unicellular organisms that are characterized by shape. 15
bariatric surgery a surgical procedure that is used to treat morbid obesity. 41
baroreceptor specialized nerve cell located in the carotid arteries and arch 33
of the aorta that responds to increased blood pressure by
sending inhibitory impulses to the sympathetic vasomotor
center, resulting in decreased heart rate, decreased force of
contraction, and peripheral vasodilation.
Barrett's esophagus a precancerous esophageal disorder characterized by 42
metaplastic cell changes.
basal cell carcinoma a malignant epithelial cell tumor arising from epidermal basal 24
cells that begins as a papule and enlarges peripherally,
developing a central crater that erodes, crusts, and bleeds.
Bell's palsy a disorder characterized by a disruption of the motor branches 61
of the facial nerve (CN VII) on one side of the face in the
absence of any other disease, such as a stroke.
benign neoplasm a localized tumor that has a fibrous capsule, limited potential 16
for growth, a regular shape, and cells that are well
differentiated; does not invade surrounding tissue or
metastasize to distant sites.
benign prostatic hyperplasia a nonmalignant, noninflammatory enlargement of the prostate 55
(BPH) gland caused by an increase in the number of epithelial cells
and stromal tissue.
bereavement an individual's response to the loss of a significant person. 11
bilirubin the orange-yellow pigment of bile, formed principally by the 39
breakdown of hemoglobin in red blood cells after termination
of their normal life span.
biologic therapy treatment using biologic agents such as interferons, 16
interleukins, monoclonal antibodies, and growth factors to
modify the relationship between the host and the tumor by
altering the biologic response of the host to the tumor cells.
bioterrorism the dispensing of disease pathogens as an overt act to panic, 69
kill, and terrorize a population.
blepharitis a chronic inflammatory condition of the lash follicles and 22
meibomian glands of the eyelids, characterized by swelling,
redness, and crusts of dried mucus on the lids.
blood pressure the pressure exerted by the circulating volume of blood on the 33
walls of the arteries and veins and on the chambers of the
heart that must be adequate to maintain tissue perfusion
during activity and rest.
blood-brain barrier an anatomic-physiologic barrier between blood capillaries and 56
brain tissue.
body mass index (BMI) a clinical index of obesity or altered body fat distribution using 40
weight/height ratios.
bone marrow the blood-forming tissue that fills the central core of bones. 30
bone marrow transplant the transplantation of bone marrow from healthy donors to 16
stimulate production of normal blood cells; provides for the
safe use of very high doses of chemotherapy or radiation
therapy to patients whose tumors have developed resistance
or failed to respond to standard doses of chemotherapy and
radiation.
borborygmi audible abdominal sounds produced by hyperactive intestinal 39
peristalsis.
botulism a serious food poisoning caused by GI absorption of the 61

neurotoxin produced by Clostridium botulinum that results in
disturbed muscle innervation.
brachytherapy radiation delivery system that means "closed" treatment and 16
consists of the implantation or insertion of radioactive
materials directly into the tumor or in close proximity to the
tumor.
brain abscess an accumulation of pus within the brain tissue that can result 57
from a local or a systemic infection from another source, such
as the skull, sinuses, or other structures in the head.
brain attack term used to describe a stroke; communicates the urgency of 58
recognizing the clinical manifestations of a stroke and treating
a medical emergency.
brain death an irreversible form of unconsciousness characterized by a 11
complete loss of brain function while the heart continues to
beat.
brain reward system an area in the mesolimbic system of the brain that creates a 12
sensation of pleasure for certain behaviors necessary for
survival, such as eating and sexual behavior.
breakthrough pain transient moderate to severe pain that occurs above the pain 10
treated by current analgesic treatment protocol.
bronchospasm narrowing and obstruction of the lumen of the bronchi caused 20
by spasm of the peribronchial smooth muscle; may occur
postoperatively as a result of endotracheal intubation or in
patients with chronic bronchitis and asthma.
Brown-Séquard syndrome damage to one half of the spinal cord characterized by spastic 61
paralysis on the body's injured side, loss of postural sense
(proprioception), and loss of the senses of pain and heat on
the other side of the body.
buffer a substance that acts chemically to change strong acids into 17
weaker acids or to bind acids to neutralize their effect.
bulimia nervosa an eating disorder characterized by frequent binge eating and 40
self-induced vomiting associated with loss of control over
eating and a persistent concern with body image.
burn an injury to the tissues of the body caused by heat, chemicals, 25
electrical current, or radiation.
bursitis inflammation of the bursa. 63
calcitonin a hormone produced by the thyroid gland in response to high 48
circulating calcium levels; acts to reduce the blood level of
calcium and to inhibit bone resorption.
calculus an abnormal stone formed in body tissues by an accumulation 46
of mineral salts.
cancer a group of more than 200 diseases characterized by 16
uncontrolled and unregulated growth of cells.
carcinogens agents capable of producing cellular alterations leading to the 16
development or increasing the incidence of neoplastic growth.
carcinoma in situ a lesion with all the histologic features of cancer except 16
invasion.
carcinomas malignant tumors that originate from embryonal ectoderm 16
(skin and glands) and endoderm (mucous membrane linings of
the respiratory tract, GI tract, and genitourinary tract).
cardiac index a measure of the cardiac output of a patient per square meter 32
of body surface area; its normal range in a healthy adult is 2.8
to 4.2 L/min/m2.
cardiac output (CO) the amount of blood pumped by each ventricle in 1 minute; 32
calculated as the stroke volume multiplied by the heart rate for
1 minute; a normal, resting adult has a cardiac output of 4 to 8

L per minute.
cardiac pacemaker an electronic device used to increase the heart rate in severe 36
bradycardia by electrically stimulating the heart muscle; may
be temporary or permanent, emit the stimulus at a constant or
fixed rate, or fire on demand, when the heart does not contract
at a minimum rate.
cardiac reserve the ability to respond to demands (exercise, stress, 32
hypovolemia) by altering cardiac output threefold or fourfold.
cardiac tamponade compression of the heart produced by fluid accumulation in 37
the pericardial sac.
cardiac transplantation a heart transplant; usually treatment of choice for patients with 35
end-stage heart disease who are unlikely to survive the next 6
to 12 months.
cardiogenic shock shock occurring when either systolic or diastolic dysfunction of 67
the myocardium results in compromised cardiac output
associated with acute myocardial infarction and heart failure.
cardiomyopathy a group of diseases that directly affect the structural or 37
functional ability of the myocardium.
carpal tunnel syndrome a condition caused by compression of the median nerve 63
beneath the transverse carpal ligament within the narrow
confines of the carpal tunnel located in the wrist.
case management a client-centered, goal-oriented process of assessing the need 7
of an individual for particular services and obtaining those
services in a cost-effective manner.
cataract an abnormal progressive condition of the lens of the eye, 22
characterized by an opacity within the lens.
catecholamines sympathomimetic compounds composed of a catechol 48
molecule and an amine from the amino acid tyrosine; include
epinephrine, norepinephrine, and dopamine.
cations positively charged ions. 17
celiac disease an inborn error of metabolism characterized by the inability to 43
hydrolyze peptides contained in gluten.
cell-mediated immunity immunity that is initiated through specific antigen recognition 14
by T lymphocytes, macrophages, and natural killer cells.
central cord syndrome damage to the central spinal cord characterized by 61
microscopic hemorrhage, edema of the central spinal cord,
and compression on anterior horn cells.
central nervous system the spinal cord and brain. 56
central parenteral nutrition delivery of a nutritionally adequate hypertonic solution 40
consisting of glucose, crystalline amino acids, fat emulsion,
minerals, and vitamins using a central venous route.
centrilobular emphysema type of emphysema often associated with chronic bronchitis in 29
which respiratory bronchioles enlarge, the walls are destroyed,
and the bronchioles become confluent; characterized by
enlargement of air spaces in the proximal part of the acinus,
primarily at the level of the respiratory bronchioles.
cerebral edema increased accumulation of fluid in the extravascular spaces of 57
brain tissue that can lead to increased intracranial pressure.
cerebrospinal fluid fluid that circulates within the subarachnoid space that 56
surrounds the brain, brainstem, and spinal cord that provides
cushioning for the brain and spinal cord; allows fluid shifts
from the cranial cavity to the spinal cavity and carries
nutrients.
chalazion a small, localized swelling of the eyelid resulting from 22
obstruction and retained secretions of the meibomian glands;
a nonmalignant condition that often requires surgery for

correction.
chancres painless indurated lesions found on the penis, vulva, lips, 53
mouth, vagina, and rectum characteristic of syphilis; heal
without treatment and leave no scars.
cheilosis a disorder of the lips and mouth characterized by bilateral 39
scales and fissures, resulting from a deficiency of riboflavin in
the diet.
chemical burns tissue injury and destruction from necrotizing substances. 25
chemoreceptor a sensory nerve cell that responds to a change in the chemical 26
composition (PaCO2 and pH) of the fluid around it.
chemotherapy the treatment of disease with chemical agents. 16
chest percussion rhythmic percussion of a patient's chest with cupped hands to 29
loosen retained respiratory secretions.
chest physiotherapy a series of maneuvers including percussion, vibration, and 29
postural drainage designed to promote clearance of excessive
respiratory secretions.
Cheyne-Stokes respiration an abnormal pattern of breathing characterized by alternating 11
periods of apnea and deep, rapid breathing.
chlamydial infections superficial mucosal infections caused by Chlamydia; C. 53
trachomatis is one of the most common sexually transmitted
organisms.
cholecystitis inflammation of the gallbladder. 44
cholelithiasis stones in the gallbladder. 44
cholesteatoma a cystic mass composed of epithelial cells and cholesterol that 22
is found in the middle ear and occurs as a congenital defect or
as a serious complication of chronic otitis media.
chronic bronchitis obstructive pulmonary disease characterized by excessive 29
production of mucus and chronic inflammatory changes in the
bronchi, resulting in a cough with expectoration for at least 3
months of the year for more than 2 consecutive years.
chronic constrictive inflammation of the pericardial sac that is characterized by 37
pericarditis fibrin deposition and thickening of the pericardium.
chronic fatigue syndrome a disorder characterized by debilitating fatigue and a variety of 65
associated complaints.
chronic kidney disease the presence of kidney damage for at least 3 months with 47
functional or structural abnormalities, with or without
decreased glomerular filtration rate; can also be a glomerular
filtration rate of < 60 ml/min/1.732m2for more than 3 months,
with or without damage to the kidney.
chronic obstructive progressive destruction of the pancreas with fibrotic 44
pulmonary disease (COPD) replacement of pancreatic tissue.
chronic pancreatitis pulmonary disease state characterized by the presence of 29
airflow obstruction caused by chronic bronchitis or
emphysema; clinical use of the term indicates the presence of
chronic bronchitis and/or emphysema; includes asthma,
chronic bronchiectasis, chronic bronchitis, and emphysema.
chronic stable angina chest pain that occurs intermittently over a long period with the 34
same pattern of onset, duration, and intensity of symptoms.
chronic venous insufficiency a condition in which the valves in the veins are damaged, 38
which results in retrograde venous blood flow, pooling of blood
in the legs, and swelling.
chylothorax a condition marked by lymphatic fluid in the pleural space 28
caused by a leak in the thoracic duct.
circulatory assist device mechanical devices (intraaortic balloon pump and left 66
ventricular assist device) used to decrease cardiac work and
Evolve: Lewis: Medical-Surgical Nursing, 7th Edition - Comprehensive Glossary & Fl... Page 10 of 49
improve organ perfusion in patients with heart failure when

conventional drug therapy is no longer adequate.
cirrhosis chronic progressive disease of the liver characterized by 44
extensive degeneration and destruction of the liver
parenchymal cells.
clinical (critical) pathway a description of practices that directs the entire health care 1
team in the daily care goals for select health care problems;
may include a nursing care plan, interventions specific for
each day of hospitalization, and a documentation tool.
clinical manifestations objective and subjective data obtained from a patient that are 4
commonly associated with a clinical problem.
clitoris erectile tissue of the female reproductive system that becomes 51
engorged during sexual excitation.
cluster headache repeated headaches that can occur for weeks to months at a 59
time, followed by periods of remission; characterized by
attacks of intense unilateral pain that occurs most often over
the eye and forehead.
collaborative problems potential or actual complications of disease or treatment that 1
nurses treat with other health care providers, most frequently
physicians.
collateral circulation development of arterial branching that occurs within the 34
coronary circulation when occlusion of the coronary arteries
occurs slowly over a long period.
coma profound state of unconsciousness. 57
community-acquired a lower respiratory tract infection of the lung parenchyma with 28
pneumonia onset in the community or during the first 2 days of
hospitalization.
community-based nursing illness-oriented care of individuals and families throughout the 7
life span to help individuals and families manage acute or
chronic health conditions in community and home settings.
community-oriented public health nursing that focuses on the health care of the 7
population-focused nursing community and community health nursing that has as its
primary focus the health care of individuals, families, and
groups in a community.
compartment syndrome a condition in which elevated intracompartmental pressure 63
within a confined myofascial compartment compromises the
neurovascular function of tissues within that space.
complementary and a broad domain of healing resources that encompasses all 8
alternative therapies health systems, modalities, and practices and their
accompanying theories and beliefs, other than those intrinsic
to the politically dominant health system of a particular society
or culture in a given historical period.
complete heart block third-degree atrioventricular heart block in which no impulses 36
from the atria are conducted to the ventricles.
compliance a measure of the ease of expansion of the lungs and thorax. 26
computerized the use of computers to document patient care. 1
documentation
concept map method of recording a nursing care plan using a visual 1
diagram of the patient's problems and interventions.
concussion a sudden transient mechanical head injury, such as a blow or 57
explosion, with disruption of neural activity and a change in the
level of consciousness.
conjunctiva the mucous membrane lining the inner surfaces of the eyelids 21
and anterior part of the sclera.
conjunctivitis an infection or inflammation of the conjunctiva, caused by 22
bacterial or viral infection, allergy, or environmental factors.
conscious sedation a minimally depressed level of consciousness with 19

maintenance of the patient's protective airway reflexes.
continuous ambulatory dialysis carried out manually by exchanging 1.5 to 3 L of 47
peritoneal dialysis (CAPD) peritoneal dialysate usually four times daily with dwell times of
4 to 10 hours; an indwelling catheter permits fluid to drain into
and out of the peritoneal cavity by gravity.
continuous bladder closed irrigation system using a three-way urinary catheter to 55
irrigation remove clotted blood from the bladder following
prostatectomy.
continuous positive airway a ventilatory maneuver similar to positive end-expiratory 66
pressure (CPAP) pressure (PEEP), but in which positive pressure is delivered
continuously during spontaneous breathing, thus preventing
the patient's airway pressure from falling to zero.
continuous renal means by which solutes and fluids can be removed slowly and 47
replacement therapy continuously in the hemodynamically unstable patient; usually
(CRRT) used to treat acute renal failure.
contracture an abnormal, usually permanent condition of a joint, 62
characterized by flexion and fixation; may be caused by
atrophy and shortening of muscle fibers resulting from
immobilization or by loss of the normal elasticity of connective
tissues or the skin, such as from the formation of extensive
scar tissue over a joint.
contusion the bruising of the brain tissue within a focal area without 57
altering the integrity of the pia mater and arachnoid layers,
caused by a blow to the body and characterized by swelling,
discoloration, and pain.
coping constantly changing cognitive and behavioral efforts to 9
manage specific external or internal demands that are
appraised as taxing or exceeding the resources of the person.
cor pulmonale hypertrophy of the right side of the heart, with or without heart 29
failure, resulting from pulmonary hypertension.
coronary artery disease an abnormal condition that may affect the heart's arteries and 34
produce various pathologic effects, especially the reduced flow
of oxygen and nutrients to the myocardium; the most common
type is coronary atherosclerosis.
corticosteroid any one of the glucocorticoid, mineralocorticoid, or androgen 48
hormones secreted by the adrenal cortex that influence or
control key processes of the body.
cortisol the most abundant and potent glucocorticoid produced by the 48
adrenal gland.
costovertebral angle one of two angles that outline a space over the kidneys that is 45
formed by the rib cage and the vertebral column.
crackle short, low-pitched sounds consisting of discontinuous bubbling 26
caused by air passing through airway intermittently occluded
by mucus, unstable bronchial wall, or fold of mucosa; evident
on inspiration and, at times, expiration; similar sound to
blowing through a straw under water.
cranial nerves the 12 paired nerves composed of cell bodies with fibers that 56
exit from the cranial cavity.
craving subjective need for a substance, usually experienced after 12
decreased use or abstinence.
creatinine waste product produced by muscle breakdown commonly 45
found in blood, urine, and muscle tissue; measured in blood
and urine tests as an indicator of kidney function.
crepitation crackling sound or grating sensation as a result of friction 62
between bones.
CREST a variant of systemic sclerosis characterized by Calcinosis 65

