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NURSING GLOSSARY
24-hour food recall client recall of all the food and beverages
consumed during a typical 24-hour period
Abdominal paracentesis removal of fluids from the peritoneal
cavity
Absorption the process by which a drug passes into the
bloodstream
Accommodation a process of change whereby cognitive
processes mature sufficiently to allow a person to solve
problems that were previously unsolvable
Accountability the ability and willingness to assume
responsibility for one's actions and to accept the
consequences of one's behavior
Acculturation the involuntary process that occurs when people
adapt to or borrow traits from another culture
Acid a substance that releases hydrogen ions ( H + ) in solution
Acidosis a condition that occurs with increases in blood carbonic
acid or with decreases in blood bicarbonate; blood pH
below 7.35
Acquired immunity see Passive immunity
Action stage occurs when a person actively implements
behavioral and cognitive strategies to interrupt previous
behavior patterns and adopt new ones; this stage requires
a great commitment of time and energy
Active euthanasia actions that directly bring about the client's
death with or without consent
Active immunity a resistance of the body to infection in which
the host produces its own antibodies in response to natural
or artificial antigens
Active ROM exercises isotonic exercises in which the client
moves each joint in the body through its complete range,
maximally stretching all muscle groups within each plane
over the joint
Active (transport movement of substances across cell
membranes against the concentration gradient Activity
theory the best way to age is to stay active physically and
mentally
Activity tolerance the type and amount of exercise or daily
activities an individual is able to perform
Activity-exercise pattern refers to a person's pattern of exercise,
activity, leisure, and recreation
Actual loss can be identified by others and can arise either in
response to or in anticipation of a situation
Acupressure a form of healing in which the therapist exerts
finger pressure on specific sites
Acupuncture a form of healing in which the therapist applies
needles to stimulate specific sites of the body
Acute confusion also called delirium; abrupt onset of confusion
and a reversible cause
Acute illness typically characterized by severe symptoms of
relatively short duration
Acute infection those that generally appear suddenly or last a
short time
Acute pain pain that lasts only through the expected recovery
period (less than 6 months), whether it has a sudden or
slow onset and regardless of the intensity
Adaptation the process of modifying to meet new, changing, or
different conditions
Adaptive mechanism learned behaviors that assist an individual
to adjust to the environment
Adherence the extent to which an individual's behavior (for
example, taking medications, following diets, or making
lifestyle changes) coincides with medical or health advice;
commitment or attachment to a regimen
Adolescence the period during which a person becomes
physically and psychologically mature and acquires a
personal identity
Adolescent growth spurt the period during puberty when
sudden and dramatic physical changes occur
Adult day care a day care center that provides health and social
services to the older person
Advance health care directive a variety of legal and lay
documents that allow persons to specify aspects of care
they wish to receive should they become unable to make or
communicate their preferences
Adventitious breath sounds abnormal or acquired breath sounds
Adverse effects more severe side effects that may justify the
discontinuation of a drug
Advocate individual who pleads the cause of another or argues
or pleads for a cause or proposal
Aerobic living only in the presence of oxygen
Aerobic exercise any activity during which the body takes in
more or an equal amount of oxygen than it expends
Aesthetic knowing providing care and meeting the needs of
clients through creativity and style
Afebrile absence of a fever
Affective domain known as the "feeling" domain and is divided
into categories that specify the degree of a person's depth
of emotional response to tasks; includes feelings, emotions,
interests, attitudes, and appreciations
Afterload the resistance against which the heart must pump to
eject blood into the circulation
Ageism deep and profound prejudice in American society against
older adults
Agglutinins specific antibodies formed in the blood
Agglutinogens a substance that acts as an antigen and stimulates
the production of agglutinins
Agnostic a person who doubts the existence of God or a
supreme being or believes the existence of God has not
been proved
Agonist a drug that interacts with a receptor to produce a
response
Agonist analgesic full agonists which are pure opioid drugs that
bind tightly to mu receptor sites, producing maximum pain
inhibition, an agonist effect
Agonist-antagonist analgesic mixed agonist-antagonist drugs
that can act like opioids and relieve pain (agonist effect)
when given to a client who has not taken any pure opioids
Airborne precautions methods used to reduce exposure to
infectious agents transmitted by airborne droplet nuclei
smaller than 5 microns
Alarm reaction the initial reaction of the body to stress, which
alerts the body's defenses
Algor mortis the gradual decrease of the body's temperature
after death
Alkalosis a condition that occurs with increases in blood
bicarbonate or decreases in blood carbonic acid; blood pH
above 7.45
Allodynia where nonpainful stimuli (e.g., contact with linen,
water, or wind) produces pain or dysthesia, which is an
unpleasant abnormal sensation
Allopathic medicine term used to describe Western medical
practice
Alopecia the loss of scalp hair (baldness) or body hair
Alternative medicine an unrelated group of nonorthodox
practices, often with explanatory systems that do not
follow conventional biomedical explanations
Alzheimer's disease disease that involves progressive dementia,
memory loss, and inability to care for self
Amblyopia reduced visual acuity in one eye
Ambulation the act of walking
Ampule a small glass container for individual doses of liquid
medications
Anabolism a process in which simple substances are converted
by the body's cells into more complex substances (e.g.,
building tissue, positive nitrogen balance)
Anaerobic living only in the absence of oxygen
Anaerobic exercise involves activity in which the muscles cannot
draw out enough oxygen from the bloodstream; used in
endurance training
Anal stimulation stimulation applied to anus for sexual pleasure
Anaphylactic reaction a severe allergic reaction that usually
occurs immediately after the administration of a drug

Andragogy the art and science of helping adults learn
Androgyny belief that most characteristics and behaviors are
human qualities and not limited to a gender
Anemia a condition in which the blood is deficient in red blood
cells or hemoglobin
Anger an emotional state consisting of a subjective feeling of
animosity or strong displeasure
Animal-assisted therapy the use of specifically selected animals
as a treatment modality in health and human service
settings
Angiography a diagnostic procedure enabling x-ray visual
examination of the vascular system after injection of a
radiopaque dye
Angle of Louis the junction between the body of the sternum
and the manubrium; the starting point for locating the ribs
anteriorly
Anions ions that carry a negative charge; includes chlorine (C1-),
bicarbonate (HCO3-), phosphate (HP04 2-), and sulfate
(S04")
Ankylosed permanently immobile joints
Anorexia lack of appetite
Anorexia nervosa a disease characterized by a prolonged
inability or refusal to eat, rapid weight loss, and emaciation
in persons who continue to believe they are fat
Anoscopy visual examination of the anal canal using an
anoscope (a lighted instrument)
Answer (legal) a written response made by the defendant
Antagonist drug that inhibits cell function by occupying the
drug's receptor sites
Antibodies immunoglobulins, part of the body's plasma proteins,
defend primarily against the extracellular phases of
bacterial and viral infections
Anticipatory grief grief experienced in advance of the event
Anticipatory loss the experience of loss before the loss actually
occurs
Antigen a substance capable of inducing the formation of
antibodies
Antihelix the anterior curve of the auricle's upper aspect
Antiseptics agents that inhibit the growth of some
microorganisms
Anuria the failure of the kidneys to produce urine, resulting in a
total lack of urination or output of less than 100 mL per day
in an adult
Anxiety a state of mental uneasiness, apprehension, or dread
producing an increased level of arousal caused by an
impending or anticipated threat to self or significant
relationships
Apgar scoring system a scoring system to assess newborn babies
Aphasia any defects in or loss of the power to express oneself by
speech, writing, or signs, or to comprehend spoken or
written language due to disease or injury of the cerebral
cortex
Apical pulse a central pulse located at the apex of the heart
Apical-radial pulse measurement of the apical beat and the
radial pulse at the same time
Apnea a complete absence of respirations
Apocrine glands sweat glands located largely in the axillae and
anogenital areas; they begin to function at puberty under
the influence of androgens
Approximated closed tissue surfaces
Aromatherapy therapeutic use of essential oils of plants in which
odor or fragrance plays an important part
Arrhythmia a pulse with an abnormal rhythm
Arterial blood gases specimen of arterial blood that assesses
oxygenation, ventilation, and acid-base status
Arterial blood pressure the measure of the pressure exerted by
the blood as it pulsates through the arteries
Arteriosclerosis a condition in which the elastic and muscular
tissues of the arteries are replaced with fibrous tissue
Ascites the accumulation of fluid in the abdominal cavity
Asepsis freedom from infection or infectious material
Asphyxiation lack of oxygen due to interrupted breathing
Aspiration the withdrawal of fluid that has abnormally collected
(e.g., pleural cavity, abdominal cavity) or to obtain a
specimen (e.g., cerebral spinal fluid)
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Assault an attempt or threat to touch another person
unjustifiably
Assessing the process of collecting, organizing, validating, and
recording data (information) about a client's health status
Assignment a downward or lateral transfer of both the
responsibility and accountability of an activity from one
individual to another
Assimilation the process by which an individual develops a new
cultural identity and becomes like the members of the
dominant culture
Assisted living facility with various degrees of personal care
assistance designed to meet the needs of an older person
Assisted suicide a form of active euthanasia in which clients are
given the means to kill themselves
Astigmatism an uneven curvature of the cornea that prevents
horizontal and vertical rays from focusing on the retina
Atelectasis a condition that occurs when ventilation is decreased
and pooled secretions accumulate in a dependent area of a
bronchiole and block it
Atheist one who denies the existence of God
Atherosclerosis buildup of fatty plaque within the arteries
Atria two upper hollow chambers of the heart
Atrioventricular (AV) node conduction pathways that slightly
delay transmission of the impulse from the atria to the
ventricles of the heart
Atrioventricular (AV) valves between the atria and ventricles of
the heart, the tricuspid valve on the right and the bicuspid
or mitral valve on the left
Atrophy wasting away; decrease in size of organ or tissue (e.g.,
muscle)
Attentive listening listening actively, using all senses, as opposed
to listening passively with just the ear
Attitudes mental stance that is composed of many different
beliefs; usually involving a positive or negative judgment
toward a person, object, or idea
Audit examination or review of records
Auditory related to or experienced through hearing
Auricle flap of the ear
Auscultation the process of listening to sounds produced within
the body
Auscultatory gap the temporary disappearance of sounds
normally heard over the brachial artery when the
sphygmomanometer cuff pressure is high and the sounds
reappear at a lower level
Authoritarian leader the individual who makes decisions for the
group
Authority the power given by an organization to direct the work
of others; the right to act
Autoantigen an antigen that originates in a person's own body
Autocratic leader see Authoritarian leader
Automaticity an electrical impulse and contraction independent
of the nervous system and generated by the cardiac muscle
Autonomy the state of being independent and self-directed,
without outside control, to make one's own decisions
Autopsy an examination of the body after death to determine
the cause of death and to learn more about a disease
process
Awareness the ability to perceive environmental stimuli and
body reactions and to respond appropriately through
thought and action
