Glossary

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Ernstmeyer & Christman (Eds.)
Chippewa Valley Technical College via OpenRN

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Glossary Entries
Word(s)	Definition	Link
Advanced Practice Nurse (APRN)	An RN who has a graduate degree and advanced knowledge. There are four categories of APRNs: certified nurse-midwife (CNM), clinical nurse specialist (CNS), certified nurse practitioner (CNP), or certified registered nurse anesthetist (CRNA). These nurses can diagnose illnesses and prescribe treatments and medications.^{^[1]}
ANA Standards of Professional Nursing Practice	Authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently. The Standards of Professional Nursing Practice describe a competent level of nursing practice as demonstrated by the critical thinking model known as the nursing process. The nursing process includes the components of assessment, diagnosis, outcomes identification, planning, implementation, and evaluation.^{^[2]}
ANA Standards of Professional Performance	Standards that describe a competent level of behavior in the professional role of the nurse, including activities related to ethics, advocacy, respectful and equitable practice, communication, collaboration, leadership, education, scholarly inquiry, quality of practice, professional practice evaluation, resource stewardship, and environmental health.^{^[3]}
Basic nursing care	Care that can be performed following a defined nursing procedure with minimal modification in which the responses of the patient to the nursing care are predictable.^{^[4]}
Board of Nursing	The state-specific licensing and regulatory body that sets the standards for safe nursing care, decides the scope of practice for nurses within its jurisdiction, and issues licenses to qualified candidates.
Chain of command	A hierarchy of reporting relationships in an agency that establishes accountability and lays out lines of authority and decision-making power.
Code of ethics	A code that applies normative, moral guidance for nurses in terms of what they ought to do, be, and seek. A code of ethics makes the primary obligations, values, and ideals of a profession explicit.
Dysphagia	Impaired swallowing.	https://med.libretexts.org/Bookshelv...3A_I._Glossary
Ethical principle	An ethical principle is a general guide, basic truth, or assumption that can be used with clinical judgment to determine a course of action. Four common ethical principles are beneficence (do good), nonmaleficence (do no harm), autonomy (control by the individual), and justice (fairness).
Evidence-based practice	A lifelong problem-solving approach that integrates the best evidence from well-designed research studies and evidence-based theories; clinical expertise and evidence from assessment of the health consumer’s history and condition, as well as health care resources; and patient, family, group, community, and population preferences and values.^{^[5]}
Expressive aphasia	The impaired ability to form words and speak.
Licensed Practical Nurse/Vocational Nurse (LPN/LVN)	An individual who has completed a state-approved practical or vocational nursing program, passed the NCLEX-PN examination, and is licensed by their state Board of Nursing to provide patient care.^{^[6]}
Malpractice	A specific term that looks at a standard of care, as well as the professional status of the caregiver.^{^[7]}
Morality	Personal values, character, or conduct of individuals within communities and societies.^{^[8]}
Negligence	A “general term that denotes conduct lacking in due care, carelessness, and a deviation from the standard of care that a reasonable person would use in a particular set of circumstances.”^{^[9]}
Nurse Licensure Compact (NLC)	Allows a nurse to have one multistate license with the ability to practice in the home state and other compact states.
Nursing	Nursing integrates the art and science of caring and focused on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence. Nursing is the diagnosis and treatment of human responses and advocacy in the care of individuals, families, groups, communities, and populations in recognition of the connection of all humanity.^{^[10]}
Nurse Practice Act (NPA)	Legislation enacted by each state that establishes regulations for nursing practice within that state by defining the requirements for licensure, as well as the scope of nursing practice.
Patient confidentiality	Keeping your patient’s Protected Health Information (PHI) protected and known only by those health care team members directly providing care for the patient.
Primary care	Care that is provided to patients to promote wellness and prevent disease from occurring. This includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations.
Protocol	A precise and detailed written plan for a regimen of therapy.^{^[11]}
Provider	A physician, podiatrist, dentist, optometrist, or advanced practice nurse provider.^{^[12]}
Quality	The degree to which nursing services for health care consumers, families, groups, communities, and populations increase the likelihood of desirable outcomes and are consistent with evolving nursing knowledge.”^{^[13]}
Registered Nurse (RN)	An individual who has graduated from a state-approved school of nursing, passed the NCLEX-RN examination, and is licensed by a state board of nursing to provide patient care.^{^[14]}
Safety culture	A culture established within health care agencies that empowers nurses, nursing students, and other staff members to speak up about risks to patients and to report errors and near misses, all of which drive improvement in patient care and reduce the incident of patient harm.
Scope of practice	Services that a qualified health professional is deemed competent to perform and permitted to undertake – in keeping with the terms of their professional license.
Secondary care	Care that occurs when a person has contracted an illness or injury and is in need of medical care.
Tertiary care	A type of care that deals with the long-term effects from chronic illness or condition, with the purpose to restore physical and mental function that may have been lost. The goal is to achieve the highest level of functioning possible with this chronic illness.
Unlicensed Assistive Personnel	Any unlicensed person, regardless of title, who performs tasks delegated by a nurse. This includes certified nursing aides/assistants (CNAs), patient care assistants (PCAs), patient care technicians (PCTs), state tested nursing assistants (STNAs), nursing assistants-registered (NA/Rs) or certified medication aides/assistants (MA-Cs). Certification of UAPs varies between jurisdictions.^{^[15]}
Aphasia	A communication disorder that results from damage to portions of the brain that are responsible for language.
Assertive communication	A way to convey information that describes the facts, the sender’s feelings, and explanations without disrespecting the receiver’s feelings. This communication is often described as using “I” messages: “I feel…,” “I understand…,” or “Help me to understand…”
Bedside nurse handoff report	A handoff report in hospitals that involves patients, their family members, and both the off-going and the incoming nurses. The report is performed face to face and conducted at the patient’s bedside.
Broca’s aphasia	A type of aphasia where patients understand speech and know what they want to say, but frequently speak in short phrases that are produced with great effort. People with Broca’s aphasia typically understand the speech of others fairly well. Because of this, they are often aware of their difficulties and can become easily frustrated.
Charting by exception	A type of documentation where a list of “normal findings” is provided and nurses document assessment findings by confirming normal findings and writing brief documentation notes for any abnormal findings.
DAR	A type of documentation often used in combination with charting by exception. DAR stands for Data, Action, and Response. Focused DAR notes are brief, and each note is focused on one patient problem for efficiency in documenting, as well as for reading.
Electronic Health Record (EHR)	A digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.
Global aphasia	A type of aphasia that results from damage to extensive portions of the language areas of the brain. Individuals with global aphasia have severe communication difficulties and may be extremely limited in their ability to speak or comprehend language. They may be unable to say even a few words or may repeat the same words or phrases over and over again. They may have trouble understanding even simple words and sentences.
Handoff report	A process of exchanging vital patient information, responsibility, and accountability between the off-going and incoming nurses in an effort to ensure safe continuity of care and the delivery of best clinical practices.
ISBARR	A mnemonic for the format of professional communication among health care team members that includes Introduction, Situation, Background, Assessment, Request/Recommendations, and Repeat back.
Minimum Data Set (MDS)	A federally mandated assessment tool used in skilled nursing facilities to track a patient’s goal achievement, as well as to coordinate the efforts of the health care team to optimize the resident’s quality of care and quality of life.
Narrative note	A type of documentation that chronicles all of the patient’s assessment findings and nursing activities that occurred throughout the shift.
Nontherapeutic responses	Responses to patients that block communication, expression of emotion, or problem-solving.
Progressive relaxation	Types of relaxation techniques that focus on reducing muscle tension and using mental imagery to induce calmness.
Relaxation breathing	A breathing technique used to reduce anxiety and control the stress response.
SOAPIE	A mnemonic for a type of documentation that is organized by six categories: Subjective, Objective, Assessment, Plan, Interventions, and Evaluation.
Therapeutic communication	The purposeful, interpersonal information transmitting process through words and behaviors based on both parties’ knowledge, attitudes, and skills, which leads to patient understanding and participation.
Therapeutic communication techniques	Techniques that encourage patients to explore feelings, problem solve, and cope with responses to medical conditions and life events.
Verbal communication	Exchange of information using words understood by the receiver.
Assimilation	The process of adopting or conforming to the practices, habits, and norms of a cultural group. As a result, the person gradually takes on a new cultural identity and may lose their original identity in the process.
Bias	To carry an attitude, opinion, or inclination (positive or negative) towards a group or members of a group. Bias can be a conscious attitude (explicit), or a person may not be aware of their bias (implicit).