(painful deposits of calcium in the skin), Raynaud's
phenomenon (abnormal blood flow in response to cold or
stress), Esophageal dysfunction (difficulty with swallowing
caused by internal scarring),Sclerodactyly (tightening of the
skin on the fingers and toes), and Telangiectasia (red spots on
the hands, forearms, palms, face, and lips).
cretinism hypothyroidism that develops in infancy. 50
Creutzfeldt-Jakob disease a rare and fatal encephalopathy thought to be caused by a 60
prion protein; human variant of mad cow disease.
critical limb ischemia a chronic condition characterized by ischemic rest pain, 38
arterial leg ulcers, and/or gangrene of the leg caused by
advanced peripheral arterial disease.
Crohn's disease a chronic inflammatory bowel disorder of unknown origin that 43
can affect any part of the GI tract from the mouth to the anus.
cross-tolerance a tolerance to other drugs that develops after exposure to a 12
different agent, such as between alcohol and barbiturates.
cryosurgery the use of subfreezing temperatures to perform surgery. 24
cue-induced craving craving that occurs in the presence of people, places, or things 12
that have been previously associated with drug taking.
cultural competence the complex integration of knowledge, attitudes, and skills that 3
enables the nurse to provide culturally appropriate health care.
cultural imposition the result when one's own cultural beliefs and practices are 3
imposed on another person or group of people.
culture a set of learned values, beliefs, customs, and behavior that is 3
shared by a group of interacting individuals.
culture-bound syndrome illnesses or afflictions that are recognized within a cultural 3
group.
cultured epithelial autograft skin grafts grown from biopsy specimens obtained from the 25
patient's own skin.
curettage scraping of material from the wall of a cavity or other surface 24
using an instrument with a circular cutting edge attached to a
handle, performed to remove tumors or other abnormal tissue
or to obtain tissue.
Cushing's syndrome a metabolic disorder resulting from the chronic and excessive 50
production of cortisol by the adrenal cortex or by the
administration of glucocorticoids in large doses for several
weeks or longer.
cystic fibrosis an autosomal recessive, multisystem disease characterized by 29
altered function of the exocrine glands involving primarily the
lungs, pancreas, and sweat glands.
cystitis an inflammatory condition of the urinary bladder, characterized 46
by pain, urgency and frequency of urination, and hematuria.
cystocele herniation or protrusion of the urinary bladder through the wall 54
of the vagina resulting from weakened connective tissue
support between the vagina and bladder.
cytokines soluble factors secreted by white blood cells and a variety of 14
other cells in the body that act as messengers among cells of
the immune, endocrine, and nervous systems.
database all the health information about a patient. 4
death the irreversible cessation of circulatory and respiratory function 11
or the irreversible cessation of all functions of the entire brain,
including the brainstem.
death rattle a sound produced by air moving through mucus that has 11
accumulated in the throat of a dying person who has lost the
cough reflex.
debridement removal of dirt, foreign objects, damaged tissue, and cellular 25

debris from a wound or a burn to prevent infection and
promote healing.
deep vein thrombosis a disorder involving a thrombus in a deep vein; most 38
commonly the iliac and femoral veins.
defecation signs and symptoms, or the clinical cues that, in a cluster, lead 1
to the nursing diagnosis.
defining characteristics the elimination of feces from the GI tract through the rectum; 39
involves a reflex action with voluntary and involuntary control.
degenerative disk disease progressive degeneration that is a normal process of aging; 64
results in the intervertebral disks losing their elasticity,
flexibility, and shock-absorbing capabilities.
deglutition swallowing. 39
dehiscence the separation and disruption of previously joined wound 13
edges, typically an abdominal incision.
delayed awakening longer than normal recovery from anesthesia that is usually 20
related to prolonged drug action.
delirium a state of temporary but acute mental confusion; common in 60
older adults who have a short-term illness such as lung or
heart disease, infections, poor nutrition, medication
interactions, and metabolic or hormone disorders.
dementia a syndrome caused by disease of the brain, usually of a 60
chronic or progressive nature, in which there are chronic
personality disintegration, confusion, memory impairment,and
deterioration of intellectual capacity and function; commonly
accompanied by deterioration in emotional control, social
behavior, and motivation.
dependence reliance on a substance that has reached the level that 12
absence of it will cause an impairment in function.
dermatome the area of skin innervated by the sensory fibers of a single 10
dorsal root of a spinal nerve.
dermatomyositis a disease of the connective tissues, characterized by pruritic 65
or eczematous inflammation of the skin and tenderness of the
muscles; muscle tissue is destroyed, and loss is often so
severe that the person may become unable to walk or perform
simple tasks.
dermis the layer of skin just below the epidermis, consisting of 23
papillary and reticular layers and containing blood and
lymphatic vessels, nerves and nerve endings, glands, and hair
follicles.
determinants of health factors that influence the health of individuals and groups. 2
detoxification process of removing the substance and its effects from the 12
individual's body.
deviated septum a deflection of the normally straight nasal septum. 27
diabetes insipidus a group of conditions associated with a deficiency of 50
production or secretion of antidiuretic hormone (ADH) or a
decreased renal response to ADH caused by injury of the
neurohypophyseal system.
diabetes mellitus a multisystem disease related to abnormal insulin production, 49
impaired insulin utilization, or both.
diabetic ketoacidosis (DKA) an acute metabolic complication of diabetes occurring when 49
fats are metabolized in the absence of insulin, resulting in
formation of acid by-products, such as ketones.
diabetic nephropathy a microvascular complication of diabetes mellitus associated 49
with damage to the small blood vessels that supply the
glomeruli of the kidney.
diabetic neuropathy nerve damage that occurs because of the metabolic 49

derangements associated with diabetes mellitus and
characterized by sensory and/or motor disturbances in the
peripheral nervous system.
diabetic retinopathy the process of microvascular damage to the retina in patients 49
with diabetes.
dialysis technique in which substances move from the blood through a 47
semipermeable membrane and into a dialysis solution; used to
correct fluid and electrolyte imbalances and to remove waste
products in renal failure.
diaphragmatic breathing breathing with the use of the diaphragm to achieve maximum 29
inhalation and slow respiratory rate.
diastole the period between contractions of the atria or the ventricles 32
during which blood enters the relaxed chambers from the
systematic circulation and the lungs.
diastolic blood pressure the residual pressure of the arterial system during ventricular 32
relaxation.
diastolic failure impaired ability of the ventricles to relax and fill during diastole. 35
diffuse axonal injury widespread axonal damage occurring after a mild, moderate, 57
or severe traumatic brain injury; the corpus callosum and the
brainstem are often affected.
diffusion the process in which particles in a fluid move from an area of 17
higher concentration to an area of lower concentration.
diffusion limitation process that occurs when gas exchange across the alveolar- 68
capillary membrane is compromised by a process that
thickens or destroys the membrane.
digestion the physical and chemical breakdown of food into absorbable 39
substances in the GI tract.
dilated cardiomyopathy cardiomyopathy characterized by a diffuse inflammation and 37
rapid degeneration of myocardial fibers that results in
ventricular dilation, impairment of systolic function, atrial
enlargement, and stasis of blood in the left ventricle.
dislocation a severe injury of the ligamentous structures that surround a 63
joint, resulting in the complete displacement or separation of
the articular surfaces of the joint.
disseminated intravascular a grave coagulopathy resulting from the overstimulation of 31
coagulation (DIC) clotting and anticlotting processes in response to disease or
injury, such as septicemia, acute hypotension, poisonous
snakebites, neoplasms, obstetric emergencies, severe trauma,
extensive surgery, and hemorrhage.
diverticulum a saccular dilation or outpouching of the mucosa through the 43
circular smooth muscle of the intestinal wall.
domestic violence a pattern of coercive behavior in a relationship that involves 69
fear, humiliation, intimidation, neglect, and/or intentional
physical, emotional, financial, or sexual injury.
dry powder inhaler dry powdered drug delivered by inhalation. 29
ductal ectasia a benign breast disease of perimenopausal and 52
postmenopausal women involving the ducts in the subareolar
area.
ductus deferens a major duct of the male reproductive system that carries 51
semen from the epididymis to the urethra; also known as the
vas deferens.
dysarthria a disturbance in the muscular control of speech, resulting from 58
interference in the control and execution over the muscles of
speech, usually caused by damage to a central or peripheral
motor nerve.
dysmenorrhea abdominal cramping pain or discomfort associated with 54

menstrual flow.
dyspareunia abnormal pain during sexual intercourse. 51
dysphagia difficulty swallowing, commonly associated with obstructive or 42
motor disorders of the esophagus.
dysphasia difficulty related to the comprehension or use of language. 58
dysplastic nevi nevi that are larger than usual (>5 mm across) with irregular 24
borders and various shades of color; also known as atypical
moles.
dyspnea shortness of breath; difficulty breathing that may be caused by 26
certain heart conditions, strenuous exercise, or anxiety.
dysrhythmias abnormal cardiac rhythms. 36
ecchymosis bruising. 30
eccrine sweat glands sweat glands that function to cool the body by evaporation. 23
ectopic pregnancy the implantation of the fertilized ovum anywhere outside the 54
uterine cavity.
ejection fraction percentage of end-diastolic blood volume that is ejected during 32
systole; provides information about the function of the left
ventricle during systole.
elastic recoil the tendency for the lungs to recoil or reduce in volume after 26
being stretched or expanded.
elder mistreatment acts of elder abuse or elder neglect that harm or threaten to 6
harm an older adult's health or welfare.
elective surgery surgery that is carefully planned and anticipated. 36
electrical burn a graphic tracing of the electrical impulses produced in the 18
heart.
electrocardiogram injury caused by intense heat generated from an electric 25
current resulting in coagulation necrosis.
electrolyte an element or compound that, when melted or dissolved in 17
water or another solvent, dissociates into ions and is able to
conduct an electric current.
embolic stroke a stroke that occurs when an embolus lodges in and occludes 58
a cerebral artery, resulting in infarction and edema of the area
supplied by the involved vessel.
emergence delirium (violent a neurologic alteration in recovery from anesthesia that can 20
emergence) include behaviors such as restlessness, agitation,
disorientation, thrashing, and shouting.
emergency any extraordinary event (e.g., multivictim train crash) that 69
threatens the life or welfare of a person or group of people,
requiring a rapid and skilled response, and that can be
managed by a community's existing resources.
emergency surgery a need for surgery that can arise with sudden and 18
unanticipated urgency.
emerging infection an infectious disease whose incidence has increased in the 15
past 20 years or threatens to increase in the immediate future.
emotion-focused coping a method of coping involving an individual's efforts to regulate 9
the emotional response to the problem.
empathy the ability to recognize and to some extent share the emotions 5
and states of mind of another and to understand the meaning
and significance of that person's behavior.
emphysema an abnormal condition of the pulmonary system, characterized 29
by overinflation and destructive changes in alveolar walls.
empyema an accumulation of purulent exudates in a body cavity, 28
especially the pleural space, as a result of bacterial infection,
such as pleurisy or tuberculosis.
encephalitis an acute inflammation of the brain usually caused by a virus. 57

end-of-life care care provided by caregivers who are knowledgeable about 11
personal issues and attitudes that affect the end-of-life
experience for patients and their family experiencing the
inevitability of death.
endometriosis the presence of normal endometrial tissue in sites outside the 54
endometrial cavity.
endoscopy the direct visualization of a body structure through a lighted 39
instrument (scope).
endotracheal intubation artificial airway created by inserting a tube into the trachea 66
through the mouth or nose past the larynx, bypassing upper
airway and laryngeal structures.
end-stage renal disease last stage of kidney disease occurring when the GFR is less 47
(ESRD) than 5% to 10% of normal or when creatinine clearances are
less than 15 ml/min.
enteral nutrition the administration of a nutritionally balanced liquefied food or 40
formula through a tube inserted into the stomach, duodenum,
or jejunum.
enucleation removal of the eye. 22
enzymatic debridement removal of damaged tissue and cellular debris from a wound 25
or burn using nonirritating, nontoxic agents that liquefy
necrotic tissue.
epidermis the avascular superficial layer of the skin, made up of an outer 23
dead cornified portion that serves as a protective barrier and a
deeper, living portion that folds into the dermis.
epididymis a comma-shaped structure located on the top and behind 51
each testis inside the scrotum where sperm are stored as they
mature until they are ejaculated or disintegrate.
epididymitis acute or chronic inflammation of the epididymis, usually 55
secondary to an infectious process (sexually or nonsexually
transmitted), trauma, or urinary reflux down the vas deferens.
epidural analgesia the infusion of pain-relieving medications through a catheter 20
placed into the epidural space surrounding the spinal cord.
epidural block injection of a local anesthetic into the epidural (extradural) 19
space by either a thoracic or lumbar approach.
epidural hematoma collection of blood between the dura and the inner surface of 57
the skull that may be of arterial or venous origin, caused by
damage to and leakage of blood from the middle meningeal
artery, producing compression of the dura matter and thus of
the brain.
epilepsy a condition in which a person has spontaneously recurring 59
seizures caused by a chronic underlying condition;
characterized by recurrent episodes of convulsive seizures,
sensory disturbances, abnormal behavior, and loss of
consciousness; an uncontrolled electrical discharge from the
nerve cells of the cerebral cortex is common to all types of
epilepsy.
epispadias an opening of the urethra on the dorsal surface of the penis. 55
epistaxis nosebleed. 27
equianalgesic dose a dose of one analgesic that is equivalent in pain-relieving 10
effects to another analgesic.
erectile dysfunction the inability to attain or maintain an erect penis that allows 55
satisfactory sexual performance.
erythrocyte red blood cell. 30
erythropoiesis process of red blood cell production. 30
escharotomy incisions into neurotic tissue from a severe burn performed 25