Ayurveda Indian system of medicine where illness is viewed as a
state of imbalance among the body's systems
Baby Boomers generation that includes those born in years
1945-1964
Bacteremia bacteria in the blood
Bacteria the most common infection-causing microorganisms
Bactericidal bacteria-killing action
Balance concept of equilibrium between mental, physical,
emotional, spiritual, and environmental components to
achieve optimum wellness
Bandage a strip of cloth used to wrap some part of the body

Basal metabolic rate (BMR) t h e r a t e o f e n e r g y u t i l i z a t i
o n i n t h e body required to maintain essential activities
such as breathing
Base of support the area on which an object rests
Bases (alkalis) have low hydrogen ion concentration and can
accept hydrogen ions in solution
Battery (legal) the willful or negligent touching of a person (or
the person's clothes or even something the person is
carrying), which may or may not cause harm
Bed rest strict confinement to bed (complete bed rest), or the
client may be allowed to use a bedside commode or have
bathroom privileges
Bedpan a receptacle for urine and feces for clients who are
restricted to bed
Behaviorist theory includes the careful identification of what is
to be taught and the immediate identification of and
reward for correct responses
Beliefs interpretations or conclusions that one accepts as true
Beneficence the moral obligation to do good or to implement
actions that benefit clients and their support persons
Bereavement a subjective response of a person who has
experienced the loss of a significant other through death
Bevel the slanted part at the tip of a needle
Bioculturalultural used to describe a person who crosses two
cultures, lifestyles, and sets of values
Binder block see Intravenous block
Binder a type of bandage applied to large body areas (abdomen
or chest) or for a specific body part (arm sling); used to
provide support
Bioelectromagnetscs science that studies how living organisms
interact with electromagnetic fields
Bioethics ethical rules or principles that govern right conduct
concerning life
Biofeedback a stress management technique that brings under
conscious control bodily processes normally thought to be
beyond voluntary command
Biomedical health belief see Scientific health belief
Biomedicme term used to describe Western medical practice
Biopsy the removal and examination of tissue from the living
body
Biorhythms inner rhythms that appear to control a variety of
biologic processes
Bioterrorism intentional attack using biological weapons such as
viruses, bacteria, or other germs
Biotransformation process by which a drug is converted to a less
active form; also called detoxification
Biot's respirations shallow breaths interrupted by apnea
Bladder training client postpones voiding, resists or inhibits the
sensation of urgency, and voids according to a timetable
rather than according to the urge to void
Blanch test a test during which the client's fingertip is
temporarily pinched to assess capillary refill and peripheral
circulation
Blood chemistry a number of tests performed on blood serum
(the liquid portion of the blood)
Blood pressure (BP) the force exerted on arterial walls by blood
flowing within the vessel
Blood urea nitrogen (BUN) a measure of blood level of urea, the
end product of protein metabolism
Bloodborne pathogens those microorganisms carried in blood
and body fluids that are capable of infecting other persons
with serious and difficult-to-treat viral infections, namely,
hepatitis B virus, hepatitis C virus, and HIV
Body image how a person perceives the size, appearance, and
functioning of his or her body and its parts
Body mass index (BMI) indicates whether weight is appropriate
for height
Body substance isolation (BSI) generic infection control
precautions for all clients except those with diseases
transmitted through the air
Body temperature the balance between the heat produced by
the body and the heat lost from the body
Bodymind a state of integration that includes body, mind, and
spirit
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Boomerang kids slang term used for young adults who move
back into their parents' homes after an initial period of
independent living
Bottle mouth syndrome describes the decay of an infant's teeth
caused by constant contact with sweet liquid from a bottle
Boundary the real or imaginary lines that differentiate one
system from another system or a system from its
environment
Bowel (fecal) incontinence loss of voluntary ability to control
fecal and gaseous discharges through the anal sphincter
Bradycardia abnormally slow pulse rate, less than 60 beats per
minute
Bradypnea abnormally slow respiratory rate, usually less than 10
respirations per minute
Brand name the name given to a drug by the drug's
manufacturer
Breach of duty a standard of care that is expected in the specific
situation but that the nurse did not observe; this is the
failure to act as a reasonable, prudent nurse under the
circumstances
Bronchoscopy visual examination of the bronchi using a
bronchoscope
Bruit a blowing or swishing sound created by turbulence of
blood flow
Buccal pertaining to the cheek
Buffers prevent excessive changes in pH by removing or
releasing hydrogen ions
Bulimia an uncontrollable compulsion to eat large amounts of
food and then expel it by self-induced vomiting or by taking
laxatives
Bundle of His the right and left bundle branches of the
ventricular conduction pathways
Burden of proof the duty of proving an assertion
Bureaucratic leader does not trust self or others to make
decisions and instead relies on the organization's rules,
policies, and procedures to direct the group's work efforts
Burn results from excessive exposure to thermal, chemical,
electric, or radioactive agents
Burnout a complex syndrome of behaviors that can be likened to
the exhaustion stage of the general adaptation syndrome;
an overwhelming feeling that can lead to physical and
emotional depletion, a negative attitude and self-concept,
and feelings of helplessness and hopelessness
Calculi renal stones
Callus a thickened portion of the skin
Caloric value the amount of energy that nutrients or foods
supply to the body
Calorie (cr cal, kcal) a unit of heat energy equivalent to the
amount of heat required to raise the temperature of 1 kg of
water 1°C
Cancer pain pain associated with cancers; can be related or
unrelated to the disease or its treatment
Cannula a tube with a lumen (channel) that is inserted into a
cavity or duct and is often fitted with a trocar during
insertion
Carbon monoxide an odorless, colorless, tasteless gas that is
very toxic
Cardiac arrest the cessation of heart function
Cardiac output (CO) the amount of blood ejected by the heart
with each ventricular contraction
Cardinal signs see Vital signs
Caregiver a role that has traditionally included those activities
that assist the client physically and psychologically
Caregiver burden responses to long-term stress, such as chronic
fatigue, sleeping difficulties, and high blood pressure, in
family members who undertake the care of a person in the
home for a long period
Caregiver role strain physical, emotional, social, and financial
burdens that can seriously jeopardize the caregiver's own
health and well-being
Caries tooth cavities

Caring intentional action that conveys physical and emotional
security and genuine connectedness with another person
or group of people
Caring practice nursing care that includes connection, mutual
recognition, and involvement
Carminative an agent that promotes the passage of flatus from
the colon
Carrier a person or animal that harbors a specific infectious
agent and serves as a potential source of infection, yet does
not manifest any clinical signs of disease
Case management a method for delivering nursing care in which
the nurse is responsible for a caseload of clients across the
health care continuum
Case manager a nurse who works with the multidisciplinary
health care team to measure the effectiveness of the case
management plan and monitor outcomes
Catabolism a process in which complex substances are broken
down into simpler substances (e.g., breakdown of tissue)
Cataracts opacity of the lens or capsule of the eye
Cathartics drugs that induce defecation
Cations ions that carry a positive charge; includes sodium (Na+),
potassium (K+), calcium (Ca2+), and magnesium (Mg24")
Causation a fact that must be proven that the harm occurred as
a direct result of the nurse's failure to follow the standard
of care and the nurse could have (or should have) known
that failure to follow the standard of care could result in
such harm
Cell-mediated defenses see Cellular immunity
Cellular immunity also known as cell-mediated defenses, occur
through the T-cell system
Center of gravity the point at which the mass (weight) of the
body is centered
Central neuropathic pain pain resulting from malfunctioning
nerves in the central nervous system
Central processing unit (CPU) the processor/microprocessor that
performs the computer program instructions, located in the
box that contains the computer hardware
Central vesious catheter catheter that is usually inserted into the
subclavian or jugular vein, with the distal tip of the catheter
resting in the superior vena cava just above the right atrium
Cephalocaudal proceeding in the direction from head to toe
Cerebral death the higher brain center or cerebral cortex is
irreversibly destroyed
Cerumen the wax-like substance secreted by glands in the
external ear canal
Change process of making something different from what it was
Change agents persons (or groups) who initiate change or who
assist others in making modifications in themselves or in
the system
Change-of-shift report a report given to nurses on the next shift
Charismatic leader characterized by an emotional relationship
between the leader and the group members; personality of
the leader evokes strong feelings of commitment to both
the leader and the leader's cause and beliefs
Chart a formal, legal document that provides evidence of a
client's care
Charting the process of making an entry on a client record
Charting by exception (CBE) a documentation system in which
only significant findings or exceptions to norms are
recorded
Chemical name the name by which a chemist knows a drug;
describes the constituents of the drug precisely
Chemical restraints medications used to control socially
disruptive behavior
Chemical thermogenesis the stimulation of heat production in
the body through increased cellular metabolism caused by
increases in thyroxine output
Cheyne-Siokes respirations rhythmic waxing and waning of
respirations from very deep breathing to very shallow
breathing with periods of temporary apnea, often
associated with cardiac failure, increased intracranial
pressure, or brain damage
Chiropractic from the Greek meaning "done by hand"; involves
adjustments of the spine and joints and is grounded in the
assumption that maintaining the alignment of the spine and
4
joints facilitates the flow of energy throughout the body,
including the nervous, circulatory, respiratory,
gastrointestinal, and limbic systems
Cholesterol a lipid that does not contain fatty acid but possesses
many of the chemical and physical properties of other lipids
Chronic illness illness that lasts for an extended period of time,
usually greater than 6 months
Chronic infection infection that occurs slowly, over a very long
period, and may last months or years
Chronic pain prolonged pain, usually recurring or persisting over
6 months or longer, and interferes with functioning
Chyimie digested products that leave the stomach through the
small intestine and then pass through the ileocecal valve
Circulating immunity see Humoral immunity
Circulating nurse assists scrub nurses and surgeons during
surgery
Civil action deals with the relationship between individuals in
society
Civil law the body of law that deals with relationships among
private individuals; also known as private law
Clara Barton a schoolteacher who volunteered as a nurse during
the Civil War. Most notably, she organized the American
Red Cross, which linked with the International Red Cross
when the U.S. Congress ratified the Geneva Convention in
1882
Clean free of potentially infectious agents
Clean voided specimen urine specimens for routine urinalysis
Clean-catch specimen urine specimens for urine culture
Cleaning bath a type of bath given chiefly for hygiene purposes
Client a person who engages the advice or services of another
person who is qualified to provide this service
Client record see C h a r t
Climacteric the point in' development when reproduction
capacity in the female terminates (menopause) and the
sexual activity of the male decreases (andropause)
Clinical aromatherapy the controlled use of essential oils for
specific measurable outcomes
Closed awareness a type of awareness in which the client is
unaware of impending death
Closed questions restrictive question requiring only a short
answer
Closed system system that does not exchange energy, matter, or
information with its environment
Closed wound drainage system consists of a drain connected to
either an electric suction or a portable drainage suction,
such as a Hemovac or Jackson-Pratt.