Cultural awareness	A deliberate, cognitive process in which health care providers become appreciative and sensitive to the values, beliefs, lifeways, practices, and problem-solving strategies of a patient’s culture. Cultural awareness goes beyond a simple awareness of the existence of other cultures and involves an interest, curiosity, and appreciation of other cultures.
Cultural competency	The process of applying evidence-based nursing in agreement with the preferred cultural values, beliefs, worldview, and practices of patients to produce improved patient outcomes.
Cultural diversity	Cultural differences in people.
Cultural encounters	A process where the nurse directly engages in face-to-face cultural interactions and other types of encounters with clients from culturally diverse backgrounds in order to modify existing beliefs about a cultural group and to prevent possible stereotyping.
Cultural humility	A humble and respectful attitude toward individuals of other cultures that pushes one to challenge their own cultural biases, realize they cannot know everything about other cultures, and approach learning about other cultures as a lifelong goal and process.^{^[1]}
Cultural negotiation	A process where the patient and nurse seek a mutually acceptable way to deal with competing interests of nursing care, prescribed medical care, and the patient’s cultural needs. Cultural negotiation is reciprocal and collaborative. When the patient’s cultural needs do not significantly or adversely affect their treatment plan, the cultural needs can be accommodated.
Culturally responsive care	Nursing actions that integrate a person’s cultural beliefs into their care.
Culturally safe environment	A safe space for patients to interact with health professionals, without judgment or discrimination, where the patient is free to express their cultural beliefs, values, and identity.
Culture	A set of beliefs, attitudes, and practices shared by a group of people or community that is accepted, followed, and passed down to other members of the group.
Discrimination	Unfair and different treatment of another person or group, denying them opportunities and rights to participate fully in society.
Ethnocentrism	The belief that one’s culture (or race, ethnicity, or country) is better and preferable than another’s.
Gender expression	A person’s outward demonstration of gender in relation to societal norms, such as in style of dress, hairstyle, or other mannerisms.
Gender identity	A person’s inner sensibility that they are a man, a woman, or perhaps neither.
Health disparities	Differences in health outcomes resulting from entrenched economic, sociopolitical, or environmental disadvantages. Health disparities negatively impact groups of people based on their ethnicity, gender, age, mental health, disability, sexual orientation or gender identity, socioeconomic status, geographic location, or other characteristics historically linked to discrimination or exclusion.
Health care disparities	Differences in access to health care and insurance coverage.
Holism	Treatment of the whole person, including physical, mental, spiritual, and social needs.	https://med.libretexts.org/Bookshelv...A_III_Glossary
Intersectionality	The many ways in which a person expresses their cultural identity are not separated, but are closely intertwined.
Justice	A principle and moral obligation to act on the basis of equality and equity; a standard linked to fairness for all in society.^{^[2]}
LGBTQ	Lesbian, gay, bisexual, transgender, queer, or questioning in reference to sexual orientation.
Prejudice	To “prejudge”; a preconceived idea, often unfavorable, about a person or group of people.
Race	A socially constructed idea; there are no truly genetically or biologically distinct races. Humans are biologically similar to each other, not different.
Racism	The presumption that races are distinct from one another and there is a hierarchy to race, implying that races are unequal. In racism, expression of one’s cultural beliefs is viewed as a heritable trait.
Sexual orientation	A person’s physical and emotional interest or desire for others. Sexual orientation is on a continuum and is manifested in one’s self-identity and behaviors.
Social determinants of health	Nonmedical factors that influence health outcomes, including conditions in which people are born, grow, work, live, and age, and the wider sets of forces and systems shaping the conditions of daily life.^{^[3]}
Social justice	Equal rights, equal treatment, and equitable opportunities for all.^{^[4]}
Stereotyping	Assuming that a person has the attributes, traits, beliefs, and values of a group because they are a member of that group.
Subculture	A smaller group of people within a larger culture, often based on a person’s occupation, hobbies, interests, or place of origin.
Transcultural nursing	Incorporating cultural beliefs and practices of people to help them maintain and regain health or to face death in a meaningful way.
Advocacy	The act or process of pleading for, supporting, or recommending a cause or course of action.^{^[1]}
Art of nursing	Unconditionally acceptance of the humanity of others, respecting their need for dignity and worth, while providing compassionate, comforting care.^{^[2]}
At-risk populations	Groups of people who share a characteristic that causes each member to be susceptible to a particular human response, such as demographics, health/family history, stages of growth/development, or exposure to certain events/experiences.^{^[3]}
Associated conditions	Medical diagnoses, injuries, procedures, medical devices, or pharmacological agents. These conditions are not independently modifiable by the nurse, but support accuracy in nursing diagnosis.^{^[4]}
Basic nursing care	Care that can be performed following a defined nursing procedure with minimal modification in which the responses of the patient to the nursing care are predictable.^{^[5]}
Caring relationship, care relationship	A relationship described as one in which the whole person is assessed while balancing the vulnerability and dignity of the patient and family.^{^[6]}
Client	Individual, family, or group, which includes significant others and populations.^{^[7]}
Clinical judgment	The observed outcome of critical thinking and decision-making. It is an iterative process that uses nursing knowledge to observe and access presenting situations, identify a prioritized client concern, and generate the best possible evidence-based solutions in order to deliver safe client care.^{^[8]}
Clinical reasoning	A complex cognitive process that uses formal and informal thinking strategies to gather and analyze patient information, evaluate the significance of this information, and weigh alternative actions. ^{^[9]}
Clustering data	Grouping data into similar domains or patterns.
Collaborative nursing interventions	Nursing interventions that require cooperation among health care professionals and unlicensed assistive personnel (UAP).
Coordination of care	While implementing interventions during the nursing process, includes components such as organizing the components of the plan with input from the health care consumer, engaging the patient in self-care to achieve goals, and advocating for the delivery of dignified and person-centered care by the interprofessional team.^{^[10]}
Critical thinking	Reasoning about clinical issues such as teamwork, collaboration, and streamlining workflow.^{^[11]}
Cue	Subjective or objective data that gives the nurse a hint or indication of a potential problem, process, or disorder.
Deductive reasoning	“Top-down thinking” or moving from the general to the specific. Deductive reasoning relies on a general statement or hypothesis—sometimes called a premise or standard—that is held to be true. The premise is used to reach a specific, logical conclusion.
Defining characteristics	Observable cues/inferences that cluster as manifestations of a problem-focused, health-promotion diagnosis, or syndrome. This does not only imply those things that the nurse can see, but also things that are seen, heard (e.g., the patient/family tells us), touched, or smelled.^{^[12]}
Delegation	The assignment of the performance of activities or tasks related to patient care to unlicensed assistive personnel while retaining accountability for the outcome.^{^[13]}
Dependent nursing interventions	Interventions that require a prescription from a physician, advanced practice nurse, or physician’s assistant.
Direct care	Interventions that are carried out by having personal contact with a patient.
Electronic Medical Record (EMR)	An electronic version of the patient’s medical record.
Evidence-Based Practice (EBP)	A lifelong problem-solving approach that integrates the best evidence from well-designed research studies and evidence-based theories; clinical expertise and evidence from assessment of the health care consumer’s history and condition, as well as health care resources; and patient, family, group, community, and population preferences and values.^{^[14]}
Expected outcomes	Statements of measurable action for the patient within a specific time frame and in response to nursing interventions. “SMART” outcome statements are specific, measurable, action-oriented, realistic, and include a time frame.
Functional health patterns	An evidence-based assessment framework for identifying patient problems and risks during the assessment phase of the nursing process.
Generalization	A judgment formed from a set of facts, cues, and observations.
Goals	Broad statements of purpose that describe the aim of nursing care.
Health teaching and health promotion	Employing strategies to teach and promote health and wellness.^{^[15]}
Independent nursing interventions	Any intervention that the nurse can provide without obtaining a prescription or consulting anyone else.
Indirect care	Interventions performed by the nurse in a setting other than directly with the patient. An example of indirect care is creating a nursing care plan.
Inductive reasoning	A type of reasoning that involves forming generalizations based on specific incidents.
Inference	Interpretations or conclusions based on cues, personal experiences, preferences, or generalizations.
Licensed Practical Nurses or Licensed Vocational Nurses (LPNs/LVNs)	Nurses who have had specific training and passed a licensing exam. The training is generally less than that of a Registered Nurse. The scope of practice of an LPN/LVN is determined by the facility and the state’s Nurse Practice Act.
Medical diagnosis	A disease or illness diagnosed by a physician or advanced health care provider such as a nurse practitioner or physician’s assistant. Medical diagnoses are a result of clustering signs and symptoms to determine what is medically affecting an individual.