when eschar formation compromises circulation.
esophageal cancer a malignant neoplasm of the esophagus. 42
esophageal diverticulum saclike outpouching of one or more layers of the esophagus. 42
esophageal speech a method of swallowing air, trapping it in the esophagus, and 27
releasing it to create sound.
esophageal varices distended, tortuous, fragile veins at the lower end of the 44
esophagus that result from portal hypertension.
esophagitis inflammation of the mucosal lining of the esophagus, caused 42
by infection, irritation from a nasogastric tube, or, most
commonly, backflow of gastric juice from the stomach.
ethnicity groups whose members share a common social and cultural 3
heritage.
ethnocentrism a belief in the inherent superiority of an ethnicity or group to 3
which one belongs.
ethnogeriatrics a term used to describe the specialty area of providing 6
culturally competent care to ethnic elders.
evaluation the last phase of the nursing process in which the nurse 1
determines if identified outcomes have been met and the
overall accuracy of the assessment, diagnosis, and
implementation phases is evaluated.
evidence-based practice the use of evidence (results from research) to improve quality 1
and outcomes of health care.
evisceration the separation and disruption of previously joined wound 13
edges to the extent that an internal organ, typically intestinal
contents, protrudes through the wound.
excision and grafting the property of myocardial tissue that allows it to be 36
depolarized by a stimulus.
excitability protrusion of the eyeballs from the orbits caused by increased 50
fat deposits and fluid in the retroorbital tissues.
exophthalmos inflammation or infection of the epithelium of the auricle and 22
ear canal.
external otitis procedure during which eschar is removed down to the 25
subcutaneous tissue or fascia, depending on the degree of
injury; a graft is then placed on clean, viable tissue to achieve
good adherence.
facilitated diffusion the movement of molecules from an area of high concentration 17
to one of low concentration at an accelerated rate with the
assistance of a specific carrier molecule.
familial Alzheimer's disease Alzheimer's disease in which a clear pattern of inheritance 60
within a family is established.
fast tracking a system of routing patients through the postanesthesia care 20
unit (PACU) depending on the type of anesthesia and surgery
experienced and expected discharge from the unit.
fat embolism syndrome embolization of fat globules that occurs in a small percentage 63
of patients with fractures; occurs most frequently in fractures
of the femur, ribs, tibia, and pelvis.
fibrinolysis a continual process resulting in the dissolution of fibrin to 30
maintain blood in its fluid form.
fibroadenoma a small, painless, round, well-delineated, mobile benign breast 52
tumor commonly found in young women.
fibroblasts immature connective tissue cells that migrate into a healing 13
site and secrete collagen.
fibrocystic changes a benign condition of the breasts characterized by 52
development of excess fibrous tissue, hyperplasia of the
epithelial lining of the mammary ducts, proliferation of

mammary ducts, and cyst formation.
fibromyalgia syndrome a chronic disorder characterized by widespread, nonarticular 65
musculoskeletal pain and fatigue with multiple tender points.
flail chest instability of the chest wall resulting from multiple rib fractures. 28
fluid spacing the distribution of water in the body. 17
focused examination a detailed assessment of a particular body system of the 4
patient that is used to assess the progress of specific
problems identified during the screening physical examination.
folk healers traditional healers who use nonconventional methods of 3
medicine; typically share a native language and ancestry with
the patient.
fracture a disruption or break in the continuity of the structure of bone. 63
frail elderly an older person (usually > 85 years of age) who has multiple 5
physical or mental disabilities that may interfere with the ability
to perform activities of daily living independently.
fremitus vibration of the chest wall produced by vocalization. 26
frontotemporal dementia dementia of the temporal and/or frontal lobes. 60
frostbite freezing that results in the formation of ice crystals in the 69
tissues and cells.
full-thickness burn destruction of all skin elements and subcutaneous tissues, 25
with possible involvement of muscles, tendons, and bones.
fulminant hepatic failure a clinical syndrome characterized by severe impairment of 44
liver function associated with hepatic encephalopathy; also
referred to as acute liver failure.
function of circulating the role used in the unsterile field in the operating room. 19
function of scrubbing the role used in the sterile field in the operating room. 19
functional health patterns an organizational model used to identify patient strengths in 4
function and to determine if dysfunctional health patterns
and/or potential dysfunctional patterns exist.
fungi an eukaryotic organism that feeds by absorbing organic 15
molecules from its surroundings.
fusion the joining of multiple entities into one, such as the movement 15
of a virus through receptor sites into a cell.
galactorrhea a milky secretion from the nipple caused by inappropriate 52
lactation; this condition is sometimes a symptom of a pituitary
gland tumor.
gastric cancer an adenocarcinoma of the stomach wall. 42
gastric varices a complex of tortuous veins located in the upper portion 44
(cardia, fundus) of the stomach.
gastritis inflammation of the gastric mucosa. 42
gastroenteritis an inflammation of the mucosa of the stomach and small 43
intestine.
gastroesophageal reflux any clinically significant symptomatic condition or 42
disease (GERD) histopathologic alteration presumed to be secondary to reflux
of gastric contents into the lower esophagus.
general adaptation physical responses to stressors from different sources; 9
syndrome (GAS) composed of three stages: alarm reaction, stage of resistance,
and stage of exhaustion.
general anesthesia a loss of sensation with loss of consciousness, skeletal muscle 19
relaxation, analgesia, and elimination of the somatic,
autonomic, and nervous system responses, including
coughing, gagging, vomiting, and sympathetic nervous system
responsiveness.
general survey statement a statement of the provider's general impression of a patient, 4

including behavioral observations.
generalized seizures seizures characterized by bilateral synchronous epileptic 59
discharge in the brain with loss of consciousness for a few
seconds to several minutes.
genital herpes a sexually transmitted disease caused by the herpes simplex 53
virus, type 2 (HSV-2) resulting in painful genital or anal
vesicular lesions.
gerontologic nursing a specialty nursing practice in which the nurse approaches the 6
older adult patient with a whole-person (physical, psychologic,
socioeconomic) perspective.
Glasgow Coma Scale assessment tool for altered states of consciousness that 57
evaluates motor responses, verbal responses, and eye
opening.
glaucoma a group of disorders characterized by (1) increased intraocular 22
pressure and the consequences of elevated pressure, (2) optic
nerve atrophy, and (3) peripheral visual field loss.
glomerular filtration rate the amount of blood filtered by the glomeruli in a given time; 45
average is 125 ml/min with 1 ml/min excreted as urine.
glomerulonephritis an immune-related inflammation of the glomeruli characterized 46
by proteinuria, hematuria, decreased urine production, and
edema.
glomerulus component of the nephron that is a tuft of up to 50 capillaries 45
where blood is filtered across the semipermeable membrane
into Bowman's capsule.
glucagon a hormone synthesized and released from pancreatic α-cells 48
in response to low levels of blood glucose, protein ingestion,
and exercise.
glycemic index term used to describe the rise in blood glucose levels after a 49
person has consumed a carbohydrate-containing food.
goiter enlargement of the thyroid gland that may be associated with 50
hyperthyroidism, hypothyroidism, or normal thyroid function.
gonads primary reproductive organs; ovaries in the female, testes in 51
the male.
gonorrhea infection of the genitalia, the rectum, and/or the oropharynx by 53
Neisseria gonorrhoeae, which, if left untreated, leads to the
formation of fibrous tissue and adhesions.
Goodpasture syndrome an example of cytotoxic (type II) autoimmune disease, 46
characterized by the presence of circulating antibodies against
the glomerular basement membrane and alveolar basement
membrane, usually associated with glomerulonephritis and
characterized by a cough with hemoptysis, dyspnea, anemia,
and progressive renal failure.
gout recurrent attacks of acute arthritis associated with increased 65
levels of serum uric acid.
Graves' disease an autoimmune disease of unknown etiology marked by 50
diffuse thyroid enlargement and excessive thyroid hormone
secretion.
grief a nearly universal pattern of physical and emotional responses 11
to bereavement, separation, or loss.
growth hormone an anterior pituitary hormone that affects the growth and 48
development of skeletal muscles and long bones affecting a
person's size and height.
Guillain-Barré syndrome an acute, rapidly progressing, and potentially fatal form of 61
polyneuritis believed to be caused by a cell-mediated
immunologic reaction directed at the peripheral nerves.
gynecomastia a transient enlargement of one or both breasts in men. 52
head injury any traumatic damage to the head resulting from blunt or 57
penetrating trauma of the skull; bleeding, edema, and
ischemia may result.
headache pain in the head from any cause. 59
health care disparities differences in the quality of health care that are not due to 2
access-related factors or clinical needs, preferences, and
appropriateness of the intervention but rather due to
stereotyping, biases, and prejudice.
health disparities differences in measures of health status among different 2
groups of people living in a community, state, or nation.
health literacy an individual's capacity to obtain, process, and understand 5
basic health information and services needed to make
appropriate health decisions.
health maintenance a health care delivery system in which voluntary enrollees 7
organization (HMO) prepay a fixed periodic fee that is set to the amount or kind of
services received for medical care, hospitalization, and other
health care services.
Healthy People broad-based program that involves government, private, 1
public, and nonprofit organizations in preventing disease and
promoting health.
heart failure an abnormal clinical condition involving impaired cardiac 35
pumping that results in pathophysiologic changes in
vasoconstriction and fluid retention.
heat cramps severe cramps in large muscle groups caused by depletion of 69
both water and salt; usually follow vigorous exertion in an
extremely hot environment.
heat exhaustion a clinical syndrome characterized by fatigue, lightheadedness, 69
nausea, vomiting, diarrhea, and feelings of impending doom
precipitated by prolonged exposure to heat over hours or
days.
heat stroke the most serious form of heat stress; results from failure of the 69
central thermoregulatory mechanisms and is considered a
medical emergency.
heaves sustained lifts of the chest wall in the precordial area that can 32
be seen or palpated.
hemachromatosis an autosomal recessive disease characterized by increased 31
intestinal iron absorption and, as a result, increased tissue iron
deposition.
hematemesis vomiting of blood that indicates bleeding in the upper GI tract; 39
may be bright red or of "coffee ground" character.
hematology the study of blood and blood-forming tissues. 30
hematopoiesis blood cell production. 30
hematopoietic stem cell transplantation of bone marrow and peripheral stem cells. 16
transplant
hemodialysis dialysis that uses an artificial membrane (usually made of 47
cellulose-based or synthetic materials) as the semipermeable
membrane through which the patient's blood circulates;
impurities or wastes are removed from the blood.
hemodynamic monitoring measurement of pressures, flow, and oxygenation within the 66
cardiovascular system; optimization of heart rate, preload,
afterload, and contractility.
hemoglobin a complex protein-iron compound that is the major component 30
of erythrocytes that carries oxygen to the cells from the lungs
and carbon dioxide away from the cells to the lungs.
hemolysis destruction of erythrocytes. 30
hemolytic anemia an anemia caused by destruction of red blood cells (RBCs) at 31

a rate that exceeds production.
hemophilia hereditary bleeding disorders caused by defective or deficient 31
clotting factors; classic hemophilia A is a sex-linked recessive
genetic disorder caused by deficient factor VIII; hemophilia B
is a deficiency of factor IX.
hemorrhagic stroke a stroke that results from bleeding into the brain tissue itself 58
(intracerebral or intraparenchymal hemorrhage) or into the
subarachnoid space or ventricles (subarachnoid hemorrhage
or intraventricular hemorrhage).
hemorrhoids varicosities in the lower rectum or anus caused by congestion 43
in the veins of the hemorrhoidal plexus.
hemostasis a homeostatic process of blood clotting and blood lysing. 30
hemothorax accumulation of blood in the pleural space. 28
hepatic encephalopathy changes in neurologic and mental function resulting from high 44
levels of ammonia in the blood that a damaged liver cannot
detoxify.
hepatitis inflammation of the liver. 44
hepatocyte a parenchymal liver cell that performs all the functions 39
ascribed to the liver.
hepatorenal syndrome a serious complication of cirrhosis characterized by functional 44
renal failure with advancing azotemia, oliguria, and intractable
ascites.
hernia a protrusion of a viscus through an abnormal opening or a 43
weakened area in the wall of the cavity in which it is normally
contained.
herniated intervertebral disk herniation of nuclear material from the intervertebral disk that 64
may compress or place tension on a cervical, lumbar, or sacral
spinal nerve root; may cause considerable pain and damage
the nerves, resulting in restriction of movement.
hiatal hernia herniation of a portion of the stomach into the esophagus 42
through an opening, or hiatus, in the diaphragm.
hiccups intermittent spasms of the diaphragm caused by irritation of 20
the phrenic nerve, which innervates the diaphragm.
high frequency ventilation a ventilatory maneuver that delivers a small tidal volume 66
(usually 1 to 5 ml/kg body weight) at rapid respiratory rates
(100 to 300 breaths/min) in an effort to recruit and maintain
lung volume and reduce intrapulmonary shunting.
Hodgkin's lymphoma a malignant condition characterized by proliferation of 31
abnormal giant, multinucleated cells, called Reed-Sternberg
cells, which are located in lymph nodes.
holding area a special waiting area inside or adjacent to the surgical suite. 19
holistic nursing nursing that incorporates mind-body-spirit principles into the 8
development of a caring-healing relationship with patients.
homeostasis the state of equilibrium in the internal environment of the body, 17
naturally maintained by adaptive responses that promote
healthy survival.
hordeolum an infection of the sebaceous glands in the lid margin. 22
hormone a chemical substance synthesized by a specific organ or 48
tissue and secreted directly into the blood, where it is
circulated to specific target tissues.
hospice a system of family-centered care designed to assist the 11
terminally ill person to be comfortable and to maintain a
satisfactory life-style through the phases of dying.
hospital-acquired pneumonia occurring 48 hours or longer after hospital 28
pneumonia admission and not incubating at the time of hospitalization.
human immunodeficiency a retrovirus that causes HIV infection and acquired 15