Clubbing elevation of the proximal aspect of the nail and
softening of the nail bed
Co-analgesic medication that is not classified as a pain
medication; however, it has properties that may reduce
pain alone, or in combination with other analgesics; relieve
other discomforts; potentiate the effect of pain medication;
or reduce the pain medication's side effects
Cochlea a seashell-shaped structure found in the inner ear;
essential for sound transmission and hearing
Code blue emergency announcing cardiac/respiratory arrest and
initiating interventions
Code of ethics a formal statement of a group's ideals and values;
a set of ethical principles shared by members of a group,
reflecting their moral judgments and serving as a standard
for professional actions
Cognitive development refers to the manner in which people
learn to think, reason, and use language
Cognitive domain the "thinking" domain, includes six intellectual
abilities and thinking processes beginning with knowing,
comprehending, and applying to analysis, synthesis, and
evaluation
Cognitive skills intellectual skills that include problem solving,
decision making, critical thinking, and creativity
Cognitive theory recognition of developmental levels of learners,
and acknowledgments of the learner's motivation and
environment
Coinsurance an insurance plan in which the client pays a
percentage of the payment and some other group (e.g.,
employer, government) pays the remaining percentage

Collaboration a collegial working relationship with another
health care provider in the provision of client care
Collaborative care plans see C r i t i c a l p a t h w a y s
Collaborative interventions actions the nurse carries out in
collaboration with other health team members, such as
physical therapists, social workers, dietitians, and
physicians
Collagen a protein found in connective tissue; a whitish protein
substance that adds tensile strength to a wound
Colloid osmotic pressure a pulling force exerted by colloids that
help maintain the water content of blood
Colloids substances such as large protein molecules that do not
readily dissolve into true solutions
Colonization the presence of organisms in body secretions or
excretions in which strains of bacteria become resident
flora but do not cause illness
Colonoscopy visual examination of the interior of the colon with
a colonoscope
Colostomy an opening into the colon (large bowel)
Commode a portable, chairlike structure used as a toilet
Common law the body of principles that evolves from court
decisions
Communicable disease a disease that can spread from one
person to another
Communication a two-way process involving the sending and
receiving of messages
Communicator nurses identify client problems and then
communicate these verbally or in writing to other members
of the health team
Community a collection of people who share some attribute of
their lives
Community health nursing t h e s y n t h e s i s of n u r s i n g a n
d p u b lic health practice as applied to promoting and
preserving the health of populations
Community nursing centers (CNCs) provide primary care to
specific populations and are staffed by nurse practitioners
and community health nurses
Community-based health care (CBHC) a s y s t e m t h a t p r o v i
d e s health-related services within the context of people's
daily lives; that is, in places where people spend their time
in the community
Community-based nursing (CBN) nursing care directed toward a
specific population or group within the community;
primary, secondary, or tertiary care may be provided to
individuals or groups
Compensation defense mechanism in which a person substitutes
an activity for one that he or she would prefer doing or
cannot do
Compensatory counterbalancing
Complaint (legal) a document filed by a plaintiff
Complementary and alternative medicine (CAM) those practices
that do not form part of the dominant system for managing
health and disease
Complementary medicine see Alternative medicine
Complementary therapies therapeutic practices that are not
currently considered an integral part of conventional
allopathic medical practice
Complete blood count (CBC) specimens of venous blood;
includes hemoglobin and hematocrit measurements,
erythrocyte
(RBC) count, leukocyte (WBC) count, red bloocl cell indices, and
a differential white cell count
Complete proteins a protein that contains all of the essential
amino acids as well as many nonessential ones
Compliance the extent to which an individual's behavior
coincides with medical or health advice
Complicated grief pathologic grief; exists when coping strategies
are maladaptive
Compress a moist gauze dressing applied frequently to an open
wound, sometimes medicated
Compromised host any person at increased risk for an infection
Computed tomography (CT) a painless, noninvasive x-ray
procedure that has the unique capability of distinguishing
minor differences in the density of tissues
5
Computer-based patient records (CPRs) e l e c t r o n i c c l i e n t
d a t a retrievable by caregivers, administrators,
accreditors, and other persons who require the data
Concept map a visual tool in which ideas or data are enclosed in
circles or boxes of some shape and relationships between
these are indicated by connecting lines or arrows
Concepts abstract ideas or mental images of phenomena or
reality
Conceptual framework a group of related concepts
Conceptual model a graphic illustration of the relationships
among concepts
Concurrent audit evaluation of a client's health care while the
client is still receiving care from the agency
Conduction the transfer of heat from one molecule to another in
direct contact
Conduction hearing Soss the result of interrupted transmission
of sound waves through the outer and middle ear
structures
Confidentiality any information a subject relates will not be
made public or available to others without the subject's
consent
Congruent communication the verbal and nonverbal aspects of
the message match
Conjunctivitis inflammation of the bulbar and palpebral
conjunctiva
Conscious sedation a minimal depression of level of
consciousness during which the client retains the ability to
consciously maintain a patent airway and respond
appropriately to verbal and physical stimuli
Consequence-based (teleological) theories the e t h i c s of
judging whether an action is moral
Constant fever a state in which the body temperature fluctuates
minimally but always remains above normal
Constipation passage of small, dry, hard stool or passage of no
stool for an abnormally long time
Consultative leader see Democratic leader Consumer an
individual, a group of people, or a community that uses a
service or commodity
Contact precautions methods used to reduce exposure to
infectious agents easily transmitted by direct client contact
or by contact with items in the client's environment
Contemplation stage stage in which a person acknowledges
having a problem, seriously considers changing a specific
behavior, actively gathers information, and verbalizes plans
to change the behavior in the near future
Continuing education (CE) formalized experiences designed to
enlarge the knowledge or skills of practitioners
Continuity of care the coordination of health care services by
health care providers for clients moving from one health
care setting to another and between and among health
care professionals
Continuity theory people maintain their values, habits, and
behavior in old age
Contract a written or verbal agreement between two or more
people to do or not do some lawful act
Contract law the enforcement of agreements among private
individuals or the payment of compensation for failure to
fulfill the agreement
Contractility the inherent ability of cardiac muscle fibers to
shorten or contract
Contractual obligations duty of care established by the presence
of an expressed or implied contract
Contractual relationships vary among practice settings; may be
as an independent or employer-employee relationship
Contracture permanent shortening of a muscle and subsequent
shortening of tendons and ligaments
Convection the dispersion of heat by air currents
Conventional medicine term used to describe Western medical
practice
Coordinating the process of ensuring that plans are carried out
and evaluating outcomes
Coping dealing with change
Coping mechanism an innate or acquired way of responding to a
changing environment or specific problem or situation
Coping strategy see Coping mechanism

Core self-concept the beliefs and images that are most vital to
the person's identity
Core temperature the temperature of the deep tissues of the
body (e.g., thorax, abdominal cavity); relatively constant at
37°C (98.6°F)
Corn a conical, circular, painful, raised area on the toe or foot
Coronary arteries a network of vessels known as the coronary
circulation
Coroner a public official, not necessarily a physician, appointed
or elected to inquire into the causes of death
Costal (thoracic) breathing u s e o f t h e e x t e r n a l i n t e r c o
s t a l m u scles and other accessory muscles, such as the
sternocleidomastoid muscles
Counseling the process of helping a client to recognize and cope
with stressful psychologic or social problems, to develop
improved interpersonal relationships, and to promote
personal growth
Countershock phase second part of the alarm reaction in which
the changes the body experienced during the shock phase
are reversed
Covert data (systems, subjective data) i n f o r m a t i o n ( d a t a
) a p parent only to the person affected that can be
described or verified only by that person
Creatine kinase (CK) enzyme that is released into the blood
during a myocardial infarction (MI)
Creatinine a nitrogenous waste that is excreted in the urine
Creatinine clearance a test uses 24-hour urine and serum
creatinine levels to determine the glomerular filtration rate,
a sensitive indicator of renal function
Creativity thinking that results in the development of new ideas
and products
Credentialing the process of determining and maintaining
competence in practice; includes licensure, registration,
certification, and accreditation
Crede's maneuver manual exertion of pressure on the bladder to
force urine out
Crepitation (1) a dry, crackling sound like that of crumpled
cellophane, produced by air in the subcutaneous tissue or
by air moving through fluid in the alveoli of the lungs; (2) a
crackling, grating sound produced by bone rubbing against
bone
Crime an act committed in violation of public (criminal) law and
punishable by a fine and/or imprisonment
Criminal actions deal with disputes between an individual and
the society as a whole
Criminal law deals with actions against the safety and welfare of
the public
Crisis counseling therapy focused on solving immediate
problems involving individuals, groups, or families in crisis
Crisis intervention a short-term helping process of assisting
clients to work through a crisis to its resolution and restore
their precrisis level of functioning
Critical analysis a set of questions one can apply to a particular
situation or idea to determine essential information and
ideas and discard superfluous information and ideas
Critical pathways multidisciplinary guidelines for client care
based on specific medical diagnoses designed to achieve
predetermined outcomes
Critical theory describes theories that help elucidate how social
structures affect a wide variety of human experiences from
art to social practices
Critical thinking a cognitive process that includes creativity,
problem solving, and decision making
Cross-dresser Individual of one gender (typically male) who
dresses in clothing specific to the opposite gender
Crystalloids salts that dissolve readily into true solutions
Cues any piece of information or data that influences decisions
Cultural care deprivation lack of culturally assistive, supportive,
or facilitative acts
Cultural deprivation see Cultural care deprivation
Culturally appropriate application of underlying background
knowledge that must be possessed to provide a given client
with the best possible health care
Culturally competent within the delivered care the nurse
understands and attends to the total context of the client's
6
situation and uses a complex combination of knowledge,
attitudes, and skills
Culturally sensitive care that demonstrates basic knowledge of
and constructive attitudes toward the health traditions
observed among the diverse cultural groups found in the
setting
Culture a world view and set of traditions used and transmitted
from generation to generation by a particular group,
includes related attitudes and institutions
Culture shock a disorder that occurs in response to transition
from one cultural setting to another
Cultures laboratory culti vations of microorganisms in a special
growth medium
Cumulative effect the increasing response to repeated doses of a
drug that occurs when the rate of administration exceeds
the rate of metabolism or excretion
Curanderismo cultural healing tradition found in Latin America