Nursing	Nursing integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence. Nursing is the diagnosis and treatment of human responses and advocacy in the care of individuals, families, groups, communities, and populations in the recognition of the connection of all humanity.^{^[16]}
Nursing care plan	Specific documentation of the planning and delivery of nursing care that is required by The Joint Commission.
Nursing process	A systematic approach to patient-centered care with steps including assessment, diagnosis, outcome identification, planning, implementation, and evaluation; otherwise known by the mnemonic “ADOPIE.”
Objective data	Data that the nurse can see, touch, smell, or hear or is reproducible such as vital signs. Laboratory and diagnostic results are also considered objective data.
Outcome	A measurable behavior demonstrated by the patient that is responsive to nursing interventions.^{^[17]}
PES Statement	The format of a nursing diagnosis statement that includes: Problem (P) – statement of the patient problem (i.e., the nursing diagnosis) Etiology (E) – related factors (etiology) contributing to the cause of the nursing diagnosis Signs and Symptoms (S) – defining characteristics manifested by the patient of that nursing diagnosis
Prescription	Orders, interventions, remedies, or treatments ordered or directed by an authorized primary health care provider.^{^[18]}
Primary data	Information collected from the patient.
Primary health care provider	Member of the health care team (usually a medical physician, nurse practitioner, etc.) licensed and authorized to formulate prescriptions on behalf of the client.^{^[19]}
Prioritization	The skillful process of deciding which actions to complete first, second, or third for optimal patient outcomes and to improve patient safety.
Quality improvement	The “combined and unceasing efforts of everyone — health care professionals, patients and their families, researchers, payers, planners, and educators — to make the changes that will lead to better patient outcomes (health), better system performance (care), and better professional development (learning).”^{^[20]}
Rapport	Developing a relationship of mutual trust and understanding.
Registered Nurse (RN)	A nurse who has had a designated amount of education and training in nursing and is licensed by a state Board of Nursing.
Related factors	The underlying cause (etiology) of a nursing diagnosis when creating a PES statement.
Right to self-determination	Patients have the right to determine what will be done with and to their own person.
Scientific method	Principles and procedures in the discovery of knowledge involving the recognition and formulation of a problem, the collection of data, and the formulation and testing of a hypothesis.
Secondary data	Information collected from sources other than the patient.
Subjective data	Data that the patient or family reports or data that the nurse makes as an inference, conclusion, or assumption, such as “The patient appears anxious.”
Unlicensed Assistive Personnel (UAP)	Any unlicensed personnel trained to function in a supportive role, regardless of title, to whom a nursing responsibility may be delegated.^{^[21]}
At-risk behavior	According to the Just Culture model, an error that occurs when a behavioral choice is made that increases risk where risk is not recognized or is mistakenly believed to be justified.
Chemical restraint	A drug used to manage a patient’s behavior, restrict the patient’s freedom of movement, or impair the patient’s ability to appropriately interact with their surroundings that is not a standard treatment or dosage for the patient’s condition.
Culture of safety	The behaviors, beliefs, and values within and across all levels of an organization as they relate to safety and clinical excellence, with a focus on people.
Handoff reports	A transfer and acceptance of patient care responsibility achieved through effective communication. It is a real-time process of passing patient specific information from one caregiver to another, or from one team of caregivers to another, for the purpose of ensuring the continuity and safety of the patient’s care.
Healthy environment	A place of physical, mental, and social well-being supporting optimal health and safety.
Human factors	A science that focuses on the interrelationships between humans, the tools and equipment they use in the workplace, and the environment in which they work.
Intimate Partner Violence (IPV)	Physical or sexual violence, stalking, and psychological or coercive aggression by current or former intimate partners.
ISBARR	A mnemonic for the components of health care team member communication that stands for Introduction, Situation, Background, Assessment, Request/Recommendations, and Repeat back.
Just Culture	A quality of an institutional culture of safety where people feel safe raising questions and concerns and reporting safety events in an environment that emphasizes a nonpunitive response to errors and near misses, but clear lines are drawn between human error, at-risk, and reckless behaviors.
Learning Culture	A quality of an institutional culture of safety where people regularly collect information and learn from errors and successes. Data is openly shared and evidence-based practices are used to improve work processes and patient outcomes.
National Patient Safety Goals	Annual patient safety goals and recommendations tailored for seven different types of health care agencies based on patient safety data from experts and stakeholders.
Near misses	An unplanned event that did not result in a patient injury or illness but had the potential to.
Never events	Adverse events that are clearly identifiable, measurable, serious (resulting in death or significant disability), and preventable.
Reckless behavior	According to the Just Culture model, an error that occurs when an action is taken with conscious disregard for a substantial and unjustifiable risk.
Reporting Culture	A quality of an institutional culture of safety where people realize errors are inevitable and are encouraged to speak up for patient safety by reporting errors and near misses.
Restraint	A device, method, or process that is used for the specific purpose of restricting a patient’s freedom of movement without the permission of the person.
Root cause analysis	A structured method used to analyze serious adverse events to identify underlying problems that increase the likelihood of errors, while avoiding the trap of focusing on mistakes by individuals.
Scheduled hourly rounds	Scheduled hourly visits to each patient’s room to integrate fall prevention activities with the rest of a patient’s care.
Seclusion	The confinement of a patient in a locked room from which they cannot exit on their own. It is generally used as a method of discipline, convenience, or coercion.
Sentinel event	An unexpected occurrence involving death or serious physiological or psychological injury or the risk thereof.
Simple human error	According to the Just Culture model, this is an error that occurs when an individual inadvertently does something other than what should have been done. Most errors are the result of human error due to poor processes, programs, education, environmental issues, or situations. These are managed by correcting the cause, looking at the process, and fixing the deviation.
Substance abuse	A maladaptive pattern of continued use of alcohol or a drug despite it causing persistent social, occupational, psychological, or physical problems that can be physically hazardous.
Universal fall precautions	A set of interventions to reduce the risk of falls for all patients and focus on keeping the environment safe and comfortable.
Adult day centers	Care that offers people with dementia and other chronic illnesses the opportunity to be social and to participate in activities in a safe environment, while also giving their caregivers the opportunity to work, run errands, or take a much-needed break.
Ageism	The stereotyping and discrimination against individuals or groups on the basis of their age. Ageism can take many forms, including prejudicial attitudes, discriminatory practices, or institutional policies and practices that perpetuate stereotypical beliefs.	https://med.libretexts.org/Bookshelv...3A_VI_Glossary
Alzheimer’s disease	An irreversible, progressive brain disorder that slowly destroys memory and thinking skills and eventually the ability to carry out the simplest tasks.
Cognition	A term used to describe our ability to think.
Cognitive impairment	Impairment in mental processes that drive how an individual understands and acts in the world, affecting the acquisition of information and knowledge.
Delirium	An acute state of cognitive impairment that typically occurs suddenly due to a physiological cause, such as infection, hypoxia, electrolyte imbalances, drug effects, or other acute brain injury.
Dementia	A chronic condition of impaired cognition, caused by brain disease or injury, marked by personality changes, memory deficits, and impaired reasoning. Dementia can be caused by a group of conditions, such as Alzheimer’s disease, vascular dementia, frontal-temporal dementia, and Lewy body disease. It is gradual, progressive, and irreversible.
Depression	A brain disorder with a variety of causes, including genetic, biological, environmental, and psychological factors.
Development	Biological changes, as well as social and cognitive changes, that occur continuously throughout our lives.
Growth	Physical changes that occur during the development of an individual beginning at the time of conception.
Intellectual disability	A diagnostic term that describes intellectual and adaptive functioning deficits identified during the developmental period prior to the age 18.
Respite care	Care provided at home (by a volunteer or paid service) or in a care setting, such as adult day centers or residential facilities, that allows the caregiver to take a much-needed break.
Sundowning	Increased confusion, anxiety, agitation, pacing, or disorientation in patients with dementia that typically begins at dusk and continues throughout the night.
Cataracts	Opacity of the lens of the eye that causes clouded, blurred, or dim vision. Cataracts can be removed with surgery that replaces the lens with an artificial lens.
Diabetic retinopathy	A complication of diabetes mellitus due to damaged blood vessels in the retina. If found early, treatments, such as laser treatment that can help shrink blood vessels, injections that can reduce swelling, or surgery, can prevent permanent vision loss.
Glaucoma	Gradual loss of peripheral vision caused by elevated intraocular pressure that leads to progressive damage to the optic nerve.
Kinesthetic impairment	An altered sense of touch that can cause difficulty in performing fine motor tasks.
Macular degeneration	Loss of central vision with symptoms such as blurred central vision, distorted vision that causes difficulty driving and reading, and the requirement for brighter lights and magnification for close-up visual activities.