virus immunodeficiency syndrome (AIDS).
human leukocyte antigens system that consists of a series of linked genes that occur 14
together on the sixth chromosome in humans and is used to
assess tissue compatibility.
humoral immunity antibody-mediated immunity. 14
Huntington's disease (HD) a genetically transmitted, autosomal dominant disorder that 59
affects both men and women of all races characterized by
chronic, devastating loss of all neurologic function resulting in
dementia.
hydrocele a nontender, fluid-filled mass that results from interference 55
with lymphatic drainage of the scrotum and swelling of the
tunica vaginalis that surrounds the testis.
hydronephrosis dilation or enlargement of the renal pelvis and calyces 46
resulting from obstruction in the lower urinary tract with
backflow of urine to the kidney.
hydrostatic pressure the force that fluid exerts within a compartment. 17
hydroureter dilation of the renal pelvis caused by backflow of urine. 46
hyperaldosteronism excessive aldosterone secretion caused by an adenoma of the 50
adrenal zona glomerulosa or bilateral adrenal hyperplasia.
hypercapnia greater than normal amounts of carbon dioxide in the blood 29
(PaCO2 > 45 mm Hg); also called hypercarbia.
hypercapnic respiratory a condition in which the PaCO2 is above normal (> 45 mm Hg) 68
failure in combination with acidemia (arterial pH < 7.35); primary
problem is insufficient carbon dioxide removal.
hypermetabolic state an increase in resting metabolic expenditure of 50% to 100% 25
above normal; often found in burn patients.
hyperopia farsightedness, or an inability of the eye to focus on nearby 21
objects.
hyperosmolar a life-threatening syndrome that can occur in the patient with 49
hyperglycemic ketotic diabetes who is able to produce enough insulin to prevent
(HHK) syndrome diabetic ketoacidosis but not enough to prevent severe
hyperglycemia, osmotic diuresis, and extracellular fluid
depletion.
hyperparathyroidism a condition involving increased secretion of parathyroid 50
hormone (PTH) resulting in increased serum calcium levels.
hyperreactivity an abnormal condition in which responses to stimuli are 29
exaggerated.
hyperresponsiveness excessive or exaggerated response to a stimulus; in asthma 29
leads to bronchoconstriction in response to physical, chemical,
or pharmacologic stimuli.
hypersensitivity reaction an inappropriate and excessive response of the immune 14
system to a sensitizing antigen, called an allergen, resulting in
tissue damage.
hypertension a common disorder characterized by sustained elevation of 33
blood pressure (BP); in adults exists when systolic blood
pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm
Hg.
hypertensive crisis a severe and abrupt elevation in BP, arbitrarily defined as a 33
diastolic BP > 120 to 130 mm Hg, occurring most frequently in
individuals who have untreated hypertension or who have
stopped taking prescribed antihypertensive medication.
hyperthyroidism a clinical syndrome where there is a sustained increase in 50
synthesis and release of thyroid hormones by the thyroid
gland.
hypertonic solutions that increase the degree of osmotic pressure on a 17

semipermeable membrane.
hypertrophic formerly called idiopathic hypertrophic subaortic stenosis; a 37
cardiomyopathy condition characterized by asymmetric left ventricular
hypertrophy without ventricular dilation.
hypertrophic scar an inappropriately large, red, raised, and hard scar that occurs 13
when the body produces excess collagen tissue.
hypocapnia low arterial carbon dioxide pressure (PaCO2 < 35 mm Hg); 29
also called hypocarbia.
hypoglycemic unawareness a condition in which a person does not experience the warning 49
signs and symptoms of hypoglycemia, increasing his or her
risk for dangerously low blood glucose levels.
hypoparathyroidism a condition of insufficient secretion of the parathyroid glands; 50
caused by primary parathyroid dysfunction or by elevated
serum calcium level.
hypopituitarism a rare disorder that involves a decrease in one or more of the 50
pituitary hormones and marked by excessive deposits of fat
and persistence or acquisition of adolescent characteristics;
serum levels of pituitary hormones are lower than normal.
hypospadias a urologic abnormality in which the urethral meatus is located 55
on the ventral surface of the penis anywhere from the corona
to the perineum.
hypothermia a core temperature < 95° F (35° C) that occurs when heat 69
produced by the body cannot compensate for heat lost to the
environment.
hypothyroidism insufficient circulation of thyroid hormones resulting in a 50
hypometabolic state.
hypotonic solutions that have a lower concentration of solute than 17
another solution, thus exerting less osmotic pressure on a
semipermeable membrane.
hypoventilation decreased respiratory function characterized by decreased 20
respiratory rate or effort, hypoxemia, and an increasing PaCO2
(hypercapnia).
hypovolemic shock shock that is caused by a loss of intravascular fluid volume. 67
hypoxemia low oxygen tension in the blood (PaO2 < 60 mm Hg) 20
characterized by a variety of nonspecific clinical signs and
symptoms, ranging from agitation to somnolence,
hypertension to hypotension, and tachycardia to bradycardia.
hypoxemic respiratory a condition in which the PaO2 is 60 mm Hg or less when the 68
failure patient is receiving an inspired oxygen concentration of 60%
or greater.
hypoxia the state in which the PaO2 has fallen sufficiently to cause 68
signs and symptoms of inadequate oxygenation; characterized
by tachycardia, hypertension, peripheral vasoconstriction,
dizziness, and mental confusion.
hysterectomy surgical removal of the uterus. 54
ileal conduit most commonly performed incontinent urinary diversion 46
procedure, in which ureters are implanted into part of ileum or
colon that has been resected from intestinal tract and
abdominal stoma is created.
imagery the use of focused images in the mind, usually used to bring 9
about a calming effect.
immunocompetence the ability of an immune system to mobilize and deploy its 14
antibodies and other responses to inactivate or destroy foreign
substances.
immunodeficiency inadequate protection of the body by the immune system. 14
immunosuppressive therapy that inhibits immune function and is prescribed for 14

therapy patients to treat autoimmune disorders and to prevent
transplant rejection; also a serious side effect of cytotoxic
drugs used in cancer chemotherapy.
impaired fasting glucose an intermediate stage between normal glucose homeostasis 49
and diabetes where the fasting blood glucose level is greater
than 110 mg/dl (6.1 mmol/L) but less than 126 mg/dl (7.0
mmol/L).
impedance cardiography a continuous, noninvasive method of obtaining cardiac output 66
and assessing thoracic fluid status with the use of external
electrodes.
implementation phase of the nursing process involving the activation of the 1
plan with the use of nursing interventions.
infective endocarditis an infection of the endocardial surface of the heart. 37
infertility the condition of being unable to produce offspring. 54
inflammatory bowel disease chronic, recurrent inflammatory diseases of the intestinal tract 43
(IBD) that include ulcerative colitis and Crohn's disease.
inflammatory response a sequential reaction to cell injury that neutralizes and dilutes 13
the inflammatory agent, removes necrotic materials, and
establishes an environment suitable for healing and repair.
informed consent an active, shared decision-making process between the 18
provider and the recipient of care that verifies the patient's
consent for treatment.
ingestion the oral taking of substances into the body; generally applied 39
to both nutrients and medications.
inspection the visual examination of a part or region of the body to 4
assess normal conditions or deviations from normal.
insulin an anabolic hormone secreted by the β-cells of the islets of 48
Langerhans in the pancreas that is the principal regulator of
the metabolism and storage of ingested carbohydrates, fats,
and proteins.
insulin pump a small battery-operated device that is programmed to deliver 49
a continuous infusion of short-acting insulin 24 hours per day,
known as the "basal rate," through a catheter inserted into the
subcutaneous tissue in the abdominal wall.
insulin resistance a condition in which body tissues do not respond to the action 49
of insulin.
integrase an enzyme used by retroviruses to splice itself to a genome. 15
intensive insulin therapy multiple daily insulin injections together with frequent self- 49
monitoring of blood glucose; alternative to insulin pump for
tight glucose control.
intermediate care facility a health care setting that provides convalescent care and 7
regular medical, nursing, social, and rehabilitative services but
without the degree of care provided by a hospital or skilled
nursing facility, in addition to room and board for people not
capable of independent living.
intermittent claudication ischemic muscle ache or pain that is precipitated by a 38
consistent level of exercise, resolves within 10 minutes or less
with rest, and is reproducible.
interstitial cystitis chronic, painful inflammatory disease of the bladder, believed 46
to be associated with an autoimmune or allergic response, and
characterized by severe bladder and pelvic pain, urinary
frequency, and urgency.
intertriginous overlapping. 23
intraaortic balloon pump a temporary circulatory assist device that is used to enhance 66
(IABP) the function of a compromised heart by reducing afterload (by
reducing systolic pressure) and augmenting the aortic diastolic

pressure.
intracerebral hematoma collection of blood within the parenchyma of the brain possibly 57
from the rupture of an intracerebral vessel at the time of a
head injury.
intracerebral hemorrhage a type of hemorrhagic stroke in which bleeding within the brain 58
caused by a rupture of a blood vessel occurs; often caused by
hypertension and is associated with increased intracranial
pressure.
intracranial pressure the hydrostatic force measured in the brain cerebrospinal fluid 57
(CSF) compartment; the pressure exerted by the total volume
from the three components within the skull: brain tissue, blood,
and CSF.
intraductal papilloma benign, wartlike growth found in the mammary ducts, 52
occasionally marked by bleeding from the nipple.
intravenous pyelogram diagnostic study using an IV contrast medium that is excreted 45
(IVP) through the urinary system used to examine the structure and
function of the urinary system.
ion an atom or group of atoms that has acquired an electrical 17
charge through the gain or loss of an electron or electrons.
iron deficiency anemia a microcytic hypochromic anemia caused by inadequate 31
supplies of iron needed to synthesize hemoglobin;
characterized by pallor, fatigue, and weakness.
irritable bowel syndrome a symptom complex characterized by intermittent and 43
(IBS) recurrent abdominal pain associated with an alteration in
bowel function (diarrhea or constipation).
ischemic stroke stroke that results from inadequate blood flow to the brain 58
caused by partial or complete occlusion of an artery.
islets of Langerhans the hormone-secreting portion of the pancreas that includes α- 48
, β-, and δ-cells that produce insulin, glucagon, and pancreatic
polypeptide.
isolated systolic a sustained elevation in systolic blood pressure ≥ 140 mm Hg 33
hypertension with a diastolic blood pressure < 90 mm Hg.
isometric contractions muscular contraction that increases tension but does not 62
produce movement.
isotonic fluids having the same concentration of solute particles as 17
another solution, thus exerting the same osmotic pressure on
a semipermeable membrane.
isotonic contractions muscular contraction with shortening that produces 62
movement.
Janeway's lesions flat, painless, small, red spots that may be found on the palms 37
and soles in patients with infective endocarditis.
jaundice symptom of yellowish discoloration of body tissues that results 44
from an increased concentration of bilirubin in the blood.
jaw thrust maneuver a technique used to maintain an open airway that should be 69
used in emergency situations instead of hyperextension of the
head.
keloid an overgrowth of collagenous scar tissue at the site of a skin 23
injury, particularly a wound or a surgical incision; the new
tissue is elevated, rounded, and firm.
keratinocytes cells synthesized from epidermal cells in the basal layer; they 23
produce a specialized protein, keratin, that is vital to the
protective barrier function of the skin.
keratitis an inflammation or infection of the cornea that can be caused 22
by a variety of microorganisms or by other factors.
keratoconus a noninflammatory, usually bilateral disease of the cornea that 22

is familial but has no exclusive inheritance pattern; the cause
of the condition is unknown.
Korotkoff sounds sounds heard during the taking of a blood pressure reading 32
using a sphygmomanometer and stethoscope; as air is
released from the cuff, pressure on the artery is reduced, and
the blood is heard pulsing through the vessel.
Korsakoff's psychosis a form of amnesia often seen in persons with chronic 12
alcoholism characterized by loss of short-term memory and an
inability to learn.
Kupffer's cells a type of macrophage found in the liver that removes bacteria 39
and toxins from the blood.
kwashiorkor a type of protein-calorie malnutrition caused by a deficiency of 40
protein intake that is superimposed on a catabolic stress
event, such as a GI obstruction, a surgical procedure, cancer,
a malabsorption syndrome, or an infectious disease.
kyphosis anteroposterior or forward bending of spine with convexity of 62
curve in posterior direction; common at thoracic and sacral
levels.
labyrinthitis an inflammation of the inner ear affecting the cochlear or 22
vestibular portion of the labyrinth or both, resulting in vertigo.
lactase deficiency an inherited abnormality in which the amount of the digestive 43
enzyme lactase is inadequate for the normal digestion of milk
products, resulting in the inability to digest lactose (except for
the bacterial breakdown of the lactose in the large intestine).
lacunar stroke a stroke resulting from occlusion of a small penetrating artery 58
with development of a cavity in the place of the infarcted brain
tissue.
leiomyoma a benign smooth muscle tumor that occurs most commonly 54
within the uterus, stomach, esophagus, or small intestine;
uterine fibroid.
lens biconvex, avascular, transparent structure located behind the 21
iris.
leukemia a broad term given to a group of malignant diseases 31
characterized by diffuse replacement of bone marrow with
proliferating leukocyte precursors, affecting the blood and
blood-forming tissues of the bone marrow, lymph system, and
spleen.
leukocyte white blood cell. 30
leukopenia an abnormal decrease in the number of total white blood cells 30
to < 4000/µl.
leukoplakia a whitish precancerous lesion on the oral mucosa or tongue 42
that results from chronic irritations.
Lewy body disease a condition characterized by the presence of Lewy bodies 60
(intraneural cytoplasmic inclusions) in the brainstem and
cortex; clinically presents with similarities to both Alzheimer's
disease and Parkinson's disease.
lichenification the thickening of the skin as a result of proliferation of 24
keratinocytes with accentuation of the normal markings of the
skin often caused by repeated scratching of a pruritic lesion.
lipectomy adipectomy; performed to remove unsightly flabby folds of 41
adipose tissue for cosmetic reasons.
lipodystrophy hypertrophy or atrophy of subcutaneous tissue; may occur if 49
the same injection sites are used frequently with the use of
beef or beef and pork insulin.
lithotripsy the use of sound waves to break renal stones into small 46
particles that can be eliminated from the urinary tract.
local anesthesia the loss of sensation without loss of consciousness. 19

long-term care (LTC) the provision of medical, social, and personal care services on 7
a recurring or continuing basis to persons with chronic
physical or mental disorders for a time period> 30 days.
lordosis lumbar spinal deformity resulting in anteroposterior curvature 62
with concavity in posterior direction.
low back pain a common problem of the musculoskeletal system caused by 64
acute lumbosacral strain, instability of lumbosacral bony
mechanism, osteoarthritis of the lumbosacral vertebrae,
intervertebral disk degeneration, and herniation of
intervertebral disks.
lower motor neuron the neuron that is the final common pathway through which 56
descending motor tracts influence skeletal muscle; the effector
organ for movement.
lumpectomy breast conservation surgery that involves the removal of the 52
entire tumor along with a margin of normal tissue.
lung abscess a pus-containing lesion of the lung parenchyma that results in 28
a cavity formed by necrosis of lung tissue.
Lyme disease a spirochetal infection caused by Borrelia burgdorferi and 65
transmitted by the bite of an infected deer tick, characterized
by fever, chills, headache, stiff neck, and migratory joint and
muscle pain.
lymphedema accumulation of lymph in soft tissue with swelling resulting 52
from inflammation, obstruction, or removal of lymph channels
and nodes.
lymphogranuloma chronic sexually transmitted infection caused by strains of 53
venereum Chlamydia trachomatis that spreads by way of the regional
lymphatics and may spread to the central nervous system
through the blood.
lymphomas malignant neoplasms originating in the bone marrow and 31
lymphatic structures resulting in the proliferation of
lymphocytes.
malabsorption syndrome a complex of symptoms resulting from disorders in the 40
intestinal absorption of nutrients, characterized by anorexia,
weight loss, abdominal bloating, muscle cramps, bone pain,
and steatorrhea.
malignant hyperthermia a rare genetic metabolic disease characterized by 19
hyperthermia with rigidity of skeletal muscles that can result in
death.
malignant melanoma a tumor arising in cells producing melanin, usually the 24
melanocytes of the skin.
malignant neoplasm a tumor that tends to grow, invade, and metastasize; usually 16
has an irregular shape and is composed of poorly
differentiated cells; if untreated, it may result in death.
Mallory-Weiss tear tear that occurs in the esophageal mucosa at the junction of 42
the esophagus and stomach caused by severe retching and
vomiting and results in severe bleeding.
malnutrition an excess, deficit, or imbalance in the essential components of 40
a balanced diet.
mammoplasty a change in the size or shape of the breast because of 52
surgery.
marasmus a type of protein-calorie malnutrition resulting from a 40
concomitant deficiency of both caloric and protein intake
leading to generalized loss of body fat and muscle.
mass casualty incident an artificial (e.g., biologic warfare) or natural (e.g., hurricane) 69
event or disaster that overwhelms a community's ability to
respond with existing resources, usually involving large
numbers of casualties, physical and emotional suffering, and