that uses Western medicine beliefs, treatments, and
practices at three levels of care: material level, spiritual
level, and mental level
Cyanosis bluish discoloration of the skin and mucous
membranes caused by reduced oxygen in the blood
Cystoscope a lighted instrument used to visualize the interior of
the urinary bladder
Cystoscopy visual examination of the urinary bladder with a
cystoscope
Dacryocystitis inflammation of the lacrimal sac
Damages if malpractice caused the injury, the nurse is held liable
for damages that may be compensated
Dandruff a dry or greasy, scaly material shed from the scalp
Data information
Data warehousing the accumulation of large amounts of data
that are stored over time
Database all information about a client, includes nursing health
history and physical assessment, physician's history,
physical examination, and laboratory and diagnostic test
results
Debridement removal of infected and necrotic tissue
Decision (legal) outcome made by a judge
Decision making the process of establishing criteria by which
alternative courses of action are developed and selected
Decode to relate the message perceived to the receiver's
storehouse of knowledge and experience and to sort out
the meaning of the message
Decubitus ulcers see Pressure ulcers
Deductive reasoning making specific observations from a
generalization
Defamation (legal) a communication that is false, or made with
careless disregard for the truth, and results in injury to the
reputation of another
Defecation expulsion of feces from the rectum and anus
Defendant (legal) person against whom a plaintiff files a
complaint
Defense mechanism any reaction that serves to protect against
something physically or psychologically harmful
Defining characteristics client signs and symptoms that must be
present to validate a nursing diagnosis
Dehiscence the partial or total rupturing of a sutured wound;
usually involves an abdominal wound in which the layers
below the skin also separate
Dehydration insufficient fluid in the body
Delegation the transfer of responsibility for the performance of
an activity from one person to another while retaining
accountability for the outcome
Delirium also called acute confusion; abrupt onset of confusion
and a reversible cause
Demand feeding child is fed when hungry
Dementia a global impairment of cognitive function that usually
is progressive and may be permanent; interferes with
normal social and occupational activities
Democratic leader encourages group discussion and decision
making

Demography the study of population, including statistics about
distribution by age and place of residence, mortality, and
morbidity
Dental caries tooth decay
Denver Developmental Screening Test (DDST) a screening test
used to assess children from birth to 6 years of age
Dependent functions with regard to medical diagnoses,
physician-prescribed therapies and treatments nurses are
obligated to carry out
Dependent interventions those activities carried out on the
order of a physician, under a physician's supervision, or
according to specified routines
Dependent variable the behavior, characteristic, or outcome
that the researcher wishes to explain or predict
Depression feelings of sadness and dejection, often
accompanied by physiologic change such as decreased
functional activity
Descriptive statistics procedures that summarize large volumes
of data; used to describe and synthesize data, showing
patterns and trends
Desire phase part of the response cycle, which starts in the
brain, with conscious sexual desires
Desired effect see Therapeutic effect
Detoxification see Biotransformation
Detrusor muscle the smooth muscle layers of the bladder
Development an individual's increasing capacity and skill in
functioning, related to growth
Developmental stage level of achievement for a particular
segment of a person's life
Developmental task skill or behavior pattern learned during
stages of development
Diagnosis a statement or conclusion concerning the nature of
some phenomenon
Diagnosis-related groups (DRGs) a Medicare payments system to
hospitals and physicians that establishes fees according to
diagnosis
Diagnostic labels title used in writing a nursing diagnosis; taken
from the North American Nursing Diagnosis Association
(NANDA) standardized taxonomy of terms
Dialysis a technique by which fluids and molecules pass through
a semipermeable membrane according to the rules of
osmosis
Diaphragmatic (abdominal) breathing contraction and relaxation
of the diaphragm, observed by the movement of the
abdomen, which occurs as a result of the diaphragm's
contraction and downward movement
Diarrhea defecation of liquid feces and increased frequency of
defecation
Diastole the period during which the ventricles relax
Diastolic pressure the pressure of the blood against the arterial
walls when the ventricles of the heart are at rest
Diet history a comprehensive assessment of a client's food
intake that involves an extensive interview by a nutritionist
or dietitian
Differentiated practice a system in which the best possible use
of nursing personnel is based on their educational
preparation and resultant skill sets
Diffusion the mixing of molecules or ions of two or more
substances as a result of random motion
Directing a management function that involves communicating
the task to b e completed and providing guidance and
supervision
Directive interview a highly structured interview that uses closed
questions to elicit specific information
Dirty denotes the likely presence of microorganisms, some of
which may be capable of causing infection
Disaccharides sugars that are composed of double molecules
Discharge planning the process of anticipating and planning for
client needs after discharge
Discovery (legal) pretrial activities to gain all of the facts of a
situation
Discrimination the differential treatment of individuals or groups
Discussion an informal oral consideration of a subject by two or
more health care personnel to identify a problem or
establish strategies to resolve a problem
7
Disease an alteration in body function resulting in a reduction of
capacities or shortening of the normal life span
Disease prevention behavior motivated by a desire to actively
avoid illness, detect it early, or maintain functioning within
the constraints of illness (also called health protection)
Disengagement theory aging involves mutual withdrawal
(disengagement) between the older person and others in
the elderly person's environment
Disinfectants agents that destroy pathogens other than spores
Dissatisfaction problems dissatisfaction with sexual encounters
despite desire, arousal, and orgasm
Distance learning learning in which people communicate
effectively across long distances
Distribution the transportation of a drug from its site of
absorption to its site of action
Diuresis the production of large amounts of urine by the kidneys
without an increased fluid intake
Diuretics agents that increase urine secretion
Diversity the fact or state of being different
Documenting see Charting or Recording
Do-not-resuscitate (DNR) order a physician's order that specifies
no effort be made to resuscitate the client with terminal or
imeversible illness in the event of a respiratory or cardiac
arrest
Dorothea Dix woman leader who provided nursing care during
the Civil War
Dorsal (supine) position a back-lying position without a pillow
Dorsal recumbent position a back-lying position with the head
and shoulders slightly elevated
Drip factor (drop factor) the number of drops per milliliter of
solution delivered for a particular drip chamber
Droplet nuclei residue of evaporated droplets that remains in
the air for long periods of time
Droplet precautions methods used to reduce exposure to
infectious agents transmitted by particle droplets larger
than 5 microns
Drug a chemical compound taken for disease prevention,
diagnosis, cure, or relief or to affect the structure or
function of the body
Drug abuse excessive intake of a substance either continually or
periodically
Drug allergy an immunologic reaction to a drug
Drug dependence inability to keep the intake of a drug or
substance under control
Drug habituation a mild form of psychologic dependence on a
drug
Drug half-life (Elimination half-life) the time required f o r the
elimination process to reduce the concentration of a drug
to one-half what it was at initial administration
Drug interaction the beneficial or harmful interaction of one
drug with another drug
Drug tolerance a condition in which successive increases in the
dosage of a drug are required to maintain a given
therapeutic effect
Drug toxicity the quality of a drug that exerts a deleterious effect
on an organism or tissue
Dullness a thudlike sound produced during percussion by dense
tissue of body organs such as the liver, spleen, or heart
Durable medical equipment (DIVSE) companies companies that
provide health care equipment for the client at home
Duration the length of time that a sound is heard
Duty the nurse must have (or should have had) a relationship
with the client that involves providing care and following an
acceptable standard of care
Dysesthesia unpleasant abnormal sensation
Dysmenorrhea painful menstruation
Dyspareunia difficult or painful intercourse
Dysphagia difficulty or inability to swallow
Dyspnea difficult or labored breathing
Dysrhythmia a pulse with an irregular rhythm
Dysuria painful or difficult voiding

Eccrine glands glands that produce sweat; found over most of
the body
Echocardiogram a noninvasive test that uses ultrasound to
visualize structures of the heart and evaluate left
ventricular function
Ectoderm the outer layer of tissue formed in the second week of
life
Edema the presence of excess interstitial fluid in the body
Effectiveness a measure of the quality or quantity of services
provided
Efficiency a measure of the resources used in the provision of
nursing services
Effleurage a stroking massage technique
Ego includes consciousness and memory, which serve to
mediate between primitive instinctual drives (id), internal
social prohibitions (superego), and reality
Ego defense mechanisms (Freud) mental mechanisms that
develop as the personality attempts to defend itself,
establish compromises among conflicting impulses, and
allay inner tensions
Ejaculation expulsion of seminal fluid and sperm
Elasticity of the arterial wall expansibility or stretching of the
vessels
Eiderspeak speech style similar to baby talk; gives the message
of dependence and incompetence to older adults
Elective surgery performed when surgical intervention is the
preferred treatment for a condition that is not imminently
life threatening or to improve the client's life
Electric shock occurs when a current travels through the body to
the ground rather than through electric wiring, or from
static electricity that builds up on the body
Electrocardiogram (ECG, E&G) a graph of the electric activity of
the heart
Electrocardiography provides a graphic recording of the heart's
electrical activity
Electroencephalogram (EEC) a graph of the electrical activity of
the brain
Electromyogram (EiVSG) a graph of the electrical activity of
muscles
Electro-oculogram (EOG) a graph of the electrical activity of eye
to eye movement
Electrolytes chemical substances that develop an electric charge
and are able to conduct an electric current when placed in
water; ions
Electronic communication communication involving computers
and technology (i.e., e-mail)
Electronic medical records (EMRs) see C o m p u t e r - b a s e d
patient records (CPRs)
Elimination half-life see Drug half-life
Embolus a blood clot (or a substance such as air) that has moved
from its place of origin and is causing obstruction to
circulation elsewhere (plural: emboli)
Embryonic phase the phase during which the fertilized ovum
develops into an organism with most of the features of a
human
Emergency surgery surgery that is performed immediately to
preserve function or the life of the client
Emmetropic normal refraction so that the eyes focus images on
the retina
Empathy the ability to discriminate what the other person's
world is like and to communicate to the other this
understanding in a way that shows that the helper
understands the client's feelings and the behavior and
experience underlying these feelings
Emphysema a chronic pulmonary condition in which the alveoli
are dilated and distended
Empirical data information collected from the observable world
Empirical knowing knowledge that comes from science; ranges
from factual, observable phenomena to theoretical analysis
Encoding involves the selection of specific signs or symbols
(codes) to transmit the message, such as which language
and words to use, how to arrange the words, and what
tone of voice and gestures to use
Endocardium a layer of the heart wall lining the inside of the
heart's chambers and great vessels
8
Endoderm the inner layer of tissue formed in the second week
of life
End-of-8ife care care provided in the final weeks before death
Endogenous developing from within