Perception	The interpretation of sensation during the sensory process.
Presbycusis	Age-related hearing loss.
Presbyopia	The impairment of near vision and accommodation as the lens of the eye gradually becomes thicker and loses flexibility as a person ages.
Proprioception	The sense of the position of our bones, joints, and muscles.
Reaction	The response that individuals have to a perception of a received stimulus.
Reception	The initial part of the sensory process when a nerve cell or sensory receptor is stimulated by a sensation.
Sensory deprivation	A condition that occurs when there is a lack of sensations due to sensory impairments or when the environment has few quality stimuli.
Sensory impairment	Any type of difficulty that an individual has with one of their five senses or sensory function.
Sensory overload	A condition that occurs when an individual receives too many stimuli or cannot selectively filter meaningful stimuli.
Somatosensation	Sensory receptors that respond to specific stimuli such as pain, pressure, temperature, and vibration; includes vestibular sensation and proprioception.
Tinnitus	Hearing ringing in the ears.
Vestibular sensation	A sense of spatial orientation and balance.
Apnea	Temporary cessation of breathing. When apnea occurs during sleep, it is often caused by the condition called Obstructive Sleep Apnea (OSA).
Arterial Blood Gas (ABG)	Diagnostic test performed on an arterial sample of blood to determine its pH level, oxygenation status, and carbon dioxide status.
Barrel chest	An increased anterior-posterior chest diameter, resulting from air trapping in the alveoli, that occurs in chronic respiratory disease.
Bilevel Positive Airway Pressure (BiPAP)	A BiPAP is an oxygenation device similar to a CPAP device in its use to prevent airways from collapsing, but it has two pressure settings. One setting occurs during inhalation and a lower pressure setting is used during exhalation. BiPAP devices may be used in the home to treat obstructive sleep apnea or in hospitals to treat patients in acute respiratory distress. For more information, see the “Oxygenation Equipment” section of the “Oxygen Therapy” chapter in Open RN Nursing Skills.
Bradypnea	Decreased respiratory rate less than the normal range according to the patient’s age.
Cardiac output	The amount of blood the heart pumps in one minute.
Continuous Positive Airway Pressure (CPAP)	A CPAP is an oxygenation device is typically used for patients who are able to breath spontaneously but need assistance in keeping their airway unobstructed, such as those with obstructive sleep apnea. The CPAP device consists of a mask that covers the patient’s nose, or nose and mouth, and is attached to a machine that continuously applies mild air pressure to keep the airways from collapsing. For more information, see the “Oxygenation Equipment” section of the “Oxygen Therapy” chapter in Open RN Nursing Skills.
Clubbing	Enlargement of the fingertips that occurs with chronic hypoxia.
Coughing and deep breathing	A breathing technique where the patient is encouraged to take deep, slow breaths and then exhale slowly. After each set of breaths, the patient should cough. This technique is repeated 3 to 5 times every hour.
Cyanosis	Bluish discoloration of the skin and mucous membranes.
Dyspnea	A subjective feeling of not getting enough air. Depending on severity, dyspnea causes increased levels of anxiety.
Endotracheal Tube (ET tube)	An ET tube is inserted by an advanced practitioner to maintain a secure airway when a patient is experiencing respiratory failure or is receiving general anesthesia. For more information, see the “Oxygenation Equipment” section of the “Oxygen Therapy” chapter in Open RN Nursing Skills.
HCO3	Bicarbonate level of arterial blood indicated in an arterial blood gas (ABG) result. Normal range is 22-26.
Huffing technique	A technique helpful for patients who have difficulty coughing. Teach the patient to inhale with a medium-sized breath and then make a sound like “ha” to push the air out quickly with the mouth slightly open.
Hypercapnia	Elevated level of carbon dioxide in the blood.	https://med.libretexts.org/Bookshelv..._VIII_Glossary
Hypoxemia	A specific type of hypoxia that is defined as decreased partial pressure of oxygen in the blood (PaO2) indicated in an arterial blood gas (ABG) result.
Hypoxia	A reduced level of tissue oxygenation. Hypoxia has many causes, ranging from respiratory and cardiac conditions to anemia.
Incentive spirometer	A medical device commonly prescribed after surgery to reduce the buildup of fluid in the lungs and to prevent pneumonia. While sitting upright, the patient should breathe in slowly and deeply through the tubing with the goal of raising the piston to a specified level. The patient should attempt to hold their breath for 5 seconds, or as long as tolerated, and then rest for a few seconds. This technique should be repeated by the patient 10 times every hour while awake.
Mechanical ventilator	A mechanical ventilator is a machine attached to an endotracheal tube to assist or replace spontaneous breathing. For more information, see the “Oxygenation Equipment” section of the “Oxygen Therapy” chapter in Open RN Nursing Skills.
Orthopnea	Difficulty in breathing that occurs when lying down and is relieved upon changing to an upright position.
PaCO2	Partial pressure of carbon dioxide level in arterial blood indicated in an ABG result. Normal range is 35-45 mmHg.
PaO2	Partial pressure of oxygen level in arterial blood indicated in an ABG result. Normal range is 80-100 mmHg.
Perfusion	The passage of blood through the arteries to an organ or tissue.
Pursed-lip breathing	A breathing technique that encourages a person to inhale through the nose and exhale through the mouth at a slow, controlled flow.
Purulent sputum	Yellow or green sputum that often indicates a respiratory infection.
Respiration	Gas exchange occurs at the alveolar level where blood is oxygenated and carbon dioxide is removed.
SaO2	Calculated oxygen saturation level in an ABG result. Normal range is 95-100%.
SpO2	Hemoglobin saturation level measured by pulse oximetry. Normal range is 94-98%.
Sputum	Mucus and other secretions that are coughed up from the mouth.
Tachypnea	Elevated respiratory rate above normal range according to the patient’s age.
Tripod position	A position that enhances air exchange when a patient sits up and leans over by resting their arms on their legs or on a bedside table; also referred to as a three-point position.
Ventilation	Mechanical movement of air into and out of the lungs.
Vibratory Positive Expiratory Pressure (PEP) Therapy	Handheld devices such as flutter valves or Acapella devices used with patients who need assistance in clearing mucus from their airways.
Acute self-limiting infections, self-limiting infections	Infections that develop rapidly and generally last only 10-14 days. Colds, ear infections, and coughs are considered acute, self-limiting infections.
Antibodies	Y proteins created by B cells that are specific to each pathogen and lock onto its surface and mark it for destruction by other immune cells. The five classes of antibodies are IgG, IgM, IgA, IgD, and IgE.
Aseptic technique	The purposeful reduction of pathogens to prevent the transfer of microorganisms from one person or object to another during a medical procedure. For example, a nurse administering parenteral medication or performing urinary catheterization uses aseptic technique. When performed properly, aseptic technique prevents contamination and transfer of pathogens to the patient from caregiver hands, surfaces, and equipment during routine care or procedures.
B cells	Immune cells that mature in the bone marrow. B cells make Y-shaped proteins called antibodies that are specific to each pathogen and lock onto its surface and mark it for destruction by other immune cells.
Bacteremia	The presence of bacteria in blood.
Chronic infections	Infections that may persist for months. Hepatitis and mononucleosis are examples of chronic infections.
Cytokines	Plasma proteins that communicate with other body organs and cells in the body to respond to and initiate inflammation.
Cytokine storm	A severe immune reaction in which the body releases too many cytokines into the blood too quickly. A cytokine storm can occur as a result of an infection, autoimmune condition, or other disease. Signs and symptoms include high fever, inflammation, severe fatigue, and nausea. A cytokine storm can be severe or life-threatening and lead to multiple organ failure.^{^[1]}
Disease	Infections can lead to disease that causes signs and symptoms resulting in a deviation from the normal structure or functioning of the host.
Disinfection	Removal of organisms from inanimate objects and surfaces. However, disinfection does not typically destroy all spores and viruses.
Exposure	An encounter with a potential pathogen.
Hand hygiene	Cleaning the hands by either washing hands with soap and water or using hand sanitizer.
Healthcare-Associated Infection (HAI)	An infection that is contracted in a health care facility or under medical care.
Incubation period	The period of a disease after the initial entry of the pathogen into the host but before symptoms develop.
Infection	The invasion and growth of a microorganism within the body.
Inflammation	A response triggered by a cascade of chemical mediators that occur when pathogens successfully breach the nonspecific physical defenses of the immune system or when an injury occurs.
Invasion	The spread of a pathogen throughout local tissues or the body.