permanent changes within a community; always require
assistance from people and resources outside the affected
community.
massage therapy therapeutic technique involving touch and movement to 8
manipulate the soft tissue and joints of the body.
mastalgia breast pain, can be caused by congestion or "caking" during 52
lactation, an infection, or fibrocystic disease, especially during
or before menstruation, or in advanced cancer.
mastectomy surgical removal of the breast. 52
mastitis an inflammatory condition of the breast that occurs most 52
frequently in lactating women caused by streptococcal or
staphylococcal infection.
mean arterial pressure a calculated average of systolic and diastolic blood pressures; 32
(MAP) calculated by adding the diastolic pressure to one third of the
pulse pressure.
mechanical receptors receptors located in lungs, upper airways, chest wall, and 26
diaphragm that are stimulated by irritants, muscle stretching,
and alveolar wall distortion.
mechanical ventilation the process by which room air or oxygen-enriched air is 66
moved into and out of the lungs mechanically.
medical history a collection of information obtained from the patient and from 4
other sources concerning the patient's physical status and
psychologic, social, and sexual function to be used primarily
by the physician to determine risk for disease and diagnose a
medical condition.
meditation a technique of contemplative and reflective thought, used to 9
create a sustained period of time in which one focuses
attention and increases self-awareness.
megaloblastic anemias a group of disorders caused by impaired DNA synthesis and 31
characterized by the presence of large red blood cells.
melanocyte a type of epidermal cell that is scattered throughout the basal 23
layer of the skin and secretes melanin, the pigment that gives
color to the skin and protects from ultraviolet light.
melena black, tarry stools that indicate slow bleeding from an upper GI 39
source.
menarche the first episode of menstrual bleeding, indicating a female has 51
reached puberty.
Meniere's disease a disease characterized by symptoms caused by inner ear 22
disease including episodic vertigo, tinnitus, fluctuating
sensorineural hearing loss, and aural fullness.
meninges three layers of protective membranes that surround the brain 56
and spinal cord; three layers include the dura mater, pia
mater, and the arachnoid.
meningitis an acute inflammation of the pia mater and the arachnoid 57
membrane surrounding the brain and the spinal cord.
menopause the physiologic cessation of menses associated with declining 51
ovarian function.
menorrhagia increased duration or amount of menstrual bleeding at the 54
time of a normal period.
menstrual cycle a monthly shedding of the uterine endometrial lining when an 51
egg is not fertilized at ovulation; process is mediated by the
hormonal activity of the hypothalamus, the pituitary gland, and
the ovaries.
metabolic equivalent (MET) a method used to determine the energy costs of various 34
exercises; 1 MET is the amount of oxygen needed by the body
at rest: 3.5 ml of oxygen per kilogram per minute or 1.4 cal/kg

of body weight per minute.
metabolic syndrome a collection of risk factors that increase an individual's chance 41
of developing cardiovascular disease and diabetes mellitus.
metastasis the spread of the cancer from the initial or primary site to a 16
distant site.
metered-dose inhaler aerosolized drug delivered in a specific amount by activating 29
the inhaler or by inhaling.
metrorrhagia uterine bleeding other than that caused by menstruation; may 54
be caused by uterine lesions and be a sign of urogenital
malignancy, especially cervical cancer.
migraine headache a recurring headache characterized by unilateral or bilateral 59
throbbing pain, a triggering event or factor, strong family
history, and manifestations associated with neurologic and
autonomic nervous system dysfunction; can occur with and
without an aura (sensation such as light or warmth).
mild cognitive impairment a state of cognition and functional ability between normal 60
aging and early Alzheimer's disease.
mitral valve prolapse (MVP) a structural abnormality of the mitral valve leaflets and the 37
papillary muscles or chordae that allows the leaflets to
prolapse, or buckle, back into the left atrium during ventricular
systole.
modulation of pain the activation of descending pathways that exert inhibitory or 10
facilitative effects on the transmission of pain.
mongolian spot a benign, bluish black macule, between 2 and 8 cm, occurring 23
over the sacrum and on the buttocks of some newborns. It is
especially common in African Americans, Native Americans,
southern Europeans, and Asian Americans and usually
disappears during early childhood.
monoclonal antibodies homogeneous populations of identical antibody molecules 14
produced by specialized tissue cell culture lines.
mons pubis a fatty layer lying over the pubic bone. 51
morbidly obese classification describing individuals with a body mass index > 41
40 kg/m2.
motivational interviewing a nonconfrontational interpersonal communication technique 12
used to motivate patients to change behavior.
multiple myeloma a condition in which malignant neoplastic plasma cells infiltrate 31
the bone marrow and destroy bone.
multiple organ dysfunction the failure of more than one organ system in an acutely ill 67
syndrome (MODS) patient such that homeostasis cannot be maintained without
intervention.
multiple sclerosis (MS) a chronic, progressive, degenerative disorder of the central 59
nervous system characterized by disseminated demyelination
of nerve fibers of the brain and spinal cord.
murmur a gentle blowing, fluttering, or humming sound, such as a 32
heart murmur, susceptible to auscultation, produced by
turbulent blood flow through the heart or the walls of large
arteries.
muscular dystrophy a group of genetically transmitted diseases characterized by 64
progressive symmetric wasting of skeletal muscle without
evidence of neurologic involvement.
myasthenia gravis (MG) an autoimmune disease of the neuromuscular junction 59
characterized by the fluctuating weakness of certain skeletal
muscle groups.
myasthenic crisis an acute exacerbation of myasthenia gravis triggered by 59

infection, surgery, emotional distress, or overdose or
inadequate medication.
myelodysplastic syndrome a group of related hematologic disorders characterized by a 31
change in the quantity and quality of bone marrow elements.
myocardial infarction (MI) irreversible cardiac cellular death caused by sustained 34
myocardial ischemia.
myocarditis a focal or diffuse inflammation of the myocardium. 37
myofascial pain syndrome musculoskeletal pain and tenderness in one anatomic region 65
of the body originating in anterior and posterior trigger points
that have resulted from muscle trauma and/or chronically
strained muscles.
myopia nearsightedness, or an inability of the eye to focus on objects 21
far away.
myxedema the progression of the mental sluggishness, drowsiness, and 50
lethargy of hypothyroidism to a notable impairment of
consciousness or coma that is a medical emergency.
nadir the lowest point, such as the blood count after it has been 16
depressed by chemotherapy.
nasal polyps benign mucous membrane masses that form slowly in 27
response to repeated inflammation of the sinus or nasal
mucosa and project into the nasal cavity.
nausea a feeling of discomfort in the epigastrium with a conscious 42
desire to vomit.
negative feedback a hormone regulating mechanism in which there is a decrease 48
or increase in hormone synthesis and secretion in response to
a stimulus.
negative pressure a type of mechanical ventilation that involves the use of 66
ventilation chambers that encase the chest or body and surround it with
intermittent subatmospheric or negative pressure causing the
chest to be pulled outward and air to enter by way of the upper
airway.
nephrolithiasis the formation of stones in the urinary tract. 46
nephron the functional unit of the kidney. 45
nephrosclerosis a vascular disease of the kidney characterized by sclerosis of 46
the small arteries and arterioles of the kidney resulting in renal
tissue necrosis.
nephrotic syndrome an abnormal condition of the kidney characterized by 46
peripheral edema, massive proteinuria, hyperlipidemia, and
hypoalbuminemia; may occur in a severe primary form or
secondary to many systemic diseases.
neurofibrillary tangles tangled bundles of fibers seen in the cytoplasm of abnormal 60
neurons in those areas of the brain (hippocampus, cerebral
cortex) most affected by Alzheimer's disease.
neurogenic bladder any type of bladder dysfunction related to abnormal or absent 61
bladder innervation caused by a lesion of the nervous system.
neurogenic bowel condition that results from less voluntary neurologic control 61
over the bowel.
neurogenic shock neurologic syndrome from the loss of vasomotor tone caused 61
by spinal cord injury at the fifth thoracic (T5) vertebra or above
and characterized by hypotension, bradycardia, and warm, dry
extremities.
neuroglia cells in the central nervous system that provide support, 56
nourishment, and protection to neurons; they perform the less
specialized function of the nerve network.
neuron the primary functional unit of the nervous system. 56
neuropathic pain pain caused by damage to nerve cells or changes in spinal 10

cord processing.
neurosyphilis an infection of any part of the nervous system by the organism 61
Treponema pallidum.
neurotransmitter a chemical involved in the transmission of an impulse across 56
the synaptic cleft.
neutropenia an abnormal reduction of the neutrophil count to< 1000/µl. 30
nociception activation of the primary afferent nerves with peripheral 10
terminals (free nerve endings) that respond to noxious (tissue-
damaging) stimuli.
nociceptive pain pain that is caused by damage to somatic or visceral tissue 10
and occurs abruptly after an injury or disease, persists until
healing occurs, and often is intensified by anxiety or fear.
nonalcoholic fatty liver a group of disorders that is characterized by hepatic steatosis 44
disease (accumulation of fat in the liver) that is not associated with
other causes such as hepatitis, autoimmune disease, or
alcohol.
non-Hodgkin's lymphoma a heterogeneous group of malignant neoplasms involving 31
lymphoid tissue.
nonstochastic theory the hypothesis that things are not related to chance; in aging it 6
refers to a theory that aging occurs at the molecular and
cellular levels and is programmed by genes.
normal pressure an uncommon disorder characterized by an obstruction in the 60
hydrocephalus flow of cerebrospinal fluid, which causes a buildup of this fluid
in the brain.
normocapnia normal arterial carbon dioxide pressure (PaCO2 35 to 45 mm 29
Hg).
nuchal rigidity resistance to flexion of the neck; a condition seen in 57
meningitis.
nulliparous never having given birth. 51
nurse anesthetist a registered nurse who has graduated from an accredited 19
nurse anesthesia program and successfully completed a
national certification examination to become a certified
registered nurse anesthetist (CRNA) who is qualified to
manage patient care during the administration of anesthesia in
selected surgical situations.
nursing diagnosis the act of identifying and labeling human responses to actual 1
or potential health problems; also is the label or concise
statement that describes a clinical judgment about an
individual, family, or community response to actual or potential
health problems/life processes.
nursing history data collected about a patient's level of wellness, changes in 4
life patterns, sociocultural role, and mental and emotional
reactions to illness.
nursing informatics nursing specialty integrating nursing science, computer 1
science, and information science in identifying, collecting,
processing, and managing information to support nursing
practice, administration, education, research, and the
expansion of knowledge.
nursing intervention any act by a nurse that implements the nursing care plan or 1
any specific objective of that plan, such as turning a comatose
patient to avoid the development of decubitus ulcers or
teaching insulin injection technique to a patient with diabetes
before discharge from the hospital.
nursing process an assertive, problem-solving approach to the identification 1
and treatment of patient problems; serves as an organizational
framework for the practice of nursing.
nutrition process by which the body uses food for energy, growth, and 40
maintenance and repair of body tissues.
nystagmus an abnormal involuntary repetitive movement of the eyes. 21
O2 toxicity a condition of oxygen overdosage caused by prolonged 29
exposure to a high levels of oxygen; may inactivate pulmonary
surfactant and lead to development of acute respiratory
distress syndrome.
obese classification used to describe individuals with body mass 41
index values of 30 kg/m2 or more.
obesity an abnormal increase in an individual's proportion of fat cells. 41
objective data data that can be obtained by an observer through direct 4
physical examination, including observation, palpation,
percussion, and auscultation, and by laboratory analyses and
radiologic and other studies.
obstructive sleep apnea a condition characterized by partial or complete upper airway 27
obstruction during sleep, causing apnea and hypopnea.
old-old adults a term used to represent adults who are 85 years of age and 6
older.
oligomenorrhea long intervals between menses, generally> 35 days. 54
oliguria < 400 ml of urine in 24 hours. 47
oncogenes potentially cancer-inducing genes. 16
oncotic pressure the osmotic pressure of a colloid in solution, such as when 17
there is a higher concentration of a protein in the plasma on
one side of a cell membrane than in the neighboring interstitial
fluid.
operating room a unique acute care setting removed from other hospital 19
clinical units where surgery is performed.
opiates natural substances, such as morphine and codeine, that are 12
directly derived from opium.
opioids category including opiates in addition to the many 12
semisynthetic and synthetic narcotic agents used as
analgesics.
opportunistic disease infections and cancers that occur in immunosuppressed 15
patients that can lead to disability, disease, and death.
oral hairy leukoplakia an Epstein-Barr virus infection that causes painless, white, 15
raised lesions on the lateral aspect of the tongue.
orchitis an acute inflammation of the testis. 55
orthostatic hypotension abnormally low blood pressure occurring when an individual 33
suddenly assumes a standing position.
Osler's nodes painful, tender, red or purple, pea-size lesions that may be 37
found on the fingertips or toes in patients with infective
endocarditis and usually last only 1 or 2 days.
osmolality the measure of the osmotic force of solute per unit of weight of 17
solvent (mOsm/kg or mmol/kg).
osmosis the movement of water between two compartments separated 17
by a membrane permeable to water but not to a solute.
osmotic pressure amount of pressure required to stop the osmotic flow of water. 17
osteoarthritis (OA) a slowly progressive noninflammatory disorder of the 65
diarthrodial (synovial) joints.
osteochondroma primary benign bone tumor that is characterized by an 64
overgrowth of cartilage and bone near the end of the bone at
the growth plate; most commonly found in the long bones of
the leg, pelvis, or scapula.
osteogenic sarcoma a primary neoplasm of bone that is extremely malignant and is 64
characterized by rapid growth and metastasis.
osteomalacia a rare condition of adult bone associated with vitamin D 64