Enema a solution introduced into the rectum and sigmoid colon
to remove feces and/or flatus
Energy the force that integrates the body, mind, and spirit
Enteral through the gastrointestinal system
Entoderm see Endoderm
Enuresis bed-wetting; involuntary passing of urine in children
after bladder control is achieved
Environment all of the conditions, circumstances, and influences
surrounding and affecting the development of an organism
or person
Enzymes biologic catalysts that speed up chemical reactions
Epicardium the visceral pericardium adhering to the surface of
the heart, forming the heart's outermost layer
Epidural commonly used route for parenteral administration
into the epidural space (the area inside the spinal column
but outside the dura mater)
Epidural anesthesia the injection of an anesthetic agent into the
epidural space
Equianafgesia equal analgesia; used when referring to the doses
of various opioid analgesics that provide approximately the
same pain relief
Equilibrium a state of balance
Erectile dysfunction the inability to achieve or maintain an
erection sufficient for sexual satisfaction for oneself or
one's partner
Erythema a redness associated with a variety of skin rashes
Erythrocytes red blood cells, or RBCs
Eschar thick necrotic tissue produced by burning, by a corrosive
application, or by death of tissue associated with loss of
vascular supply, bacterial invasion, and putrefaction
Essential amino acids amino acids that cannot be manufactured
in the body and must be supplied as part of the protein
ingested in the diet
Ethical knowing knowledge that focuses on matters of obligation
or what ought to be done
Ethics the rules or principles that govern right conduct
Ethnic belonging to a specific group of individuals who share a
common social and cultural heritage
Ethnocentrism the belief that one's own culture or way of life is
better than that of others
Ethnography research that provides a framework to focus on the
culture of a group of people
Ethnopharmacology study of the effect of ethnicity on responses
to prescribed medicines
Etiology the causal relationship between a problem and its
related or risk factors
Eupnea normal, quiet breathing
Eustachian tube the part of the middle ear that connects the
middle ear to the nasopharynx; stabilizes air pressure
between the external atmosphere and the middle ear
Euthanasia the act of painlessly putting to death persons
suffering from incurable or distressing disease
Evaluating a planned ongoing, purposeful activity in which
clients and health care professionals compare expected
outcomes to actual outcomes
Evaluation statement a statement that consists of two parts: a
conclusion and supporting data
Evidence-based practice (EBP) the use of some form of
substantiation in making clinical decisions
Evisceration extrusion of the internal organs
Exacerbation the period during a chronic illness when symptoms
reappear after remission
Excitement/plateau phase part of the response cycle, involves
vasocongestion and myotonia
Excoriation loss of the superficial layers of the skin
Excretion elimination of a waste product produced by the body
cells from the body
Exercise a type of physical activity; a planned, structured, and
repetitive bodily movement done to improve or maintain
one or more components of physical fitness

Exhalation (expiration) the movement of gases from the lungs to
the atmosphere
Exogenous developing from outside sources
Exophthalmos a protrusion of the eyeballs with elevation of the
upper eyelids, resulting in a startled or staring expression
Expectorate to cough and spit up mucus or other materials
Expert witness one. who has special training, experience, or skill
in a relevant area and is allowed by the court to offer an
opinion on some issue within that area of expertise
Expiration see Exhalation
Express consent an oral or written agreement
Extended family family that includes the relatives of the nuclear
family (e.g., grandparents, aunts, uncles)
External auditory meatus t h e e n t r a n c e t o t h e e a r c a n a l
Extinction the failure to perceive touch on one side of the body
when two symmetric areas of the body are touched
simultaneously
Extracellular fluid (ECF) fluid found outside the body cells
Exudate material, such as fluid and cells, that has escaped from
blood vessels during the inflammatory process and is
deposited in tissue or on tissue surfaces
Fabiola a wealthy Roman matron; viewed by some as the patron
saint of early nursing who used her position and wealth to
establish hospitals for the sick
Fad a widespread but short-lived interest, or a practice followed
with considerable zeal
Failure to thrive a unique syndrome in which an infant falls
below the fifth percentile for weight and height on a
standard growth chart or is falling in percentiles on a
growth chart
Faith an active "mode of being-in-relation" to another or others
in which we invest commitment, belief, love, and hope
False imprisonment the unlawful restraint or detention of
another person against his or her wishes
Family the basic unit of society that consists of those individuals,
male or female, youth or adult, legally or not legally related,
genetically or not genetically related, who are considered
by others to represent their significant persons
Family-centered nursing nursing that considers the health of the
family as a unit in addition to the health of individual family
members
Fats lipids that are solid at room temperature
Fat-soluble vitamins A, D, E, and K vitamins that the body can
store
Fatty acids the basic structural units of most lipids made up of
carbon chains and hydrogen
Fear an emotional response to an actual, present danger
Feasibility the availability of time as well as the material and
human resources needed to investigate a research problem
or question
Febrile pertaining to a fever; feverish
Fecal impaction a mass or collection of hardened, putty-like
feces in the folds of the rectum
Fecal incontinence see Bowel incontinence
Feces (stool) body wastes and undigested food eliminated from
the bowel
Feedback the response or message that the receiver returns to
the sender during communication
Felony a crime of a serious nature, such as murder, punishable
by a term in prison
Female orgasmic disorder when the female sexual response
stops before orgasm occurs
Female sexual arousal disorder when lack of vaginal lubrication
causes discomfort or pain during intercourse
Fetal phase characterized by a period of rapid growth in the size
of the fetus; both genetic and environmental factors affect
its growth
Fever elevated body temperature
Fever spike a temperature that rises to fever level rapidly
following a normal temperature and then returns to normal
within a few hours
Fibrin an insoluble protein formed from fibrinogen during the
clotting of blood
9
Fidelity a moral principle that obligates the individual to be
faithful to agreements and responsibilities one has
undertaken
Fifth vital sign p a i n a s s e s s m e n t
Filtration process whereby fluid and solutes move together
across a membrane from one compartment to another
Filtration pressure the pressure in a compartment that results in
the movement of fluid and substances dissolved in fluid out
of the compartment
First-level manager a manager responsible for managing the
work of nonmanagerial personnel and the day-to-day
activities of a specific work group or groups
Fissures deep grooves that occur as a result of dryness and
cracking of the skin
Fixation immobilization or the inability of the personality to
proceed to the next developmental stage because of
anxiety
Flaccid weak or lax
Flatness an extremely dull sound produced, during percussion,
by very dense tissue, such as muscle or bone Flatulence the
presence of excessive amounts of gas in the stomach or
intestines
Flatus gas or air normally present in the stomach or intestines
Florence Nightingale considered the founder of modern nursing,
she was influential in developing nursing education,
practice, and administration
Flow sheet a record of the progress of specific or specialized
data such as vital signs, fluid balance, or routine
medications; often charted in graph form
Fluid volume deficit (hypovolemia) loss of both water and
electrolytes in similar proportions from the extracellular
fluid
Fluid volume excess (FVE) (hypervolemia) retention of both
water and sodium in similar proportions to normal
extracellular fluid (ECF)
Focus charting a method of charting that uses key words or foci
to describe what is happening to the client
Folk medicine beliefs and practices relating to illness prevention
and healing that derive from cultural traditions rather than
from modern medicine's scientific base
Fontanels unossified membranous gaps in the bone structure of
the skull of a newborn that make molding of the head
possible
Food diary a detailed record of measured amounts (portion
sizes) of all food and fluids a client consumes during a
specified period, usually 3 to 7 days
Food frequency record a checklist that indicates how often
general food groups or specific foods are eaten
Foot drop plantar flexion contracture
Foreseeability a link that must exist between the nurse's act and
the injury suffered
Formal leader an appointed leader selected by an organization
and given official authority to make decisions and act
Formal nursing care plan a written or computerized guide
that organizes information about the client's care
Fowler's position a bed-sitting position with the head of the bed
raised to 45 degrees
Friction rubbing; the force that opposes motion
Full disclosure a basic right, which means that deception, either
by withholding information about a client's participation in
a study or by giving the client false or misleading
information about what participating in the study will
involve, must not occur
Functional strength ability of the body to perform work
Fungi infection-causing microorganisms that include yeasts and
molds

Gait the way a person walks
Gastrocolic reflex increased peristalsis of the colon after food
has entered the stomach
Gastrostomy an opening through the abdominal wall into the
stomach
Gastrostomy tube a tube that is surgically placed directly into
the client's stomach and provides a route for administering
nutrition and medications
Gauge diameter of a shaft
Gender indicates biologic male or female status
Gender identity a person's sense of being masculine or feminine,
as distinct from being male or female Gender-role behavior
outward expression of a person's sense of maleness or
femaleness
General adaptation syndrome (GAS) (Selye) a general arousal
response of the body to a stressor characterized by certain
physiologic events and dominated by the sympathetic
nervous system
General anesthesia the induced loss of all sensation and
consciousness
Generation X generation that includes those born in years 1965-
1978
Generation Y generation that includes those born in years 1979-
2000
Generativity concern for establishing and guiding the next
generation
Generic name a drug name not protected by trademark and
usually describing the chemical structure of the drug
Genital intercourse penile/vaginal intercourse (coitus)
Geragogy the term used to describe the process involved in
stimulating and helping elderly persons to learn
Geriatrics medical care of the elderly
Gerontology the study of aging and older adults
Gingival of or relating to the gums
Gingivitis red, swollen gingiva (gums)
Glaucoma a disturbance in the circulation of aqueous fluid;
causes an increase in intraocular pressure
Global self refers to the collective beliefs and images one holds
about oneself; the most complete description that
individuals can give of themselves at any one time
Global self-esteem how much one likes one's perceived self as a
whole
Glomerulus a tuft of capillaries in the kidney surrounded by
Bowman's capsule
Glossitis inflammation of the tongue
Glycerides the most common form of lipids consisting of a
glycerol molecule with up to three fatty acids
Glycogen the chief carbohydrate stored in the body, particularly
in the liver and muscles
Glycogenesis the process of glycogen formation
Goals/desired outcomes a part of a care plan that describes, in
terms of observable client responses, what the nurse hopes
to achieve by implementing the nursing interventions
Goniometer a device used to measure the angle of a joint in
degrees
Governance the establishment and maintenance of social,
political, and economic arrangements by which
practitioners control their practice, self-discipline, working
conditions, and professional affairs
Grand theories articulate a broad range of the significant
relationships among the concepts of a discipline
Granulation tissue young connective tissue with new capillaries
formed in the wound healing process
Grief emotional suffering often caused by bereavement
Gross negligence involves extreme lack of knowledge, skill, or
decision making that the person clearly should have known
would put others at risk for harm
Grounded theory research to understand social structures and