Local infection	Infection confined to a small area of the body, typically near the portal of entry, and usually presents with signs of redness, warmth, swelling, warmth, and pain. Purulent drainage may be present and extensive tissue involvement can cause decreased function.
Microbiome	Every human being carries their own individual suite of microorganisms in and on their body referred to as their microbiome. A person’s microbiome is acquired at birth and evolves over their lifetime. It is different across body sites and between individuals.
Mode of transmission	The vehicle by which the organism is transferred such as physical contact, droplets, or airborne. The most common vehicles are a cough, sneeze, or on the hands.
Nonspecific innate immunity	A system of defenses in the body that targets invading pathogens in a nonspecific manner that is present from the moment we are born. Nonspecific innate immunity includes physical defenses, chemical defenses, and cellular defenses.
Normal flora	Microorganisms that live on our skin and in the nasopharynx and gastrointestinal tracts and don’t cause an infection unless the host becomes susceptible.
Opportunistic pathogen	A pathogen that only causes disease in situations that compromise the host’s defenses, such as the body’s protective barriers, immune system, or normal microbiota. Individuals susceptible to opportunistic infections include the very young, the elderly, women who are pregnant, patients undergoing chemotherapy, people with immunodeficiencies (such as acquired immunodeficiency syndrome [AIDS]), patients who are recovering from surgery, and those who have had a breach of protective barriers (such as a severe wound or burn).
Pathogen	Microorganisms that cause disease.
Pathogenicity	The ability of a microorganism to cause disease.
Peristalsis	A series of muscular contractions in the digestive tract that moves digested material and microbes through the intestine and excretes it in the feces.
Personal Protective Equipment (PPE)	Gloves, gowns, face shields, goggles, and masks used to prevent the spread of infection to and from patients and health care providers.
Portal of entry	An anatomic site through which pathogens can pass into a host, such as mucous membranes, skin, respiratory, or digestive systems.
Portal of exit	The method by which the organism leaves the reservoir as through secretions, blood, urine, breast milk, or feces.
Primary pathogen	A pathogen that can cause disease in a host regardless of the host’s resident microbiota or immune system.
Prodromal period	The disease stage after the incubation period when the pathogen continues to multiply and the host begins to experience general signs and symptoms of illness that result from activation of the immune system, such as fever, pain, soreness, swelling, or inflammation. Usually, such signs and symptoms are too general to indicate a particular disease.
Reservoir	The place the organism grows such as a wound, blood, or food.
Secondary infection	A localized pathogen that spreads to a secondary location.
Sepsis	An existing infection that triggers an exaggerated inflammatory reaction called SIRS throughout the body. If left untreated, sepsis causes tissue damage and quickly spreads to multiple organs. It is a life-threatening medical emergency.
Septicemia	Bacteria that are both present and multiplying in the blood.
Septic shock	Severe sepsis that leads to a life-threatening decrease in blood pressure (systolic pressure <90 mm Hg), preventing cells and other organs from receiving enough oxygen and nutrients. It can cause multi-organ failure and death.
Specific adaptive immunity	The immune response that is activated when the nonspecific innate immune response is insufficient to control an infection. There are two types of adaptive responses: the cell-mediated immune response, which is carried out by T cells, and the humoral immune response, which is controlled by activated B cells and antibodies.
Standard precautions	The minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where health care is delivered.
Sterile technique	A process, also called surgical asepsis, used to eliminate every potential microorganism in and around a sterile field while also maintaining objects as free from microorganisms as possible. It is the standard of care for surgical procedures, invasive wound management, and central line care. Sterile technique requires a combination of meticulous hand washing, creating a sterile field, using long-lasting antimicrobial cleansing agents such as Betadine, donning sterile gloves, and using sterile devices and instruments.
Sterilization	A process used to destroy all pathogens from inanimate objects, including spores and viruses.
Susceptible host	The person whose body the organism has entered.
Systemic infection	An infection that becomes disseminated throughout the body.
Systemic Inflammatory Response Syndrome (SIRS)	An exaggerated inflammatory response to a noxious stressor (including, but not limited to, infection and acute inflammation) that affects the entire body.
T cells	Immune cells that mature in the thymus. T cells are categorized into three classes: helper T cells, regulatory T cells, and cytotoxic T cells. Helper T cells stimulate B cells to make antibodies and help killer cells develop. Killer T cells directly kill cells that have already been infected by a pathogen. T cells also use cytokines as messenger molecules to send chemical instructions to the rest of the immune system to ramp up its response.
Transmission-based precautions	Precautions used for patients with documented or suspected infection, or colonization, of highly-transmissible pathogens, such as C. difficile (C-diff), Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE), Respiratory Syncytial Virus (RSV), measles, and tuberculosis (TB). Three categories of transmission-based precautions are contact precautions, droplet precautions, and airborne precautions.
Virulence	The degree to which a microorganism is likely to become a disease.
Angiogenesis	The process of wound healing when new capillaries begin to develop within the wound 24 hours after injury to bring in more oxygen and nutrients for healing.
Approximated edges	The well-closed edges of a wound healing by primary intention.
Arterial insufficiency	A condition caused by lack of adequately oxygenated blood supply to specific tissues.
Braden Scale	A standardized assessment tool used to assess and document a patient’s risk factors for developing pressure injuries.
Deep tissue pressure injuries	Persistent; non-blanchable; deep red, maroon, or purple discoloration of intact or nonintact skin revealing a dark wound bed or blood-filled blister. Pain and temperature change often precede skin color changes. Discoloration may appear differently in darkly pigmented skin.
Dehiscence	The separation of a surgical incision.
Dermis	The layer of skin underneath under the epidermis, containing hair follicles, sebaceous glands, blood vessels, endocrine sweat glands, and nerve endings.
Epidermis	The very thin, top layer of the skin that contains openings of the sweat gland ducts and the visible part of hair known as the hair shaft.
Epithelialization	The development of new epidermis and granulation tissue in a healing wound.
Eschar	Dark brown/black, dry, thick, and leathery dead tissue in wounds.
Excoriation	Redness and removal of the surface of the topmost layer of skin, often due to maceration or itching.
Friction	The rubbing of skin against a hard object, such as the bed or the arm of a wheelchair. This rubbing causes heat that can remove the top layer of skin and often results in skin damage.
Granulation tissue	New connective tissue in a healing wound with new, fragile, thin-walled capillaries.
Hemostasis phase of wound healing	The first stage of wound healing when clotting factors are released to form clots to stop the bleeding.
Hypodermis	The bottom layer of skin, also referred to as the subcutaneous layer, consisting mainly of adipose tissue or fat, along with some blood vessels and nerve endings. Beneath this layer lies muscles, tendons, ligaments, and bones.
Impaired skin integrity	Altered epidermis and/or dermis.
Impaired tissue integrity	Damage to deeper layers of the skin or other integumentary structures. The NANDA-I definition of impaired tissue integrity is, “Damage to the mucous membrane, cornea, integumentary system, muscular fascia, muscle, tendon, bone, cartilage, joint capsule, and/or ligament.”
Inflammatory phase of wound healing	The second stage of healing when vasodilation occurs to move white blood cells into the wound to start cleaning the wound bed.
Maceration	A condition that occurs when skin has been exposed to moisture for too long causing it to appear soggy, wrinkled, or whiter than usual.
Maturation phase	The final stage of wound healing when collagen continues to be created to strengthen the wound and prevent it from reopening.
Necrosis	Tissue death.
Necrotic	Dead tissue that is black.
Nonblanchable erythema	Skin redness that does not turn white when pressed.
Osteomyelitis	Bone infection.
Pressure injuries	Localized damage to the skin or underlying soft tissue, usually over a bony prominence, as a result of intense and prolonged pressure in combination with shear.
Primary intention	A type of wound that is sutured, stapled, glued, or otherwise closed so the wound heals beneath the closure.
Proliferative phase of wound healing	The third stage of wound healing that begins a few days after injury and includes four processes: epithelialization, angiogenesis, collagen formation, and contraction.
Purulent	Drainage that is thick; opaque; tan, yellow, green, or brown in color. New purulent drainage should always be reported to the health care provider.
Sanguineous	Drainage from a wound that is fresh bleeding.
Secondary intention	A type of healing that occurs when the edges of a wound cannot be brought together, so the wound fills in from the bottom up by the production of granulation tissue. An example of a wound healing by secondary intention is a pressure ulcer.
Serosanguinous	Serous drainage with small amounts of blood present.
Serous	Drainage from a wound that is clear, thin, watery plasma. It’s normal during the inflammatory stage of wound healing, and small amounts are considered normal wound drainage.
Shear	Damage that occurs when tissue layers move over the top of each other, causing blood vessels to stretch and break as they pass through the subcutaneous tissue.