deficiency, resulting in decalcification and softening of bone.
osteomyelitis a severe infection of the bone, bone marrow, and surrounding 64
soft tissue.
osteoporosis a metabolic bone disease characterized by low bone mass 64
and structural deterioration of bone tissue leading to increased
bone fragility and pathologic fractures.
osteotomy removing or adding a wedge or slice of bone to change its 63
alignment and shift weight bearing, thereby correcting
deformity and relieving pain.
ostomy a surgical procedure in which an opening is made to allow the 43
passage of urine from the bladder or intestinal contents from
the bowel to an incision or stoma surgically created in the wall
of the abdomen.
otosclerosis a hereditary condition of unknown cause in which irregular 22
ossification occurring on the footplate of the stapes in the oval
window results in decreased hearing acuity.
overnutrition the ingestion of more food than is required for body needs, as 40
in obesity.
oxytocin a hormone that stimulates ejection of milk into mammary ducts 48
and contraction of uterine smooth muscle.
Paget's disease of the bone a skeletal bone disorder in which there is excessive bone 64
resorption followed by replacement of normal marrow by
vascular, fibrous connective tissue and new bone that is
larger, disorganized, and weaker; characterized by excessive
bone destruction and unorganized bone repair.
Paget's disease of the a breast malignancy characterized by a persistent lesion of the 52
breast nipple and areola with or without a palpable mass, usually
affecting middle-aged and elderly people, and characterized
by excessive bone destruction and unorganized bone repair.
pain an unpleasant sensory and emotional experience arising from 10
actual or potential tissue damage and described in terms of
such damage; whatever the person experiencing the pain says
it is, existing whenever the person says it does.
palliative care health care aimed at symptom management rather than 11
curative treatment for diseases that no longer respond to
treatment.
palpation a technique used in physical examination in which the 4
examiner feels the texture, size, consistency, and location of
certain body parts with the hands.
pancreatic insufficiency a condition characterized by inadequate production and 29
secretion of pancreatic hormones or enzymes.
panlobular emphysema type of emphysema involving distention and destruction of the 29
entire primary respiratory lobule; usually associated with "1-
antitrypsin deficiency; also called chronic hypertrophic, diffuse,
generalized, panlobular, or vesicular emphysema.
pancytopenia marked decrease in the number of red blood cells, white blood 30
cells, and platelets.
paracentesis a procedure in which fluid is withdrawn from a cavity of the 44
body.
paralytic ileus lack of intestinal peristalsis. 43
paraphimosis tightness of the foreskin resulting in the inability to pull it 55
forward from a retracted position.
paraplegia paralysis characterized by motor and/or sensory loss in the 61
lower limbs and trunk; occurs with spinal cord damage at T1 or
below.
parathyroid hormone a hormone secreted by the parathyroid glands that acts to 48

maintain a constant concentration of calcium in the
extracellular fluid; stimulates bone resorption.
parenteral nutrition the administration of nutrients by a route (e.g., bloodstream) 40
other than the GI tract.
Parkinson's disease a disease of the basal ganglia characterized by a slowing 59
down in the initiation and execution of movement
(bradykinesia), increased muscle tone (rigidity), tremor at rest,
and impaired postural reflexes.
paroxysmal nocturnal a disorder characterized by sudden attacks of respiratory 35
dyspnea distress that awaken the person, usually after several hours of
sleep in a reclining position; most commonly caused by
pulmonary edema resulting from heart failure.
partial liquid ventilation the use of perflubron (LiquiVent), a inert, biocompatible, clear, 66
odorless liquid that has an affinity for both oxygen and carbon
dioxide and surfactant-like qualities that is trickled into the
patient's lungs.
partial seizures seizures that begin in a specific region of the cortex and may 59
be confined to one side of the brain and remain partial or focal
in nature, or they may spread to involve the entire brain.
partial-thickness burn varying degrees of epidermal and dermal skin injury in which 25
some skin elements remain viable for regeneration.
patient-controlled analgesia an analgesic delivery system that allows the patient to receive 10
a bolus infusion of an analgesic on demand within the
parameters programmed into the delivery system.
peer teaching teaching that occurs in support groups or self-help 5
organizations that can provide continuing information, shared
experiences, acceptance, understanding, and useful
suggestions about a problem or concern.
pelvic inflammatory disease an infectious condition of the pelvic cavity that may involve 54
(PID) infection of the fallopian tubes (salpingitis), ovaries
(oophoritis), and pelvic peritoneum (peritonitis).
peptic ulcer disease a condition characterized by erosion of the GI mucosa 42
resulting from the digestive action of HCl acid and pepsin.
perception of pain the state in which pain is recognized, defined, and responded 10
to by the individual experiencing the pain.
percussion a technique in physical examination of tapping the body with 4
the fingertips or fist to evaluate the size, borders, and
consistency of some of the internal organs and to discover the
presence and evaluate the amount of fluid in a body cavity.
percutaneous coronary a common elective intervention for angina in which a catheter 34
intervention equipped with an inflatable balloon tip is inserted into a
narrowed coronary artery and the balloon is inflated,
compressing the atherosclerotic plaque and dilating the artery.
pericardial effusion an accumulation of excess fluid in the pericardial sac. 37
pericardial friction rub a scratching, grating, high-pitched sound believed to arise 37
from friction between the roughened pericardial and epicardial
surfaces.
pericardiocentesis procedure in which a 16- to 18-gauge needle is inserted into 37
the pericardial space to remove fluid for analysis and to relieve
cardiac pressure.
pericarditis a condition caused by inflammation of the pericardial sac. 37
perimenopause a normal life transition that begins with the first signs of 54
change in menstrual cycles and ends after cessation of
menses.
perineal prostatectomy surgical removal of the prostate gland through a perineal 55
approach.
perioperative nurse a registered nurse who implements patient care based on the 19
nursing process during the preoperative, intraoperative, and
postoperative period.
peripheral arterial disease progressive narrowing and degeneration of the arteries of the 38
neck, abdomen, and extremities.
peripheral nervous system consists of the cranial and spinal nerves and the peripheral 56
components of the autonomic nervous system (ANS); the
system consists of 12 pairs of cranial nerves, 31 pairs of spinal
nerves, and their various branches in the body organs.
peripheral parenteral nutrients administered through a peripherally inserted catheter 40
nutrition or vascular access device, which uses a large peripheral vein.
peritoneal dialysis dialysis with the use of the peritoneal membrane as the 47
semipermeable membrane; performed to correct an imbalance
of fluid or of electrolytes in the blood or to remove toxins,
drugs, or other wastes normally excreted by the kidney.
peritonitis the inflammation of the peritoneum; produced by bacteria or 43
irritating substances introduced into the abdominal cavity by a
penetrating wound or perforation of an organ in the GI tract or
the reproductive tract.
pernicious anemia a progressive megaloblastic macrocytic anemia resulting from 31
inadequate gastric secretion of intrinsic factor necessary for
absorption of cobalamin (vitamin B12).
petechiae small purplish lesions. 30
pH abbreviation for potential hydrogen, a scale representing the 17
relative acidity (or alkalinity) of a solution, in which a value of
7.0 is neutral, below 7.0 is acid, and above 7.0 is alkaline.
phagocytosis the process by which certain cells, such as a white blood cell, 30
engulf and destroy microorganisms and cellular debris.
phantom limb sensation perception of sensations or pain in an amputated limb. 63
pheochromocytoma a rare condition characterized by a tumor of the adrenal 50
medulla that produces excessive catecholamines
(epinephrine, norepinephrine) causing persistent or
intermittent hypertension.
phimosis a constriction of the uncircumcised foreskin around the head 55
of the penis making retraction difficult.
phlebostatic axis an external landmark that is the intersection of two imaginary 66
lines drawn on the chest used to position the zero reference
on the transducer level with the atria.
physical examination an investigation of the body to determine its state of health, 4
using any or all of the techniques of inspection, palpation,
percussion, auscultation, and smell; the physical examination,
history, and initial laboratory tests constitute the database on
which a diagnosis is made and on which a plan of treatment is
developed.
physiologic dependence an altered physiologic state resulting from prolonged 12
(physical dependence) substance use in which regular use is necessary to prevent
withdrawal.
physiologic stress ulcer an acute ulcer that develops following a major physiologic 42
insult such as trauma and/or surgery.
Pick's disease a rare brain disorder characterized by disturbances in 60
behavior, sleep, personality, and eventually memory.
planning third phase of the nursing process consisting of setting goals 1
and expected outcomes with the patient and family, when
feasible, and determining strategies for accomplishing the
goals.
pleural effusion an abnormal accumulation of fluid in the intrapleural spaces of 28
the lungs.
pleural friction rub creaking or grating sound from roughened, inflamed surfaces 26
of the pleura rubbing together, evident during inspiration,
expiration, or both and no change with coughing; usually
uncomfortable, especially on deep inspiration.
pleurisy (pleuritis) inflammation of the pleura. 28
pneumoconiosis a general term for lung diseases caused by inhalation and 28
retention of dust particles.
pneumonia an acute inflammation of the lungs, often caused by inhaled 28
pneumococci of the species Streptococcus pneumoniae.
pneumothorax a collection of air or gas in the pleural space causing the lung 28
to collapse.
poikilothermism the adjustment of the body temperature to the room 61
temperature.
point of maximal impulse the site on the chest wall where the thrust or pulsation of the 32
left ventricle is most prominent; normally found at the mitral
valve area in the fifth intercostal space of the thorax, just
medial to the left midclavicular line.
polycystic kidney disease a genetic kidney disorder in which the cortex and the medulla 46
are filled with thin-walled cysts that enlarge and destroy
surrounding tissue.
polycythemia an abnormal condition with excessive levels of red blood cells. 30
polymyositis diffuse, idiopathic, inflammatory myopathies of striated 65
muscle, producing bilateral weakness usually most severe in
the proximal or limb-girdle muscles; some forms of
polymyositis are associated with malignancy.
polypharmacy the use of multiple medications by one patient who has more 6
than one health problem.
portal hypertension increased venous pressure in the portal circulation caused by 44
compression and destruction of the portal and hepatic veins
and sinusoids resulting in splenomegaly, large collateral veins,
ascites, systemic hypertension, and esophageal varices.
positive end-expiratory a ventilatory maneuver in which positive pressure is applied to 66
pressure (PEEP) the airway during exhalation.
positive pressure ventilation a method of mechanical ventilation in which the ventilator 66
pushes air into the lungs under positive pressure during
inspiration.
posterior cord syndrome damage to the posterior spinal artery with damage to the 61
dorsal columns, resulting in loss of proprioception.
postexposure prophylaxis treatment with combination antiretroviral therapy on exposure 15
(PEP) to HIV-infected fluids.
postmenopause a term that refers to the time in a woman's life after 54
menopause.
postpolio syndrome recurrence of neuromuscular symptoms experienced by polio 61
survivors who experienced the disease previously.
postural drainage the use of various positions to promote gravity drainage of 29
bronchial secretions; coughing usually expels secretions of the
trachea.
potentiation condition occurring when a central nervous system depressant 12
is taken with alcohol, thereby increasing the effect.
prediabetes impaired glucose tolerance; occurs when the alteration in 49
islets of Langerhans is mild and a 2-hour plasma glucose level
is higher than normal but lower than that considered
diagnostic for diabetes.
preferred provider a health care reimbursement system in which charges are 7
organization (PPO) negotiated in advance with physicians, hospitals, and
pharmacists who discount their health care services to
subscriber patients of the delivery of care using predetermined

reimbursement rates or capitation fees for medical care,
hospitalization, and other health care services.
prehypertension disorder characterized by a systolic blood pressure of 120 to 33
139 and a diastolic blood pressure of 80 to 90.
preload the volume of blood in the ventricles at the end of diastole 32
before the next contraction.
premature atrial contraction contraction originating from an ectopic focus in the atrium in a 36
location other than the sinus node.
premature ventricular a contraction originating in an ectopic focus in the ventricles. 36
contraction
premenstrual syndrome a common disorder in women in which a group of physical and 54
(PMS) psychologic symptoms occur during the last few days of the
menstrual cycle and before the onset of menstruation.
presbycusis hearing loss associated with aging. 22
presbyopia a hyperopic shift to farsightedness resulting from a loss of 21, 22
elasticity of the lens of the eye; the condition commonly
develops with advancing age, with the first symptoms
appearing about age 40 years.
pressure support ventilation a mode of volume ventilation in which positive pressure is 66
applied to the airway only during inspiration and is used in
conjunction with the patient's spontaneous respirations.
pressure ulcer a localized area (usually over a bony prominence) of tissue 13
necrosis caused by unrelieved pressure that occludes blood
flow to the tissues.
pressure ventilation a ventilator that delivers the tidal volume based on a 66
predetermined peak inspiratory pressure for the individual
patient.
primary (essential) an elevated systemic arterial pressure for which no cause can 33
hypertension be found and which is often the only significant clinical finding.
primary survey initial assessment in emergency situations that focuses on 69
airway, breathing, and circulation and serves to identify life-
threatening problems so that appropriate interventions can be
initiated.
Prinzmetal's angina variant angina; occurs at rest, usually in response to 34
reversible, severe spasm of a major coronary artery.
problem-focused coping a method of coping involving an individual's attempts to deal 9
with demands (internal or environmental) or obstacles that
create the demands.
prostate cancer a malignant tumor of the prostate gland. 55
prostate-specific antigen a glycoprotein found only in the epithelial cells of the prostate 55
(PSA) that, when elevated, indicates a prostatic pathologic condition
but not necessarily cancer of the prostate.
prostatic acid phosphatase an isoenzyme of prostatic tissue that, when elevated, indicates 55
prostatic cancer.
prostatitis acute or chronic inflammation of the prostate gland, usually as 55
a result of infection.
protease a type of enzyme necessary for completion of HIV replication 15
within a cell.
protein-calorie malnutrition the most common form of undernutrition; caused by a lack of 40
adequate calories and proteins to meet the body's needs.
protooncogenes normal cellular genes that are important regulators of normal 16
cellular processes.
protozoa free-living, unicellular organisms that ingest food. 15
pruritus itching. 23
pseudofolliculitis bacterial disorder caused by Staphylococcus aureus that is an 23