social processes; this method focuses on the generation of
categories or hypotheses that explain patterns of behavior
of people in the study
Group two or more people with shared purposes and goals
Group dynamics forces that determine the behavior of the group
and the relationships among the group members
Growth physical change and increase in size
10
Guaiac test a test performed for occult (hidden) blood to detect
gastrointestinal bleeding not visible to the eye
Guided imagery state of focused attention that encourages
changes in attitudes, behavior, and physiologic reactions
Gustatory referring to the sense of taste
Habit training attempts to keep clients dry by having them void
at regular intervals; also referred to as timed voiding or
scheduled toileting
Hardware the physical parts of a computer
Harm (Injury) the client or plaintiff must demonstrate some type
of harm or injury (physical, financial, or emotional)
as a result of the breach of duty owed the client; the plaintiff will
be asked to document physical injury, medical costs, loss of
wages, "pain and suffering," and any other damages
Harriet Tubman known as "the Moses of Her People" for her
work with the Underground Railroad; during the Civil War
she nursed the sick and suffering of her own race
Haustra pouches that form in the large intestine when the
longitudinal muscles are shorter than the colon
Haustral churning (shuffling) movement of the chyme back and
forth within the haustra in the large intestine
Health behaviors the actions a person takes to understand his or
her health state, maintain an optimal state of health,
prevent illness and injury, and reach his or her maximum
physical and mental potential
Health beliefs concepts about health that an individual believes
are true
Health care proxy a legal statement that appoints a proxy to
make medical decisions for the client in the event the client
is unable to do so
Health care system the totality of services offered by all health
disciplines
Health literacy ability to read, understand, and act on provided
health information
Health maintenance organization (HMO) a group health care
agency that provides basic and supplemental health
maintenance and treatment services to voluntary enrollees
Health promotion any activity undertaken for the purpose of
achieving a higher level of health and well-being
Health protection behavior motivated by a desire to actively
avoid illness, detect it early, or maintain functioning within
the constraints of illness
Health risk assessment (HRA) an assessment and educational
tool that indicates a client's risk for disease or injury during
the next 10 years by comparing the client's risk with the
mortality risk of the corresponding age, sex, and racial
group
Health status the health of a person at a given time
Heart failure a condition that develops if the heart cannot keep
up with the body's need for oxygen and nutrients to the
tissues; usually occurs because of myocardial infarction, but
it may also result from chronic overwork of the heart
Heart-lung death the traditional clinical signs of death: cessation
of the apical pulse, respirations, and blood pressure
Heat balance the state a person is in when the amount of heat
produced by the body exactly equals the amount of heat
lost
Heat exhaustion condition that is the result of excessive heat
and dehydration
Heat stroke life-threatening condition with body temperature
greater than 106°F
Heimlich maneuver subdiaphragmatic abdominal thrusts used to
clear an obstructed airway
Helix the posterior curve of the auricle's upper aspect
Helping relationships the nurse-client relationship
Hematocrit the proportion of red blood cells (erythrocytes) to
the total blood volume
Hematoma a collection of blood in a tissue, organ, or space due
to a break in the wall of a blood vessel
Hemoglobin (Hg) the red pigment in red blood cells that carries
oxygen
Hemoglobin A1C measurement of blood glucose that is bound to
hemoglobin

Hemolytic transfusion reaction destruction of red blood cells as
a result of transfusion of incompatible blood
Hemoptysis the presence of blood in the sputum
Hemorrhage excessive loss of blood from the vascular system
Hemorrhagic exudate see Sanguineous exudate
Hemorrhoids distended veins in the rectum
Hemostasis cessation of bleeding
Hemothorax a collection of blood in the pleural cavity
Herbal medicine treating illness with herbs
Heritage consistency the degree to which one's lifestyle reflects
his or her respective tribal culture
Heritage inconsistency the observance of the beliefs and
practices of one's acculturated belief system
Hernia a protrusion (such as of the intestine through the inguinal
wall or canal)
High Fowler's position a bed-sitting position in which the head of
the bed is elevated 90 degrees
Higher brain death see Cerebral death
Hirsutism abnormal hairiness, particularly in women
Holism all living organisms are seen as interacting, unified
wholes that are more than the sums of their parts
Holistic health a model of health based on the belief that the
whole is more than the sum of its parts
Holistic health belief holds that the forces of nature must be
maintained in balance or harmony
Holistic health care a system that considers all components of
health: health promotion, health maintenance, health
education and illness prevention, and restorative-
rehabilitative care
Holistic nursing nursing practice that has as its goal the healing
of the whole person
Holy day a day set aside for special religious observance
Homans' sign calf pain produced by dorsiflexion of the foot
Home care providing care in the client's home
Home health care nursing services and p r o d u c t s p r o v i d e
d to clients in their homes that are needed to maintain,
restore, or promote their physical, psychologic, and social
well-being
Homeopathy an alternative therapy based on the theory that
the cure for the disease lies in the disease itself; thus,
treatment is with highly diluted amounts of substances that
at a higher concentration would produce the same
symptoms as the disease
Homeostasis the tendency of the body to maintain a state of
balance or equilibrium while continually changing; a
mechanism in which deviations from normal are sensed
and counteracted
Hope a multidimensional concept that includes perceiving
realistic expectations and goals, having motivation to
achieve goals, anticipating outcomes, establishing trust and
interpersonal relationships, relying on internal and external
resources, having determination to endure, and being
oriented to the future
Hordeolum (sty) a redness, swelling, and tenderness of the hair
follicle and glands that empty at the edge of the eyelids
Horticultural therapy also called gardening or healing garden;
adjunct therapy to occupational and physical therapy that
may involve viewing nature, visiting a healing garden or
wander garden, or actively gardening
Hospice the delivery of care for terminally ill clients either in
health care facilities or in the client's home
Hospice nursing care frequently given to terminally ill clients in
their home; often considered a subspecialty of public
health nursing
Hospital information system (HIS) computer software program
suite used to manage client, financial, and administrative
data
Hub the part of a needle that fits onto a syringe
Humanism learning that focuses on the feelings and attitudes of
learners, the importance of the individual in identifying
learning needs and taking responsibility for them, and the
self-motivation of the learners to work toward self-reliance
and independence
Humanist a perspective that includes propositions such as the
mind and body are indivisible, people have the power to
11
solve their own problems, and people are responsible for
their lives and well-being
Humidifiers devices that add water vapor to inspired air
Humoral immunity antibody-mediated defense; resides
ultimately in the B lymphocytes and is mediated by the
antibodies produced by B cells
Hydrostatic pressure the pressure a liquid exerts on the sides of
the container that holds it; also called filtration force
Hygiene the science of health and its maintenance
Hyperalgesia extreme sensitivity to pain
Hypercalcemia an excess of calcium in-the blood plasma
Hypercapnia a condition in which carbon dioxide accumulates in
the blood
Hypercarbia see Hypercapnia
Hyperchloremia an excess of chloride in the blood plasma
Hyperemia increased blood flow to an area
Hyperinflation giving the client breaths that are 1 to 1.5 times
the tidal volume through the ventilator circuit or via a
manual resuscitation bag
Hyperkalemia an excess of potassium in the blood plasma
Hypermagnesemia an excess of magnesium in the blood plasma
Hypernatremia an excess of sodium in the blood plasma
Hyperopia abnormal refraction in which light rays focus behind
the retina, farsightedness
Hyperoxygenation done with a manual resuscitation bag or
through a ventilator; increases oxygen flow (usually to
100%) before suctioning and between suction attempts
Hyperpathia heightened response to a painful stimulus;
hyperalgesia
Hyperphosphatemia an excess of phosphate in the blood plasma
Hyperpyrexia see Hyperthermia
Hyperresonance an abnormal booming sound produced during
percussion of the lungs
Hypersomnia excessive sleep
Hypertension an abnormally high blood pressure; over 140 mm
Hg systolic and/or 90 mm Hg diastolic
Hyperthermia an extremely high body temperature (e.g., 41°C
[105.8°F])
Hypertonic solutions that have a higher osmolality than body
fluids
Hypertrophy enlargement of a muscle or organ
Hyperventilation very deep, rapid respirations
Hypervolemia increased blood volume
Hypnotherapy application of hypnosis (trance state or altered
state of consciousness) to a medical or psychologic disorder
Hypoactive sexual desire disorder i n v o l v e s a p e r s i s t e n t
o r recurring absence of sexual thoughts or disinterest in
sexual activity
Hypocalcemia deficiency of calcium in the blood plasma
Hypochloremia deficiency of chloride in the blood plasma
Hypodermic under the skin
Hypodermic syringe a type of syringe that comes in 2-, 2.5-, and
3-mL sizes; the syringe usually has two scales marked on it:
the minim and the milliliter
Hypokalemia deficiency of potassium in the blood plasma
Hypomagnesemia deficiency of magnesium in the blood plasma
Hyponatremia deficiency of sodium in the blood plasma
Hypophosphatemia deficiency of phosphate in the blood plasma
Hypotension an abnormally low blood pressure; less than 100
mm Hg systolic in an adult
Hypothalamic integrator the center in the brain that controls the
core temperature; located in the preoptic area of the
hypothalamus
Hypothermia a core body temperature below the lower limit of
normal
Hypothesis a prediction of the relationship among two or more
variables
Hypotonic solutions that have a lower osmolality than body
fluids
Hypoventilation very shallow respirations
Hypovolemia an abnormal reduction in blood volume
Hypoxemia reduced oxygen in the blood
Hypoxia insufficient oxygen anywhere in the body

Iatrogenic disease disease caused unintentionally by medical
therapy
iatrogenic infections infections that are the direct result of
diagnostic or therapeutic procedures
Id the source of instinctive and unconscious psychologic urges
Ideal body weight (IBW) the optimal weight recommended for
optimal health
Ideal self how we would prefer to be; the individual's perception
of how one should behave based on certain personal
standards, aspirations, goals, or values identification
perceiving one's self as similar to and behaving like another
person
Idiosyncratic effect a different, unexpected, or individual effect
from the normal one usually expected from a medication;
the occurrence of unpredictable and unexplainable
symptoms
Ileal conduit channel created when a segment of the ileum is
removed and the intestinal ends reattached
Ileostomy an opening into the ileum (small bowel)
Illicit drugs drugs that are sold illegally; street drugs
Illness a highly personal state in which the person feels
unhealthy or ill, may or may not be related to disease
Illness behavior the course of action a person takes to define the
state of his or her health and pursue a remedy
Imagery the internal experience of memories, dreams, fantasies,
and visions that serve as a bridge connecting body, mind,
and spirit
Imagination an important part of preschoolers' life (the
preschooler has an active imagination and fantasizes in
play) imitation copying the behaviors and attitudes of
another person
Immobility prescribed or unavoidable restriction of movement in
any area of a person's life
Immune defenses see Specific (immune) defenses
Immunity a specific resistance of the body to infection; it may be
natural, or resistance may develop after exposure to a
disease agent
Immunoglobulins see Antibodies
Impaired nurse a nurse whose practice has deteriorated because
of chemical abuse
Implementing the phase of the nursing process in which the
nursing care plan is put into action