Slough	Inflammatory exudate in wounds that is usually light yellow, soft, and moist.
Stage 1 pressure injuries	Intact skin with a localized area of nonblanchable erythema where prolonged pressure has occurred.
Stage 2 pressure injuries	Partial-thickness loss of skin with exposed dermis. The wound bed is viable and may appear like an intact or ruptured blister.
Stage 3 pressure injuries	Full-thickness tissue loss in which fat is visible, but cartilage, tendon, ligament, muscle, and bone are not exposed. The depth of tissue damage varies by anatomical location. Undermining and tunneling may be present. If slough or eschar obscures the wound so that tissue loss cannot be assessed, the pressure injury is referred to as unstageable.
Stage 4 pressure injuries	Full-thickness tissue loss like Stage 3 pressure injuries but also have exposed cartilage, tendon, ligament, muscle, or bone.
Tertiary intention	The healing of a wound that has had to remain open or has been reopened, often due to severe infection.
Tunneling	Passageways underneath the surface of the skin that extend from a wound and can take twists and turns.
Undermining	A condition that occurs in wounds when the tissue under the wound edges becomes eroded, resulting in a pocket beneath the skin at the wound’s edge.
Unstageable pressure injuries	Full-thickness skin and tissue loss in which the extent of tissue damage within the ulcer cannot be confirmed because it is obscured by slough or eschar.
Venous insufficiency	A condition that occurs when the cardiovascular system cannot adequately return blood and fluid from the extremities to the heart.
Acute pain	Pain that is limited in duration and is associated with a specific cause.
Addiction	A chronic disease of the brain’s reward, motivation, memory, and related circuitry reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by several symptoms, such as the inability to consistently abstain from a substance, impaired behavioral control, cravings, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response.
Adjuvant	Medication that is not classified as an analgesic but has been found in clinical practice to have either an independent analgesic effect or additive analgesic properties when administered with opioids.
Analgesics	Medications used to relieve pain.
Chronic pain	Pain that is ongoing and persistent for longer than six months.
Misuse	Taking prescription pain medications in a manner or dose other than prescribed; taking someone else’s prescription, even if for a medical complaint such as pain; or taking a medication to feel euphoria (i.e., to get high).
Neuropathic pain	Pain caused by a lesion or disease of the somatosensory nervous system that is typically described by patients as “burning” or “like pins and needles.”
Nociceptor	A sensory receptor for painful stimuli.
Pain	An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.
Patient-Controlled Analgesia (PCA)	A method of pain management that allows hospitalized patients with severe pain to safely self-administer opioid medications using a programmed pump according to their level of discomfort.
Physical dependence	Withdrawal symptoms that occur when chronic pain medication is suddenly reduced or stopped because of physiological adaptations that occur from chronic exposure to the medication.
Referred pain	Pain perceived at a location other than the site of the painful stimulus. For example, pain from retained gas in the colon can cause pain to be perceived in the shoulder.
Substance abuse disorder	Significant impairment or distress from a pattern of substance use (i.e., alcohol, drugs or misuse of prescription medications).
Tolerance	A reduced response to pain medication when the same dose of a drug has been given repeatedly, requiring a higher dose of the drug to achieve the same level of response.
Circadian rhythms	Body rhythms that direct a wide variety of functions, including wakefulness, body temperature, metabolism, and the release of hormones. They control the timing of sleep, causing individuals to feel sleepy at night and creating a tendency to wake in the morning without an alarm.
Insomnia	A common sleep disorder that causes trouble falling asleep, staying asleep, or getting good quality sleep. Insomnia interferes with daily activities and causes the person to feel unrested or sleepy during the day. Short-term insomnia may be caused by stress or changes in one’s schedule or environment, lasting a few days or weeks. Chronic insomnia occurs three or more nights a week, lasts more than three months, and cannot be fully explained by another health problem or a medicine. Chronic insomnia raises the risk of high blood pressure, coronary heart disease, diabetes, and cancer.
Microsleep	Brief moments of sleep that occur when a person is awake. A person can’t control microsleep and might not be aware of it.
Narcolepsy	An uncommon sleep disorder that causes periods of extreme daytime sleepiness and sudden, brief episodes of deep sleep during the day.
Non-REM sleep	Slow-wave sleep when restoration takes place and the body’s temperature, heart rate, and oxygen consumption decrease.
REM sleep	Rapid eye movement (REM) sleep when heart rate and respiratory rate increase, eyes twitch, and brain activity increases. Dreaming occurs during REM sleep, and muscles become limp to prevent acting out one’s dreams.
Sleep apnea	A common sleep condition that occurs when the upper airway becomes repeatedly blocked during sleep, reducing or completely stopping airflow. If the brain does not send the signals needed to breathe, the condition may be called central sleep apnea.
Sleep diary	A record of the time a person goes to sleep, wakes up, and takes naps each day for 1-2 weeks. Timing of activities such as exercising and drinking caffeine or alcohol are also recorded, as well as feelings of sleepiness throughout the day.
Sleep study	A diagnostic test that monitors and records data during a patient’s full night of sleep. A sleep study may be performed at a sleep center or at home with a portable diagnostic device.
Sleep-wake homeostasis	The homeostatic sleep drive keeps track of the need for sleep, reminds the body to sleep after a certain time, and regulates sleep intensity. This sleep drive gets stronger every hour a person is awake and causes individuals to sleep longer and more deeply after a period of sleep deprivation.
Active assist range of motion exercise	A patient’s joint receiving partial assistance in movement from an outside force.
Active range of motion	Movement of a joint by the individual performing the exercise.
Ambulation	The ability of a patient to safely walk independently, with assistance from another person, or with an assistive device, such as a cane, walker, or crutches.
Assistive device	An object or piece of equipment designed to help a patient with activities of daily living, such as a walker, cane, gait belt, or mechanical lift.
Bed mobility	The ability of a patient to move around in bed, including moving from lying to sitting and sitting to lying.
Body mechanics	The coordinated effort of muscles, bones, and the nervous system to maintain balance, posture, and alignment during moving, transferring, and repositioning patients.
Fowler’s position, Fowler	A position where the patient is supine with the head of bed placed at a 45- to 90-degree angle. The bed can be used to slightly flex the hips to help prevent the patient from migrating downwards in bed.
Functional mobility	The ability of a person to move around in their environment, including walking, standing up from a chair, sitting down from standing, and moving around in bed.
Gait belt	A 2-inch-wide (5 mm) belt, with or without handles, that is fastened around a patient’s waist used to ensure stability when assisting patients to stand, ambulate, or to transfer from bed to chair.
Lateral positioning	A position where the patient lies on one side of the body with the top leg over the bottom leg. This position helps relieve pressure on the coccyx.
Mechanical lift	A hydraulic lift with a sling used to move patients who cannot bear weight or have a medical condition that does not allow them to stand or assist with moving. It can be a portable device or permanently attached to the ceiling.
Mobility	The ability of a patient to change and control body position. Mobility exists on a continuum ranging from no impairment (i.e., the patient can make major and frequent changes in position without assistance) to being completely immobile (i.e., the patient is unable to make even slight changes in body or extremity position without assistance).
Orthostatic hypotension	Low blood pressure that occurs when a patient changes position from lying to sitting or sitting to standing that causes symptoms of dizziness or light-headedness. Orthostatic hypotension is defined as a drop in systolic blood pressure of 20 mm Hg or more or a drop of diastolic blood pressure of 10 mm Hg or more within three minutes of sitting or standing.
Passive range of motion exercises	Movement applied to a joint solely by another person or a passive motion machine. When passive range of motion is applied, the joint of an individual receiving exercise is completely relaxed while the outside force moves the body part.
Prone positioning	A position where the patient lies on their stomach with their head turned to the side.
Range of motion (ROM) exercises	Activities aimed to facilitate movement of specific joints and promote mobility of extremities.
Semi-Fowler’s position, Semi-Fowler	A position where the head of the bed is placed at a 30- to 45-degree angle. The patient’s hips may or may not be flexed.
Sims positioning	A position where the patient is positioned halfway between the supine and prone positions with their legs flexed.
Sit to stand lifts	Mobility devices that assist weight-bearing patients who are unable to transition from a sitting position to a standing position by using their own strength. They are used to safely transfer patients who have some muscular strength, but not enough strength to safely change positions by themselves. Some sit to stand lifts use a mechanized lift whereas others are nonmechanized.
Slider board	A board (also called a transfer board) used to transfer an immobile patient from one surface to another while the patient is lying supine (e.g., from a stretcher to hospital bed).
Supine positioning	A position where the patient lies flat on their back.