inflammatory response to ingrown hairs characterized by
papules/pustules.
psychologic dependence a compulsive need to experience a pleasurable response from 12
a substance.
psychoneuroimmunology an interdisciplinary science that seeks to understand the 9
interactions among psychologic, neurologic, and immune
responses.
pulmonary edema an abnormal accumulation of fluid in the alveoli and interstitial 28, 35
spaces of the lungs caused most commonly by heart failure;
an acute, life-threatening situation in which the lung alveoli
become filled with serous or serosanguineous fluid caused
most commonly by heart failure.
pulmonary embolism a thromboembolic occlusion of the pulmonary vasculature 28
resulting from thrombi in the venous circulation or right side of
the heart and from other sources, such as amniotic fluid, air,
fat, bone marrow, and foreign IV material that travel as emboli
until lodging in the pulmonary vessels.
pulmonary hypertension elevated pulmonary pressure resulting from an increase in 28
pulmonary vascular resistance to blood flow through small
arteries and arterioles.
pulse pressure the difference between the systolic and diastolic pressures, 32
normally 30 to 50 mm Hg.
pursed-lip breathing a technique of exhaling against pursed lips to prolong 29
exhalation, preventing bronchiolar collapse and air trapping;
done to increase expiratory airway pressure, improve
oxygenation of the blood, and help prevent early airway
closure.
pyelonephritis a diffuse pyogenic infection of the renal parenchyma and 46
collecting system.
pyorrhea a discharge of purulent material. 39
pyrosis burning in epigastric or substernal area; heartburn. 39
qi energy or the primal life force resulting from the interaction of 8
yin and yang.
race vague divisions of humankind, more closely related to people 3
who share a common ancestry and physical characteristics
such as skin color, bone structure, or blood group.
radiation the emission and distribution of energy through space or a 16
material medium that can be used to cause cellular death.
radical prostatectomy surgical removal of the entire prostate gland, seminal vesicles, 55
and part of the bladder neck (ampulla).
range of motion degree of movement of joints. 62
rapid postanesthesia care the rapid progression of patients through Phase I; used for 20
unit progression both inpatients and outpatients.
Raynaud's phenomenon an episodic vasospastic disorder of small cutaneous arteries, 38
most frequently involving the fingers and toes; caused by
exposure to cold or by emotional stimuli.
reactive arthritis (Reiter's a symptom complex more commonly found in young men that 65
arthritis) includes urethritis, conjunctivitis, and mucocutaneous lesions.
rectocele herniation or protrusion of the rectum through the wall of the 54
vagina resulting from weakened connective tissue support
between the vagina and rectum.
reflex an involuntary response to a stimulus. 56
refraction the ability of the eye to bend light rays so that they fall on the 21
retina.
refractive error a defect in the ability of the lens of the eye to focus an image 22
accurately, such as occurs in nearsightedness and
farsightedness.
refractory hypoxemia severe ventilation/perfusion mismatch and shunting of 68
pulmonary capillary blood that result in hypoxemia
unresponsive to increasing concentrations of oxygen.
regeneration the replacement of lost cells and tissues with cells of the same 13
type.
regional anesthesia the loss of sensation to a region of the body when a specific 19
nerve or group of nerves is blocked with the administration of
a local anesthetic without loss of consciousness.
regurgitation backward flow from normal direction; incomplete closure of the 37
valve leaflets resulting in the backward flow of blood.
relapse return to substance abuse during abstinence. 12
relative hypovolemia loss of intravascular fluid volume resulting from the movement 67
of fluid out of the vascular space into extravascular space
(e.g., interstitial or intracavitary space).
relaxation breathing a technique of focusing breathing with the diaphragm with 9
slow, steady, even breaths.
renal arteriogram diagnostic study performed by injecting contrast media into a 45
renal artery to visualize the renal blood vessels.
renal artery stenosis a partial occlusion of one or both renal arteries and their major 46
branches; a major cause of abrupt onset hypertension.
renal biopsy procedure to obtain renal tissue for examination to determine 45
renal disease; usually performed percutaneously with a biopsy
needle.
renal osteodystrophy syndrome of skeletal changes found in chronic kidney disease 47
as a result of alterations in calcium and phosphate
metabolism; characterized by uneven bone growth and
demineralization.
repair healing as a result of lost cells being replaced by connective 13
tissue.
repetitive strain injury a cumulative trauma disorder resulting from prolonged, 63
forceful, or awkward movements resulting in strain of tendons,
ligaments, and muscles, causing tiny tears that become
inflamed.
residential care facility a facility that provides custodial care to persons who, because 7
of physical, mental, or emotional disorders, are not able to live
independently.
resilience being resourceful, flexible, and having an available source of 9
problem-solving strategies.
restless legs syndrome unpleasant sensory (paresthesias) and motor abnormalities of 59
one or both legs; characterized by an irritating sensation of
uneasiness, tiredness, and itching deep within the muscles of
the leg, especially the lower part of the limb, accompanied by
twitching and sometimes by pain.
reticulocyte an immature erythrocyte characterized by a meshlike pattern 30
of threads and particles at the former site of the nucleus;
measurement of the number of reticulocytes is a useful means
of evaluating the rate and adequacy of erythrocyte production.
retina a layered nervous tissue membrane of the eye, continuous 21
with the optic nerve, that receives images of external objects
and transmits visual impulses through the optic nerve to the
brain.
retinal detachment a separation of the retina from the retinal pigment epithelium in 22
the back of the eye, allowing the vitreous humor to leak
between the two layers.
retinopathy the process of microvascular damage of the retina; may 22

develop slowly or rapidly.
retrograde pyelogram radiologic technique for examining the structures of the 45
collecting system of the kidneys that is especially useful in
locating a urinary tract obstruction.
retropubic prostatectomy removal of the prostate gland through a low abdominal incision 55
without entry into the bladder.
retrovirus RNA viruses that replicate in a "backward" manner (going from 15
RNA to DNA).
reverse transcriptase enzyme that is present in retroviruses; allows for synthesis of 15
DNA from RNA.
rheumatic fever an inflammatory disease of the heart potentially involving all 37
layers (endocardium, myocardium, and pericardium).
rheumatic heart disease the resulting damage to the heart muscle and heart valves 37
from rheumatic fever, a chronic condition characterized by
scarring and deformity of the heart valves.
rheumatoid arthritis (RA) a chronic, systemic autoimmune disease characterized by 65
inflammation of connective tissue in the diarthrodial (synovial)
joints, typically with periods of remission and exacerbation.
rhinoplasty the surgical reconstruction of the nose. 27
rhonchi continuous rumbling, snoring, or rattling sounds from 26
obstruction of large airways with secretions; most prominent
on expiration; change often evident after coughing or
suctioning.
same-day admission admission of surgical patients to the hospital on the day of 18
surgery because of increased interest in cost containment and
advances in technology.
sarcoma a malignant tumor that originates from embryonal mesoderm 16
that becomes connective tissue, muscle, bone, and fat.
sclera an opaque structure composed of collagen fibers meshed 21
together that encircles the globe of the eye; commonly
referred to as the "white" of the eye.
scoliosis a lateral S-shaped curvature of the thoracic and lumbar spine. 62
screening physical an examination performed for screening situations, health 4
examination surveillance, and health maintenance purposes that examines
major body systems.
sebaceous glands glands that secrete sebum, which is emptied into the hair 23
shaft, which prevents the skin and hair from being dry.
secondary hypertension elevated blood pressure associated with any of several 33
primary diseases, such as renal, pulmonary, endocrine, and
vascular diseases.
secondary survey a brief, systematic assessment process following the primary 69
survey that is aimed at identifying all injuries.
seizure a paroxysmal, uncontrolled electrical discharge of neurons in 59
the brain that interrupts normal function leading to a sudden,
violent involuntary series of contractions of a group of
muscles.
self-efficacy a person's belief in his or her ability to successfully cope with 5
and manage a situation.
self-monitoring of blood the use of blood glucose meters by patients to determine 49
glucose (SMBG) blood glucose levels and promote self-management decisions
regarding diet, exercise, and medication.
sense of coherence a coping style that refers to how an individual sees the world 9
and one's life in it.
sepsis a systemic inflammatory response to infection. 67
septic arthritis infectious or bacterial arthritis caused by invasion of the joint 65

cavity with microorganisms; characterized by bacterial
inflammation of a joint caused by the spread of bacteria
through the bloodstream from an infection elsewhere in the
body or by contamination of a joint during trauma or surgery.
septic shock the presence of sepsis with hypotension despite adequate 67
fluid resuscitation along with the presence of tissue perfusion
abnormalities; may be caused by the presence of fungi or
viruses in the blood.
seroconversion a change in serologic test results from negative to positive as 15
antibodies develop in reaction to an infection or vaccine.
sexual assault the forcible perpetration of a sexual act on a person without 54
his or her consent.
sexually transmitted infectious diseases transmitted most commonly through 53
diseases sexual intercourse or genital contact.
shearing force pressure exerted on the skin when it adheres to the bed and 13
the skin layers slide in the direction of body movement.
shock a syndrome characterized by decreased tissue perfusion and 67
impaired cellular metabolism resulting in an imbalance
between the supply of and demand for oxygen and nutrients;
associated with inadequate cardiac output, hypotension,
oliguria, changes in peripheral blood flow resistance and
distribution, and tissue damage.
short bowel syndrome a condition of rapid intestinal transit, impaired digestive and 43
absorption processes, and fluid and electrolyte losses that
results from extensive resection of the small intestine.
shunt the process of blood exiting the heart without having 68
participated in gas exchange.
sickle cell disease a group of inherited, autosomal recessive disorders 31
characterized by the presence of an abnormal form of
hemoglobin in the erythrocyte.
silent ischemia asymptomatic ischemia that may damage the heart. 34
Sjögren's syndrome an autoimmune disease that targets moisture-producing 65
glands, leading to the common symptoms of xerostomia (dry
mouth) and keratoconjunctivitis sicca (dry eyes).
skilled nursing facility nursing center that provides care for patients who require 24- 7
hour nursing supervision.
smoke and inhalation damage to the tissues of the respiratory tract resulting from 25
injuries the inhalation of hot air or noxious chemicals.
Somogyi effect a condition in which an excessive insulin dose causes a 49
decline in blood glucose levels during sleep, causing the
release of counterregulatory hormones that increase the blood
glucose levels, resulting in high blood glucose levels at
morning testing; indicates a need for reduced insulin dose.
spermatocele a firm, sperm-containing, painless cyst of the epididymis that 55
may be visible with transillumination.
spermatogenesis formation of sperm. 51
spider angiomas small, dilated blood vessels with a bright-red center point the 44
size of a pinhead from which small blood vessels radiate.
spinal anesthesia the injection of a local anesthetic into the cerebrospinal fluid 19
found in the subarachnoid space, usually below the level of
L2.
spinal shock immediate failure of all spinal cord function at the time of injury 61
below the level of cord damage, resulting in flaccid paralysis,
loss of reflexes, and loss of sympathetic innervation; usually
associated with cervical or high thoracic injury and usually
lasts 7 to 10 days after onset.
spondyloarthropathies a group of interrelated multisystem inflammatory disorders that 65

affect the spine, peripheral joints, and periarticular structures.
sprain an injury to ligamentous structures surrounding a joint, usually 63
caused by a wrenching or twisting motion.
squamous cell carcinoma a slow-growing malignant tumor of squamous epithelium; 24
found in the lungs and skin and occurring also in the anus,
cervix, larynx, nose, and bladder.
stages of behavioral a series of steps that patients and their families may progress 5
change through before they are willing or able to accept a change in
health behaviors; six stages of change have been identified in
the Transtheoretical Model of Health Behavior Change
developed by Prochaska and Velicer.
staging the process of classifying the extent and spread of disease. 16
standardized nursing a readily understood common language used among nurses to 1
languages clearly define and evaluate nursing care and to improve
communication.
status asthmaticus a severe, life-threatening asthma attack that is refractory to 29
usual treatment and places the patient at risk for developing
respiratory failure.
status epilepticus a state of continuous seizure activity or a condition in which 59
seizures recur in rapid succession without return to
consciousness between seizures.
steatorrhea greater than normal amounts of fat in the feces, characterized 43
by frothy, foul-smelling fecal matter that floats, as in celiac
disease, some malabsorption syndromes, and any condition in
which fats are poorly absorbed by the small intestine.
stem cell a formative cell; a cell whose daughter cells may give rise to 30
other cell types, including blood cells.
stenosis constriction or narrowing. 37
stent expandable meshlike structure designed to maintain vessel 34
patency by compressing the arterial walls and resisting
vasoconstriction.
stereotyping the viewing of members of a specific culture, race, age, or 3
ethnic group as being alike and sharing the same values and
beliefs.
stochastic theory the hypothesis that the occurrences of the aging process are 6
due to chance.
strabismus a condition in which the patient cannot consistently focus two 22
eyes simultaneously on the same object.
strain an excessive stretching of a muscle and its fascial sheath that 63
results from excessive.
stress any emotional, physical, social, economic, or other demand 9
that requires a response or change.
stressor physical or emotional, pleasant or unpleasant demands that 9
require an individual to adapt.
stress-related mucosal see physiologic stress ulcer. 42
disease
stricture an abnormal temporary or permanent narrowing of the lumen 46
of a hollow organ, such as the esophagus, pylorus of the
stomach, ureter, or urethra; caused by inflammation, external
pressure, or scarring.
stroke death of brain cells that occurs when there is ischemia 58
(inadequate blood flow) to a part of the brain or hemorrhage
into the brain.
subarachnoid hemorrhage a stroke resulting from intracranial bleeding into the 58

cerebrospinal fluid–filled space between the arachnoid and pia
mater membranes on the surface of the brain.
subculture an ethnic, regional, economic, or social group with 3
characteristic patterns of behavior, background, or ideals that
distinguish it from the rest of a culture or society.
subdural hematoma collection of blood between the dura mater and the arachnoid 57
layer of the meninges of the brain that is usually of venous
origin, usually caused by injury.
subjective data data collected by interviewing the patient during the nursing 4
history; includes information that can only be described or
verified by the patient and includes a full description of the
onset, the course, and the character of the problem and any
factors that aggravate or ameliorate it.
subluxation a partial or incomplete displacement of the joint surface. 63
submersion injury hypoxia resulting from submersion in a substance, usually 69
water.
substance abuse overindulgence in and dependence on a substance that has a 12
negative impact on psychologic, physiologic, and social
functioning of an individual.
substance dependence reliance on a substance that has reached the level that an 12
absence of it will cause an impairment in function.
substance misuse use of a drug for purposes other than those intended. 12
sudden cardiac death unexpected death from cardiac causes. 34
suffering the state of severe distress associated with events that 10
threaten the intactness of the person.
sundowning condition in which the patient becomes more confused and 60
agitated in the late afternoon or evening; behaviors commonly
exhibited include agitation, aggressiveness, wandering,
resistance to redirection, and increased verbal activity such as
yelling; thought to be caused by disruption of circadian
rhythms.
sunscreen protective factor a system of measuring the effectiveness of various 24
(SPF ) index formulations for protecting the skin from actinic rays of the
sun.
superficial thrombophlebitis inflammation of a superficial vein; occurs in about 65% of all 38
patients receiving IV therapy.
suprapubic resection removal of the prostate gland through a low prostatectomy 55
abdominal incision that cuts through the bladder to the anterior
aspect of the prostate.
surfactant a lipoprotein that lowers the surface tension in the alveoli, 26
reduces the amount of pressure needed to inflate the alveoli,
and decreases the tendency of the alveoli to collapse.
surgery the art and science of treating diseases, injuries, and 18
deformities by operation and instrumentation.
surgical suite a controlled environment designed to minimize the spread of 19
infectious organisms and allow a smooth flow of patients,
personnel, and the instruments and equipment needed to
provide safe patient care during surgery.
synapse the structural and functional junction between two neurons, 56
across which nerve impulses are transmitted through the
action of a neurotransmitter, such as acetylcholine or
norepinephrine.
syncope fainting that may occur with decreased cardiac output, fluid 20
deficits, or defects in cerebral perfusion.
synovectomy surgical removal of synovial membrane. 63
syphilis a complex disease in which many organs and tissues of the 53