Implied consent consent that is assumed in an emergency when
consent cannot be obtained from the client or a relative
Implied contract a contract that has not been explicitly agreed to
by the parties but that the law nevertheless considers to
exist
Incentive spirometers devices that measure the flow of air
inhaled through the mouthpiece
Incomplete proteins protein that lacks one or more essential
amino acids; usually derived from vegetables
Incus the anvil bone of the middle ear
Independent variable the presumed cause or influence on the
dependent variable
Independent functions areas of health care unique to nursing,
separate and distinct from medical management
Independent interventions activities that the nurse is licensed to
initiate as a result of the nurse's own knowledge and skills
Independent practice associations (IPAs) p r o v i d e c a r e in o
ffices; clients pay a fixed prospective payment and 1PA pays
the provider; earnings or losses are assumed by the IPA
Indicator an observable patient state, behavior, or self-reported
perception or evaluation; similar to desired outcomes in
traditional language
Individualized care plan a plan tailored to meet the unique
needs of a specific client—needs that are not addressed by
the standardized plan
Individualized exercise prescription exercise mode and dose
tailored to a specific individual to ensure greater adherence
to the exercise program
Inductive reasoning making generalizations from specific data
Infection the disease process produced by microorganisms
inferences interpretations or conclusions made based on
cues or observed data inflammation local and nonspecific
defensive tissue response to injury or destruction of cells
12
infrared photoenergy therapy treatment to improve
sensory impairment associated with peripheral neuropathy
Influence an informal strategy used to gain the cooperation of
others without exercising formal authority
Informal nursing care plan a strategy for action that exists in the
nurse's mind
informal leader an individual selected by the group as its leader
because of seniority, age, special abilities, or charisma
Informed consent a client's agreement to accept a course of
treatment or a procedure after receiving complete
information, including the risks of treatment and facts
relating to it, from the physician
Ingestion the act of taking in food or medication
Ingrown toenail the growing inward of the nail into the soft
tissues around it, most often results from improper nail
trimming
Inhalation (inspiration) the act of breathing in; the intake of air
or other substances into the lungs
Inhibiting effect the decreased effect of one or both drugs
Injury see Harm
Input consists of information, material, or energy that enters a
system
Inquest a legal inquiry into the cause or manner of a death
Insensible fluid loss fluid loss that is not perceptible to the
individual
Insensible heat loss heat loss that occurs from evaporation
(vaporization) of moisture from the respiratory tract,
mucosa of the mouth, and the skin
Insensible water loss continuous and unnoticed water loss
In-service education education that is designed to upgrade the
knowledge or skills of employees
insomnia inability to obtain a sufficient quality or quantity of
sleep
inspection the visual examination, that is, assessment by using
the sense of sight
Inspiration see Inhalation
Insulin syringe similar to a hypodermic syringe, but the scale is
specially designed for insulin: a 100-unit calibrated scale
intended for use with U-100 insulin
integrated delivery system (IDS) a system that incorporates
acute care services, home health care, extended and skilled
care facilities, and outpatient services
Integrated health care system one that makes all levels of care
available in an integrated form—primary care, secondary
care, and tertiary care
Intensity the loudness or softness of a sound, amplitude
intention tremor involuntary trembling when an individual
attempts a voluntary movement
Intermittent fever a body temperature that alternates at regular
intervals between periods of fever and periods of normal or
subnormal temperatures
Internet a worldwide computer network
Interpersonal skills all verbal and nonverbal activities people use
when communicating directly with one another
Interpreter an individual who mediates spoken communication
between people speaking different languages without
adding, omitting, or distorting meaning or editorializing
Intersex ambiguous gender
Interstate compact an agreement between two or more states
Interstitial fluid fluid that surrounds the cells, includes lymph
Interview a planned communication; a conversation with a
purpose
Intracellular fluid (ICF) fluid found within the body cells, also
called cellular fluid
Intractable pain pain that is resistant to cure or relief
Intradermal under the epidermis (into the dermis)
Intradermal (ID) injection the administration of a drug into the
dermal layer of the skin just beneath the epidermis
Intramuscular into the muscle
Intramuscular (Ift/I) injections injections into muscle tissue that
are absorbed more quickly than subcutaneous injections
because of the greater blood supply to the body muscles
Intraoperative phase begins when the client is transferred to the
operating table and ends when the client is admitted to the
postanesthesia care unit

Intrapleural pressure pressure in the pleural cavity surrounding
the lungs
Intrapuimonary pressure pressure within the lungs
Intraspinal into the spinal cord
Intrathecal see Intraspinal
Intravascular fluid plasma
Intravenous within a vein
Intravenous block anesthesia used most often for procedures
involving the arm, wrist, and hand
Intravenous pyelography (I VP) x-ray filming of the kidney and
ureters after injection of a radiopaque material into the
vein
Intimacy a close friendship
Introjection the assimilation of the attributes of others
Intuition the understanding or learning of things without the
conscious use of reasoning
Invasion of privacy a direct wrong of a personal nature, it injures
the feelings of the person and does not take into account
the effect of revealed information on the standing of the
person in the community
Ions atoms or group of atoms that carry a positive or negative
electric charge; electrolytes
Iron deficiency anemia a form of anemia caused by inadequate
supply of iron for synthesis of hemoglobin
Irrigation (Savage) a flushing or washing-out of a body cavity,
organ, or wound with a specified solution that may or may
not be medicated
Ischemia deficiency of blood supply caused by obstruction of
circulation to the body part
isokinetic (resistive) exercises muscle contraction or tension
against resistance
Isolation practices that prevent the spread of infection and
communicable disease
Isometric (static or setting) exercise t e n s i n g of a m u s c l e
against an immovable outer resistance that does not
change muscle length or produce joint motion
Isotonic solutions that have the same osmolality as body fluids
Isotonic (dynamic) exercise exercise in which muscle tension is
constant and the muscle shortens to produce muscle
contraction and active movement
Jaundice a yellowish color of the sclera, mucous membranes,
and/or skin
Jejunostomy an opening through the abdominal wall into the
jejunum
Justice fairness
Kardex the trade name for a method that makes use of a series
of cards to concisely organize and record client data and
instructions for daily nursing care—especially care that
changes frequently and must be kept up to date
Keloid a hypertrophic scar containing an abnormal amount of
collagen
Kidneys/ureters/bladder (KUB) x-ray of the kidneys, ureters, and
bladder
Kilocalorie (kcal) see C a l o r i e
Kilojoule (kJ) a metric measurement referring to the amount of
energy required when a force of 1 newton (N) moves 1 kg
of weight 1 m of distance
Kinesthetic refers to awareness of the position and movement of
body parts
Knights of Saint Lazarus an order of knights that dedicated
themselves to the care of people with leprosy, syphilis, and
chronic skin conditions
Korotkoff's sounds a series of five sounds produced by blood
within the artery with each ventricular contraction
Kosher acceptable or prepared according, to Jewish law
Kussmaul's breathing hyperventilation that accompanies
metabolic acidosis in which the body attempts to
compensate (give off excess body acids) by blowing off
carbon dioxide through deep and rapid breathing
Kyphosis excessive convex curvature of the thoracic spine
13
Laissez-faire (nondirective, permissive) leader r e c o g n i z e s
the group's need for autonomy and self-regulation
Lanugo the fine, woolly hair or down on the shoulders, back,
sacrum, and earlobes of the unborn child that may remain
for a few weeks after birth
Large calorie (Calorie, kilocalorie [kcal]) see C a l o r i e
Laryngoscopy visual examination of the larynx with a
laryngoscope
Lateral position a side-lying position
Lavage an irrigation or washing of a body organ, such as the
stomach
Lavinia L, Dock a nursing leader and suffragist who was active in
the protest movement for women's rights that resulted in
the U.S. Constitution amendment allowing women to vote
in 1920
Law a rule made by humans that regulates social conduct in a
formally prescribed and binding manner
Laxatives medications that stimulate bowel activity and assist
fecal elimination
Leader a person who influences others to work together to
accomplish a specific goal
Leadership style describes traits, behaviors, motivations, and
choices used by individuals to effectively influence others
Leading question a question that influences the client to give a
particular answer
Learning a change in human disposition or capability that
persists over a period of time and cannot be solely
accounted for by growth
Learning need a desire or a requirement to know something that
is currently unknown to the learner
Leukocytes white blood cells
Leukocytosis an increase in the number of white blood cells
Liability the quality or state of being legally responsible for one's
obligations and action and to make financial restitution for
wrongful acts
Libel defamation by means of print, writing, or pictures
Libido urge or desire for sexual activity
License a legal permit granted to individuals to engage in the
practice of a profession and to use a particular title
Licensed vocational (practical) nurse (LVN/LPN) a n u r s e w h o
practices under the supervision of a registered nurse,
providing basic direct technical care to clients
Lifestyle the values and behaviors adopted by a person in daily
life
Lift an abnormal anterior movement of the chest related to
enlargement of the right ventricle
Lillian Wald founder of the Henry Street Settlement and Visiting
Nurse Service, which provided nursing and social services and
organized educational and cultural activities; considered
the founder of public health nursing
Linda Richards America's first trained nurse
Line of gravity an imaginary vertical line running through the
center of gravity
Lipids organic substances that are greasy and insoluble in water
but soluble in alcohol or ether
Lipoproteins soluble compounds made up of various lipids
Litigation the action of a lawsuit
Living will a document that states medical treatments(s) the
client chooses to omit or refuse in the event that the client
is unable to make these decisions
Livor mortis discoloration of the skin caused by breakdown of
the red blood cells; occurs after blood circulation has
ceased; appears in the dependent areas of the body
Lobule earlobe
Local adaptation syndrome (LAS) t h e r e a c t i o n of o n e o r g
a n or body part to stress
Local anesthesia an anesthetic agent used for minor surgical
procedures that is injected into a specific area
Local area network (LAN) personal computers (PCs) linked
directly to nearby PCs and servers by wires or wireless
communication devices
Local infection an infection that is limited to the specific part of
the body where the microorganisms remain
Locus of control (LOC) a concept about whether cl ients believe
their health status is under their own or others' control

Logrolling a technique used to turn a client whose body must at
all times be kept in straight alignment (like a log)
Long-term memory the repository for information stored for
periods longer than 72 hours and usually weeks and years
Lordosis an exaggerated concavity in the lumbar region of the
vertebral column
Loss an actual or potential situation in which a valued ability,
object, or person is inaccessible or changed so that it is
perceived as no longer valuable
Low Fowler's position a bed-sitting position in which the head of
the bed is elevated between 15 and 45 degrees, with or
without knee flexion
Lumbar puncture a procedure where cerebrospinal fluid (CSF) is
withdrawn through a needle that is inserted into the
subarachnoid space of the spinal canal between the third
and fourth lumbar vertebrae or between the fourth and
fifth lumbar vertebrae
Lung compliance expansibility of the lung
Lung recoil the tendency of lungs to collapse away from the