Timed Get Up and Go Test	A mobility assessment by nurses that begins by having the patient stand up from an armchair, walk three yards, turn, walk back to the chair, and sit down. As the patient performs these maneuvers, their posture, alignment, balance, and gait are analyzed as the patient’s mobility status is assessed.
Transferring	The action of a patient moving from one surface to another. This includes moving from a bed into a chair or moving from one chair to another.
Trendelenburg position	A position where the head of the bed is placed lower than the patient’s feet. This position is used in situations such as hypotension and medical emergencies because it helps promote venous return to major organs such as the brain and heart.
Tripod position	A position where the patient sits in a chair with their elbows on their knees or at the side of the bed with their arms resting on an overbed table. This position is often naturally assumed by patients with breathing difficulties.
Vertigo	A sensation of dizziness as if the room is spinning.
Body Mass Index (BMI)	A measure of weight categories including underweight, normal weight, overweight, and obese taking height and weight into consideration.
Calorie-dense foods	Foods with a substantial amount of calories and few nutrients.
Carbohydrates	Sugars and starches that provide an important energy source, providing 4 kcal/g of energy.
Chemical digestion	Breakdown of food with stomach acids, bile, and pancreatic enzymes for nutrient release.
Chyme	Broken-down food that has undergone chemical digestion in the stomach.
Colostrum	A thick yellowish-white fluid rich in proteins and immunoglobulin A (IgA) and lower in carbohydrates and fat than mature breast milk secreted within the first 2-3 days after giving birth.
Complete proteins	Proteins with enough amino acids in enough quantities to perform necessary functions such as growth and tissue maintenance. These must be ingested in the diet.
Complex carbohydrates	Larger molecules of polysaccharides that break down more slowly and release sugar into the bloodstream more slowly than simple carbohydrates.
Dietary Reference Intakes (DRIs)	Set requirements or limit amounts of a certain nutrient, including proteins, carbohydrates, fats, vitamins, minerals, and fiber.
Dysphagia	Difficulty swallowing.	https://med.libretexts.org/Bookshelv...A_XIV_Glossary
Enteral nutrition	Liquid nutrition given through the gastrointestinal tract via a tube while bypassing chewing and swallowing.
Essential nutrients	Nutrients that must be ingested from dietary intake. Essential nutrients cannot be synthesized by the body.
Fat-soluble vitamins	Vitamins that dissolve in fats and oils and are stored in fat tissue and can build up in the liver, resulting in toxicity. Fat-soluble vitamins include vitamins A, D, E, and K.
Fats	Fatty acids and glycerol that are essential for tissue growth, insulation, energy source, energy storage, and hormone production. Fats provide 9 kcal/g of energy.
Glycemic index	A measure of how quickly plasma glucose levels are released into the bloodstream after carbohydrates are consumed.
Incomplete proteins	Proteins that do not contain enough amino acids to sustain life. Incomplete proteins can be combined with other types of proteins to add to amino acids consumed to form complete protein combinations.
Lactation	Breast milk production.
Macrominerals	Minerals needed in larger amounts and measured in milligrams, grams, and milliequivalents.
Macronutrients	Nutrients needed in larger amounts due to energy needs. Macronutrients include carbohydrates, proteins, and fats.
Mastication	The chewing of food in the mouth.
Mechanical digestion	Breaking food down into small chunks through chewing prior to swallowing.
Nitrogen balance	The net loss or gain of nitrogen excreted compared to nitrogen taken into the body in the form of protein consumption; an indicator of protein status where a negative nitrogen balance equates to a protein deficit in the diet and a positive nitrogen balance equates to a protein excess in the diet.
Nutrient-dense foods	Foods with a high proportion of nutritional value relative to calories contained in the food.
Parenteral nutrition	An intravenous solution containing glucose, amino acids, minerals, electrolytes, and vitamins, along with supplemental lipids.
Partially complete proteins	Proteins that have enough amino acids to sustain life, but not enough for tissue growth and maintenance. Typically interchanged with incomplete proteins.
Peristalsis	Coordinated muscle movements in the esophagus that move food or liquid through the esophagus and into the stomach or coordinated muscle movements in the intestines that move food/waste products through the intestines.
Proteins	Sources of peptides, amino acids, and some trace elements that provide 4 kcal/g of energy. Proteins are necessary for tissue repair, tissue function, growth, fluid balance, and clotting, as well as energy in the absence of sufficient intake of carbohydrates.
Refined grains	Grains that have been processed to remove parts of the grain kernel and supply little fiber.
Saturated fats	Fats derived from animal products, such as butter, tallow, and lard for cooking, or from meat products such as steak. Saturated fats are generally solid at room temperature and can raise cholesterol levels, contributing to heart disease.
Simple carbohydrates	Small molecules of monosaccharides or disaccharides that break down quickly and raise blood glucose levels quickly.
Trace minerals	Minerals needed in tiny amounts.
Trans fats	Fats that have been altered through hydrogenation and as such are not in their natural state. Fat is changed to make it harder at room temperature and to make it have a longer shelf life and contributes to increased cholesterol and heart disease.
Unsaturated fats	Fats derived from oils and plants, though chicken and fish contain some unsaturated fats as well. Unsaturated fats are healthier than saturated fats, and some containing omega-3 fatty acids are considered polyunsaturated fats and help lower LDL cholesterol levels.
Water-soluble vitamins	Vitamins that are not stored in the body and include vitamin C and B-complex vitamins: B1 (thiamine), B2 (riboflavin), B3 (niacin), B6 (pyridoxine), B12 (cyanocobalamin), and B9 (folic acid, biotin, and pantothenic acid). Toxicity is rare as excess water-soluble vitamins are excreted in the urine.
Whole grains	Grains with the entire grain kernel that supply more fiber than refined grains.
Active transport	Movement of solutes and ions across a cell membrane against a concentration gradient from an area of lower concentration to an area of higher concentration using energy during the process.
Chvostek’s sign	An assessment sign of acute hypocalcemia characterized by involuntary facial muscle twitching when the facial nerve is tapped.
Diffusion	The movement of solute particles from an area of higher concentration to an area of lower concentration.
Edema	Swelling caused by excessive interstitial fluid retention.
Extracellular fluids (ECF)	Fluids found outside cells in the intravascular or interstitial spaces.
Filtration	Movement of fluids through a permeable membrane utilizing hydrostatic pressure.
Hydrostatic pressure	The pressure that a contained fluid exerts on what is confining it.
Hypercapnia	Elevated levels of retained carbon dioxide in the body.	https://med.libretexts.org/Bookshelv...3A_XV_Glossary
Hypertonic solution	Intravenous fluids with a higher concentration of dissolved particles than blood plasma.
Hypervolemia	Excess intravascular fluid. Used interchangeably with “excessive fluid volume.”
Hypotonic solution	Intravenous fluids with a lower concentration of dissolved particles than blood plasma.
Hypovolemia	Intravascular fluid loss. Used interchangeably with “deficient fluid volume” and “dehydration.”
Interstitial fluids	Fluids found between the cells and outside of the vascular system.
Intracellular fluids (ICF)	Fluids found inside cells consisting of protein, water, and electrolytes.
Intravascular fluids	Fluids found in the vascular system consisting of the body’s arteries, veins, and capillary networks.
Isotonic solution	Intravenous fluids with a similar concentration of dissolved particles as blood plasma.
Oncotic pressure	Pressure inside the vascular compartment created by protein content of the blood (in the form of albumin) that holds water inside the blood vessels.
Osmolality	Proportion of dissolved particles in a specific weight of fluid.
Osmolarity	Proportion of dissolved particles or solutes in a specific volume of fluid.
Osmosis	Movement of fluid through a semipermeable membrane from an area of lesser solute concentration to an area of greater solute concentration.
Passive transport	Movement of fluids or solutes down a concentration gradient where no energy is used during the process.
Renin-Angiotensin-Aldosterone System (RAAS)	A body system that regulates extracellular fluids and blood pressure by regulating fluid output and electrolyte excretion.
Trousseau’s sign	A sign associated with hypocalcemia that causes a spasm of the hand when a blood pressure cuff is inflated.
Urine specific gravity	A measurement of hydration status that measures the concentration of particles in urine.
Anuria	Absence of urine output that is typically found during kidney failure. Can be defined as less than 50 mL of urine over a 24-hour period.
Black stools	Black-colored stools can be caused by iron supplements or bismuth subsalicylate (Pepto-Bismol) taken for an upset stomach.
Bowel incontinence	The loss of bowel control, causing the unexpected passage of stool.
Bowel retraining	Involves teaching the body to have a bowel movement at a certain time of the day.