body can become infected by Treponema pallidum; infection
causes the production of antibodies that also react with normal
tissues.
systemic inflammatory a systemic inflammatory response to a variety of insults, 67
response syndrome (SIRS) including infection, ischemia, infarct, and injury characterized
by inflammation in body organs not involved in the initial insult.
systemic lupus a chronic multisystem inflammatory disease associated with 65
erythematosus (SLE) abnormalities of the immune system.
systemic sclerosis (SS) a disorder of connective tissue characterized by fibrotic, 65
degenerative, and occasionally inflammatory changes in the
skin, blood vessels, synovium, skeletal muscle, and internal
organs.
systemic vascular the resistance the left ventricle must overcome to pump blood 33
resistance through the systematic circulation; primarily influenced by the
radius of small arteries and arterioles.
systole contraction of myocardium, driving blood into the aorta and 32
pulmonary arteries.
systolic blood pressure the peak pressure exerted against the arteries when the heart 32
contracts.
systolic failure a type of ventricular failure caused by impaired contractile 35
function (e.g., myocardial infarction), increased afterload (e.g.,
hypertension), or mechanical abnormalities (e.g., valvular
heart disease); characterized by low forward blood flow.
target tissue the body tissue or organ that the hormone affects. 48
targeted therapy treatment that interferes with cancer growth by targeting 16
specific cellular receptors and pathways that are important in
tumor growth.
teaching plan a formal plan to address the learning needs of the patient 5
based on assessment of the patient's ability, need, and
readiness to learn with identification of problems that can be
resolved with teaching.
teaching process a systematic problem-solving approach to the identification 5
and treatment of the patient's learning needs and includes
assessment, diagnosis, setting patient outcomes or objectives,
intervention, and evaluation.
telemetry monitoring the observation of a patient's heart rate and rhythm that is 36
used for the diagnosis of dysrhythmias.
teletherapy radiation therapy administered by a machine that is positioned 16
at some distance from the patient; the most common form of
radiation therapy treatment.
tenesmus spasmodic contraction of the anal sphincter with pain and 39
persistent desire to empty the bowel.
tension pneumothorax a pneumothorax with rapid accumulation of air in the pleural 28
space causing severely high intrapleural pressures with
resultant tension on the heart and great vessels.
tension-type headache headache that is characterized by a bilateral feeling of 59
pressure around the head.
testicular torsion twisting of the spermatic cord that supplies blood to the testes 55
and epididymis.
tetanus lockjaw, an extremely severe polyradiculitis and polyneuritis 61
affecting spinal and cranial nerves that results from the effects
of a potent neurotoxin released by the anaerobic bacillus
Clostridium tetani.
tetany increased nerve excitability and sustained muscle contraction 17
that results from low calcium levels that allow sodium to move
into excitable cells, increasing depolarization; low calcium

levels affect the membrane potential.
tetraplegia paralysis of the arms, legs, and trunk occurring with spinal 61
cord damage at C8 or above.
thalassemia an autosomal recessive genetic disorder of inadequate 31
production of normal hemoglobin.
therapeutic touch a nursing intervention defined as attuning to the universal 8
healing field, seeking to act as an instrument for healing
influence, and using the natural sensitivity of the hands to
gently focus and direct the intervention process.
thermal burn injury caused by flame, flash, scald, or contact with hot 25
objects; the most common type of burn.
thoracentesis a surgical procedure done to remove fluid from the pleural 28
space.
thoracotomy surgical opening into the thoracic cavity. 28
thromboangiitis obliterans a somewhat rare nonatherosclerotic, segmental inflammatory 38
disorder of the medium-sized arteries, veins, and nerves of the
upper and lower extremities.
thrombocyte platelet. 30
thrombocytopenia a reduction of the platelet count below 100,000/µl. 30
thrombocytosis a condition marked by excessive platelets; a disorder that 30
occurs with inflammation and some malignant disorders.
thrombotic stroke a stroke resulting from thrombosis or narrowing of the blood 58
vessel.
thyroiditis an inflammation of the thyroid gland that may cause 50
hyperthyroid or hypothyroid manifestations.
thyrotoxic crisis an acute, rare condition in which all hyperthyroid 50
manifestations are heightened.
thyrotoxicosis a hypermetabolic state caused by excessive circulating levels 50
of T4, T3, or both; also referred to as thyrotoxic crisis, thyroid
storm, or hyperthyroid crisis.
thyroxine (T4) the most abundant thyroid hormone that influences metabolic 48
rate; accounts for 90% of thyroid hormone produced by the
thyroid gland; converted to T3 in the periphery.
tidal volume volume of air exchanged with each breath. 26
tinnitus a subjective noise sensation, often described as ringing, heard 21
in one or both ears.
titration dose adjustment based on assessment of the adequacy of 10
analgesic effect versus the side effects produced.
tolerance a phenomenon by which the body becomes increasingly 12
resistant to a drug or other substance through continued
exposure to the substance.
tonic-clonic seizure a seizure characterized by loss of consciousness and falling to 59
the ground if the patient is upright, followed by stiffening of the
body (tonic phase) for 10 to 20 seconds and subsequent
jerking of the extremities (clonic phase) for another 30 to 40
seconds.
tracheostomy surgical opening into the trachea through which an indwelling 27
tube may be inserted.
tracheotomy a surgical incision into the trachea for the purpose of 27
establishing an airway; performed below a blockage by a
foreign body, tumor, or edema of the glottis.
traction the application of a pulling force to an injured or diseased part 63
of the body or an extremity while countertraction pulls in the
opposite direction; traction devices exert a pulling force on a
fractured extremity and may be used to reduce or immobilize a
fracture; may be applied to the skin (skin traction) or to the

bone (skeletal traction).
Traditional Chinese a system of medicine developed in China that is one of the 8
Medicine (TCM) world's oldest and most comprehensive medical systems.
transcultural nursing a specialty that focuses on the comparative study and analysis 3
of cultures and subcultures; the goal is the discovery of
culturally relevant facts that can guide the nurse in providing
culturally appropriate and competent care.
transduction of pain the conversion of a mechanical, thermal, or chemical stimulus 10
into a neuronal action potential.
transient ischemic attack a temporary focal loss of neurologic function caused by 58
(TIA) ischemia of the brain, lasting less than 24 hours, and often
lasting less than 15 minutes; usually associated with partial
occlusion of an artery by atherosclerotic plaque or an
embolism.
transmission of pain movement of pain impulses from the site of transduction to the 10
brain.
transurethral incision of the a surgical procedure in which transurethral incisions or slits 55
prostate are made into prostatic tissue to relieve obstruction.
transurethral resection of a surgical procedure involving the removal of prostate tissue 55
the prostate (TURP) with the use of a resectoscope inserted through the urethra.
triage system that identifies and categorizes patients so the most 69
critical are treated first.
trigeminal neuralgia a neurologic condition of the trigeminal facial nerve, 61
characterized by paroxysms of flashing, stablike pain radiating
along the course of a branch of the nerve from the angle of the
jaw.; it is caused by degeneration of the nerve or by pressure
on it.
trigger a substance, object, or agent that initiates or stimulates an 29
action; in asthma, any stimuli that initiates the IgE–mast cell
mediated response resulting in the pathophysiologic
responses of asthma.
trigger point a circumscribed hypersensitive area within a tight band of 10
muscle that is caused by acute or chronic muscle strain.
triiodothyronine (T3) hormone produced by the thyroid gland; regulates growth and 48
development, helps control metabolism and body temperature,
and acts to inhibit the secretion of thyrotropin by the pituitary
gland.
tropic hormone a hormone secreted by one gland that stimulates another 48
gland to synthesize and secrete its hormones (i.e., thyrotropin
from the anterior pituitary gland stimulates the thyroid gland to
synthesize and secrete thyroid hormones).
tube feeding the administration of a nutritionally balanced liquefied food or 40
formula through a tube inserted into the stomach, duodenum,
or jejunum.
tuberculosis an infectious disease caused by Mycobacterium tuberculosis; 28
usually involves the lungs but also occurs in the larynx,
kidneys, bones, adrenal glands, lymph nodes, and meninges
and can be disseminated throughout the body.
tumor angiogenesis the process of the formation of blood vessels within the tumor 16
itself.
tumor suppressor genes genes that suppress neoplastic growth. 16
ulcerative colitis chronic inflammatory bowel disease that causes ulceration of 43
the colon and rectum.
unconsciousness abnormal state of complete or partial unawareness of self or 57
environment.
undernutrition a state of poor nourishment as a result of inadequate diet or 40

diseases that interfere with normal appetite and assimilation of
ingested food.
unlicensed assistive unlicensed individual who is trained to function in an assistive 1
personnel role to the professional nurse.
unstable angina angina that is new in onset, occurs at rest, or has a worsening 34
pattern.
upper motor neuron the neuron that originates in the cerebral cortex and projects 56
downward to the spinal cord; these neurons influence skeletal
muscle movement.
uremia the presence of excessive amounts of urea and other 47
nitrogenous waste products in the blood; renal function
declines to the point that symptoms develop in multiple body
systems.
urethritis inflammation of the urethra. 46
urinalysis analysis of urine for color, pH, specific gravity, osmolality, and 45
normal and abnormal constituents.
urinary incontinence an uncontrolled leakage of urine as a result of cerebral 46
clouding and/or physical factors that make it difficult to get to
the bathroom facilities on time.
urinary retention the inability to empty the bladder despite micturition or the 46
accumulation of urine in the bladder because of an inability to
urinate.
urosepsis urinary tract infection that has spread into the systemic 46
circulation; life-threatening condition requiring emergency
treatment.
uterine prolapse the downward displacement of the uterus into the vaginal 54
canal as a result of impaired pelvic support.
valence the electrical charge of an ion that is a numeric expression of 17
the capability of an element to combine chemically with other
elements.
Valsalva maneuver a maneuver that involves contraction of the chest muscles on 39
a closed glottis with simultaneous contraction of the abdominal
muscles.
values the sets of rules by which individuals, families, groups, and 3
communities live.
varicocele a dilation of the veins that drain the testes. 55
varicose veins dilated, tortuous subcutaneous veins most frequently found in 38
the saphenous system.
vascular dementia the loss of cognitive function resulting from ischemic, ischemic 60
-hypoxic, or hemorrhagic brain lesions caused by
cardiovascular disease.
vasectomy bilateral surgical ligation or resection of the vas deferens 55
performed for the purpose of sterilization.
venereal disease sexually transmitted disease. 53
venous thrombosis the formation of a thrombus (clot) in association with 38
inflammation of the vein.
ventricular assist device device that is applied externally or internally into the path of 66
(VAD) flowing blood to augment or replace the action of the ventricle
of the heart.
ventricular fibrillation a severe derangement of the heart rhythm characterized on 36
ECG by irregular undulations of varying contour and
amplitude.
ventricular tachycardia a condition that occurs when an ectopic focus or foci fire 36
repetitively and the ventricle takes control as the pacemaker.
vertigo a sensation that a person or objects around the person are 21

moving or spinning; usually stimulated by movement of the
head.
vesicants agents that when accidentally infiltrated into the skin cause 16
severe local tissue breakdown and necrosis.
vibration pressing on the chest with the flat of the hands while 29
repeatedly tensing the hand and arm muscles to facilitate
movement of secretions to larger airways.
villi minute, fingerlike projections in the mucous membrane that 39
are the functional units of the small intestine.
violence the acting out of the emotions of fear or anger to cause harm 69
to someone or something.
viral load quantity of viral particles in a biologic sample. 15
Virchow's triad three important factors in the etiology of venous thrombosis: 38
(1) venous stasis, (2) damage of the endothelium (inner lining
of the vein), and (3) hypercoagulability of the blood.
viremia large amounts of virus in the blood, resulting from initial 15
infection with a virus.
virus a minute, parasitic organism that has no independent 15
metabolic activity and may only replicate within a cell of a
living plant or animal host.
volume ventilator a ventilator that delivers a predetermined tidal volume with 66
each inspiration and the amount of pressure needed to deliver
the breath varies based on the compliance and resistance
factors of the patient-ventilator system.
vomiting the forceful ejection of partially digested food and secretions 42
(emesis) from the upper GI tract.
weaning the process of reducing ventilator support and resuming 66
spontaneous ventilation.
Wernicke's encephalopathy an inflammatory, hemorrhagic, degenerative condition of the 12
brain resulting from a deficiency of thiamine; seen in
association with chronic alcoholism.
wheezes a form of rhonchus characterized by continuous high-pitched 26
squeaking sound caused by rapid vibration of bronchial walls.
window period period of 2 months after infection during which an infected 15
individual will not test HIV-antibody positive.
withdrawal constellation of physiologic and psychologic responses that 12
occur when there is abrupt cessation or reduced intake of a
substance on which an individual is dependent or when the
effect is counteracted by a specific antagonist.
wound dehiscence separation and disruption of previously joined wound edges. 20
x-ray the most common diagnostic study used to assess 62
musculoskeletal problems and to monitor the effectiveness of
treatment.
young-old adults a term used to represent adults who are 55 to 75 years of age. 6
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Lewis: Medical-Surgical Nursing, 7th Edition

unstable angina, non–ST-segment-elevation myocardial

alveolar hypoventilation a generalized decrease in ventilation that results in an 68

α-antitrypsin a serum protein produced by the liver normally found in the 29

assist-control mechanical the ventilator delivery of a preset tidal volume at a preset 66

botulism a serious food poisoning caused by GI absorption of the 61

1 minute; a normal, resting adult has a cardiac output of 4 to 8

a nonmalignant condition that often requires surgery for

improve organ perfusion in patients with heart failure when

conscious sedation a minimally depressed level of consciousness with 19

CREST a variant of systemic sclerosis characterized by Calcinosis 65

debridement removal of dirt, foreign objects, damaged tissue, and cellular 25

diabetic neuropathy nerve damage that occurs because of the metabolic 49

dysmenorrhea abdominal cramping pain or discomfort associated with 54

encephalitis an acute inflammation of the brain usually caused by a virus. 57

escharotomy incisions into neurotic tissue from a severe burn performed 25

epithelial lining of the mammary ducts, proliferation of

general survey statement a statement of the provider's general impression of a patient, 4

hemolytic anemia an anemia caused by destruction of red blood cells (RBCs) at 31

human immunodeficiency a retrovirus that causes HIV infection and acquired 15

hypertonic solutions that increase the degree of osmotic pressure on a 17

immunosuppressive therapy that inhibits immune function and is prescribed for 14

reducing systolic pressure) and augmenting the aortic diastolic

keratoconus a noninflammatory, usually bilateral disease of the cornea that 22

local anesthesia the loss of sensation without loss of consciousness. 19

numbers of casualties, physical and emotional suffering, and

at rest: 3.5 ml of oxygen per kilogram per minute or 1.4 cal/kg

myasthenic crisis an acute exacerbation of myasthenia gravis triggered by 59

neuropathic pain pain caused by damage to nerve cells or changes in spinal 10

osteomalacia a rare condition of adult bone associated with vitamin D 64

parathyroid hormone a hormone secreted by the parathyroid glands that acts to 48

subscriber patients of the delivery of care using predetermined

pseudofolliculitis bacterial disorder caused by Staphylococcus aureus that is an 23

retinopathy the process of microvascular damage of the retina; may 22

septic arthritis infectious or bacterial arthritis caused by invasion of the joint 65

spondyloarthropathies a group of interrelated multisystem inflammatory disorders that 65

subarachnoid hemorrhage a stroke resulting from intracranial bleeding into the 58

syphilis a complex disease in which many organs and tissues of the 53

into excitable cells, increasing depolarization; low calcium

fracture; may be applied to the skin (skin traction) or to the

undernutrition a state of poor nourishment as a result of inadequate diet or 40

vertigo a sensation that a person or objects around the person are 21

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