Constipation	A decrease in normal frequency of defecation accompanied by difficult or incomplete passage of stool and/or passage of excessively hard, dry stool.
Contrast	A special dye administered to patients before some diagnostic tests so that certain areas show up better on the X-rays.
Diarrhea	More than three unformed stools in 24 hours.
Dysuria	Painful or difficult urination.
Enuresis	Incontinence when sleeping (i.e., bedwetting).
Fecal impaction	A condition that occurs when stool accumulates in the rectum usually due to the patient not feeling the presence of stool or not using the toilet when the urge is felt. Large balls of soft stool may need to be digitally removed or treated with mineral oil enemas.
Frequency	Urinary frequency is the need to urinate many times during the day or at night (nocturia) in normal or less-than-normal volumes. It may be accompanied by a feeling of urgency.
Functional incontinence	Occurs in older adults who have normal bladder control but have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly. Patients with dementia also have increased risk for functional incontinence.
Hematuria	Blood in urine, either visualized or found during microscopic analysis.
Intestinal obstruction	A partial or complete blockage of the intestines so that contents of the intestine cannot pass through it.
Meconium	The black to dark green, sticky first bowel movement of a newborn.
Melena	Black, sticky, tar-looking stools. Melena is typically caused by bleeding in the upper part of the gastrointestinal tract, such as the esophagus, stomach, or the first part of the small intestine, or due to the patient swallowing blood. The blood appears darker and tarry-looking because it undergoes digestion on its way through the GI tract.
Mixed urinary incontinence	Urinary frequency, urgency, and stress incontinence.
Nocturia	The need for a patient to get up at night on a regular basis to urinate. Nocturia often causes sleep deprivation that affects a person’s quality of life.
Occult blood	Hidden blood in the stool not visible to the naked eye.
Oliguria	Decreased urine output, defined as less than 500 mL urine in adults in a 24-hour period. In hospitalized patients, oliguria is further defined as less than 0.5 mL of urine per kilogram per hour for adults and children or less than 1 mL of urine per kilogram per hour for infants.
Overflow incontinence	Occurs when small amounts of urine leak from a bladder that is always full. This condition tends to occur in males with enlarged prostates that prevent the complete emptying of the bladder.
Paralytic ileus	A condition where peristalsis is not propelling the contents through the intestines.
Peristalsis	The involuntary contraction and relaxation of the muscles of the intestine creating wave-like movements that push the digested contents forward.
Polyuria	Greater than 2.5 liters of urine output over 24 hours; also referred to as diuresis. Urine is typically clear with no color.
Postvoid residual, post-void residual	A measurement of urine left in the bladder after a patient has voided by using a bladder scanner or straight catheterization.
Pyuria	At least ten white blood cells in each cubic millimeter of urine in a urine sample that typically indicates infection. In some cases, pus may be visible in the urine.
Rectal bleeding	Bright red blood in the stools; also referred to as hematochezia.
Stress urinary incontinence	The involuntary loss of urine on intra-abdominal pressure (e.g., laughing and coughing) or physical exertion (e.g., jumping).
Tarry stools	Stools that are black and sticky that appear like tar; also referred to as melena.
Urgency	A sensation of an urgent need to void. Urgency may be associated with urge incontinence.
Urge urinary incontinence	Also referred to as “overactive bladder”; urine leakage accompanied by a strong desire to void. It can be caused by increased sensitivity to stimulation of the detrusor in the bladder or decreased inhibitory control of the central nervous system.
Urinary retention	A condition when the patient cannot empty all of the urine from their bladder.
Acute grief	Grief that begins immediately after the death of a loved one and includes the separation response and response to stress.
Advance directives	Legal documents that direct care when the patient can no longer speak from themselves, including the living will and the health care power of attorney.
Anorexia	Loss of appetite or loss of desire to eat.
Anticipatory grief	Grief before a loss, associated with diagnosis of an acute, chronic, and/or terminal illness experienced by the patient, family, and caregivers. Examples of anticipatory grief include actual or fear of potential loss or health, independence, body part, financial stability, choice, or mental function.
Bereavement period	The time it takes for the mourner to feel the pain of the loss, mourn, grieve, and adjust to the world without the presence of the deceased.
Burnout	A caregiver’s diminished caring and cynicism that can be triggered by workplace demands, lack of resources to do work professionally and safely, interpersonal relationship stressors, or work policies that can lead to diminished caring and cynicism. Burnout may be manifested physically and psychologically with a loss of motivation.
Cachexia	Wasting of muscle and adipose tissue due to lack of nutrition.
Cardiopulmonary resuscitation (CPR)	Emergency treatment initiated when a patient’s breathing stops or their heart stops beating. It may involve chest compressions and mouth-to-mouth breathing, electric shocks to restart the heart, breathing tubes to open the airway, or cardiac medications.
Comfort care	Care that occurs when the patient’s and medical team’s goals shift from curative interventions to symptom control, pain relief, and quality of life.
Compassion fatigue	A state of chronic and continuous self-sacrifice and/or prolonged exposure to difficult situations that affect a health care professional’s physical, emotional, and spiritual well-being.
Complicated grief	Chronic grief, delayed grief, exaggerated grief, and masked grief are types of complicated grief.
Disenfranchised grief	Any loss that is not validated or recognized.
Do-not-resuscitate (DNR) order	A medical order that instructs health care professionals not to perform cardiopulmonary resuscitation (CPR) if a patient’s breathing stops or if the patient’s heart stops beating.
Fading away	A transition that families make when they realize their seriously ill family member is dying.
Grief	The emotional response to a loss, defined as the individualized and personalized feelings and responses that an individual makes to real, perceived, or anticipated loss.
Health care power of attorney	A legal document that identifies a trusted individual to serve as a decision maker for health issues when the patient is no longer able to speak for themselves.
Hospice care	A type of palliative care that addresses care for patients who are terminally ill when a health care provider has determined they are expected to live six months or less.	https://med.libretexts.org/Bookshelv..._XVII_Glossary
Hospice care	Care that focuses on providing comfort and dignity at the end of life. It involves care and support services that can be of great benefit to people in the final stages of dementia and to their families.	https://med.libretexts.org/Bookshelv...3A_VI_Glossary
Living will	A legal document that describes the patient’s wishes if they are no longer able to speak for themselves due to injury, illness, or a persistent vegetative state. The living will addresses issues like ventilator support, feeding tube placement, cardiopulmonary resuscitation, and intubation.
Loss	The absence of a possession or future possession with the response of grief and the expression of mourning.
Mourning	The outward, social expression of loss. Individuals outwardly express loss based on their cultural norms, customs, and practices, including rituals and traditions.
Normal grief	The common feelings, behaviors, and reactions to loss.
Palliative care	Patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care occurs throughout the continuum of care and involves the interdisciplinary team collaboratively addressing physical, intellectual, emotional, social, and spiritual needs and facilitating patient autonomy, access to information, and choice.
Chaplains	Trained professionals in hospitals, nursing homes, assisted living facilities, and hospices that assist with the spiritual, religious, and emotional needs of patients, families, and staff. Chaplains support and encourage people of all religious faiths and cultures and customize their approach to each individual’s background, age, and medical condition.
Holism	The concept that a human is composed of a mind, body, and soul integrated into an inseparable whole.	https://med.libretexts.org/Bookshelv...XVIII_Glossary
Religion	A unified system of beliefs, values, and practices that a person holds sacred or considers to be spiritually significant. Spiritual practices often unite a moral community called a church. Some people associate religion with a place of worship (e.g., a synagogue or church), a practice (e.g., attending religious services, receiving communion, or going to confession), or a concept that guides one’s daily life (e.g., sin or kharma).
Spiritual distress	A state of suffering related to the impaired ability to experience meaning in life through connections with self, others, the world, or a superior being.
Spirituality	A dynamic and intrinsic aspect of humanity through which persons seek ultimate meaning, purpose, and transcendence and experience relationships to self, family, others, community, society, nature, and the significant or sacred. Spirituality is expressed through beliefs, values, traditions, and practice.
Spiritual well-being	A pattern of experiencing and integrating meaning and purpose in life through connectedness with self, others, art, music, literature, nature, and/or a power greater than oneself.
Transcendence	An understanding of being part of a greater picture or of something greater than oneself, such as the awe one can experience when walking in nature. It can also be expressed as a search for the sacred through subjective feelings, thoughts, and behaviors.
Ageism	Negative stereotypes of older individuals.	https://med.libretexts.org/Bookshelv...A_XIX_Glossary
Gerontology	The study of the social, cultural, psychological, cognitive, and biological aspects of aging.
SPICES tool	Focuses on areas of common problems for aging individuals and can lead to early intervention and treatment.