chest wall
Lung scan records the emissions from radioisotopes that
indicate how well gas and blood are traveling through the
lungs; also known as a V/Q (ventilation/perfusion) scan
Maceration the wasting away or softening of a solid as if by the
action of soaking; often used to describe degenerative
changes and eventual disintegration
Macrominerals any of the minerals that people require daily in
amounts over 100 mg
Macronutrients refers to carbohydrates, fats, and protein
because they are needed in large amounts (e.g., hundreds
of grams) to provide energy
Magico-religious health belief a belief system in which people
attribute the fate of the world and those in it to the actions
of God, the gods, or other supernatural forces for good or
evil Magnetic resonance imaging ( M R I ) a n o n i n v a s i v
e d i a g n o s t i c scanning technique in which the client is
placed in a magnetic field
Maintenance stage stage at which a person integrates newly
adopted behavior patterns into his or her lifestyle
Major surgery surgery that involves a high degree of risk for a
variety of reasons; it may be complicated or prolonged;
large losses of blood may occur; vital organs may be
involved; postoperative complications may occur
Male erectile disorder when a man has erection problems during
25% or more of his sexual interactions
Male orgasmic disorder disorder where a man can maintain an
erection but has difficulty ejaculating
Malleus hammer bone of the middle ear
Malnutrition a disorder of nutrition; insufficient nourishment of
the body cells
Malpractice the negligent acts of persons engaged in professions
or occupations in which highly technical or professional
skills are employed
Managed care a method of organizing care delivery that
emphasizes communication and coordination of care
among all health care team members
Management information system ( M I S ) s o f t w a r e d e s i g n
e d to facilitate the organization and application of data
used to manage an organization or department
Manager one who is appointed to a position in an organization
that gives the power to guide and direct the work of others
Mandated reporters a role of the nurse in which he or she
identifies and assesses cases of violence against others, and
in every case the situation must be reported to the proper
authorities
Manometer an instrument used to measure the pressure of
fluids or gases
Manslaughter second-degree murder
Manubrium the handle-like superior part of the sternum that
joins with the clavicles
Margaret Higgins Sanger considered the founder of Planned
Parenthood, was imprisoned for opening the first birth
control information clinic in Baltimore in 1916
14
Mary Breckinridge a nurse who practiced midwivery in England,
Australia, and New Zealand; founded the Frontier
Nursing Service in Kentucky in 1925 to provide familycentered
primary health care to rural populations
Mary Mahoney first African American professional nurse
Mass peristalsis involves a wave of powerful muscular
contraction that moves over large areas of the colon;
usually occurs after eating
Mastoid a bony prominence behind the ear
Masturbation sexual self-stimulation
Maturity the state of maximal function and integration; the state
of being fully developed Mean a measure of central
tendency, computed by summing all scores and dividing by
the number of subjects; commonly symbolized as X or M
Measures of central tendency measures that describe the center
of a distribution of data, denoting where most of the
subjects lie; include the mean, median, and mode
Measures of variability measures that indicate the degree of
dispersion or spread of the data; include range, variance,
and standard deviation
Meatus an opening, passage, or channel
Meconium the first fecal material passed by the newborn,
normally up to 24 hours after birth
Median a measure of central tendency, representing the exact
middle score or value in a distribution of scores; the median
is the value above and below which 50% of the scores lie
Medicaid a U.S. federal public assistance program paid out of
general taxes and administered through the individual
states to provide health care for those who require financial
assistance
Medical asepsis all practices intended to confine a specific
microorganism to a specific area, limiting the number,
growth, and spread of microorganisms
Medical examiner a physician who usually has advanced
education in pathology or forensic medicine who
determines causes of death
Medicare a national and state health insurance program for U.S.
residents older than 65 years of age
Medication a substance administered for the diagnosis, cure,
treatment, or relief of a symptom or for prevention of
disease
Medication reconciliation comparison of medications client is
taking to physician's admission, transfer, and/or discharge
orders
Meditation mental exercise that directs the mind to think
inwardly by closing the sense organs to external stimulation
Menarche onset of menstruation
Meniscus the crescent-shaped upper surface of a column of fluid
Menopause cessation of menstruation
Menstruation the monthly discharge of blood through the
vagina occurring in nonpregnant women from puberty to
menopause
Mentor a person who serves as an experienced guide, adviser,
or advocate and assumes responsibility for promoting the
growth and professional advancement of a less experienced
individual
Mesoderm middle layer of the embryonic tissue that forms
during the first 3 weeks of life
Metabolic acidosis a condition characterized by a deficiency of
bicarbonate ions in the body in relation to the amount of
carbonic acid in the body; the pH falls to less than 7.35
Metabolic alkalosis a condition characterized by an excess of
bicarbonate ions in the body in relation to the amount of
carbonic acid in the body; the pH rises to greater than 7.45
Metabolism the sum of all physical and chemical processes by
which a living substance is formed and maintained and by
which energy is made available for use by the organism
Metabolites end products or enzymes
Metaparadigm originates from the Greek meta, meaning "with,"
and paradigm, meaning "pattern"; based on four
theoretical concepts of nursing: person, environment,
health, and nursing
Metered-dose inhaler (MDI) a handheld nebulizer, which is a
pressurized container of medication that can be used by
the client to release the medication through a mouthpiece

Microminerals a vitamin or mineral
Micronutrients vitamins and minerals that are needed in small
amounts (e.g., milligrams or micrograms) to metabolize
energy-providing nutrients
Micturition see Urination
Mid-arm circumference (MAC) a measure of fat, muscle, and
skeleton
Mid-arm muscle circumference (MAMC) calculated by using
reference tables or by using a formula that incoiporates the
triceps skinfold and the MAC
Middle-level manager a manager who supervises a number of
first-level managers and is responsible for the activities in
the departments supervised
Midlevel theories focus on exploration of concepts such as pain,
self-esteem, learning, and hardiness
Midstream urine specimen see Clean-catch specimen
Milliequivalent one-thousandth of an equivalent, which is the
chemical combining power of a substance
Minerals a substance found in organic compounds, as inorganic
compounds and as free ions
Minor surgery surgery that i nvol ves little risk, produces few
complications, and is often performed in a "day surgery"
facility
Miosis constricted pupils
Misdemeanor a legal offense usually punishable by a fine or a
short-term jail sentence, or both
Mixed hearing loss a combination of conduction and
sensorineural loss
Mobility ability to move about freely, easily, and purposefully in
the environment
Mode the score or value that occurs most frequently in a
distribution of scores
Modeling observing the behavior of people who have
successfully achieved a goal that one has set for oneself
and, through observing, acquiring ideas for behavior and
coping strategies
Monosaccharides sugars that are composed of single molecules
Monotheism belief in the existence of one God
Monounsaturated fatty acids a fatty acid with one double bond
Moral relating to right and wrong
Moral behavior the way a person perceives the requirements
necessary for people to live together and how he or she
responds to them
Moral development process of learning to tell the difference
between right and wrong and of learning what ought and
ought not to b e done
Moral rules specific prescriptions for actions
Morality a doctrine or system denoting what is right and wrong
in conduct, character, or attitude
Mortician a person trained in the care of the dead; also called an
undertaker
Motivation the desire to learn
Mourning the process through which grief is eventually resolved
or altered
Multidisciplinary care plan a standardized plan that outlines the
care required for clients with common, predictable—
usually medical—conditions
Music therapy the behavioral science concerned with the
systematic application of music to produce relaxation and
desired changes in emotions, behavior, and physiology
Mutual pretense a type of awareness in which the client, family,
and health personnel know that the prognosis is terminal
but do not talk about it and make an effort not to raise the
subject
Mutual recognition model a regulatory model developed by the
National Council of State Boards of Nursing (NCSBN), which
allows for multistate licensure
Mydriasis enlarged pupils
Myocardial infarction (Ml) heart attack; cardiac tissue necrosis
owing to obstruction of blood flow to the heart
Myocardium a layer of the heart wall; cardiac muscle cells that
form the bulk of the heart and contract with each beat
Myopia abnormal refraction in which light rays focus in front of
the retina (nearsightedness)
15
Narcolepsy an uncontrollable desire for sleep or attacks of sleep
during the day
Narrative charting a descriptive record of client data and nursing
interventions, written in sentences and paragraphs
Nasoenteric tube a tube inserted through one of the nostrils,
down the nasopharynx, and into the alimentary tract
Nasogastric tube a tube inserted by way of the nasopharynx and
placed into the client's stomach for the purpose of feeding
the client or to remove gastric secretions
Naturopathic medicine practice that focuses on nutrition, herbs,
homeopathy, acupuncture, hydrotherapy, physical
medicine, counseling, and minor surgical interventions
Negative feedback feedback that inhibits change
Negligence failure to behave in a reasonable and prudent
manner; an unintentional tort
Nephrostomy diversion of urine from a kidney to a stoma
Nerve block chemical interruption of a nerve pathway effected
by injecting a local anesthetic
Network linkages
Networking a process by which people develop linkages
throughout the profession to communicate, share ideas
and information, and offer support and direction to each
other
Neurectomy surgery in which peripheral or cranial nerves are
interrupted to alleviate localized pain
Neurogenic bladder interference with the normal mechanisms of
urine elimination in which the client does not perceive
bladder fullness and is unable to control the urinary
sphincters; the result of impaired neurologic function
Neuropathic pain the result of a disturbance of the peripheral or
central nervous system that results in pain that may or may
not be associated with an ongoing tissue-damaging process
Neutral question a question that does not direct or pressure a
client to answer in a certain way
Nitrogen balance a measure of the degree of protein anabolism
and catabolism; net result of intake and loss of nitrogen
Nociception the physiologic processes related to pain perception
Nociceptor a pain receptor
Nocturia voiding two or more times at night
Nocturnal emissions orgasm and emission of semen during sleep
Nocturnal enuresis involuntary urination at night
Nocturnal frequency the need for older adults to arise during the
night to urinate
Nondirective interview an interview using open-ended questions
and empathetic responses to build rapport and learn client
concerns
Nondirective leader see Laissez-faire (nondirective, permissive)
leader
Nonessential amino acids an amino acid that the body can
manufacture
Nonmaleficence the duty to do no harm
Nonspecific defenses bodily defenses that protect a person
against all microorganisms, regardless of prior exposure
Nonsteroidal anti-inflammatory drugs (NSAIDs) drugs that
relieve pain by acting on the peripheral nerve endings to
inhibit the formation of the prostaglandins that tend to
sensitize nerves to painful stimuli; have analgesic,
antipyretic, and anti-inflammatory effects; include aspirin
and ibuprofen
Nonverbal communication communication other than words,
including gestures, posture, and facial expressions
Norm an ideal or fixed standard; an expected standard of
behavior of group members
Normocephalic normal head size
Normocephaly normal head circumference at birth; usually 35
cm (14 in.)
Nosocomial infections infections associated with the delivery of
health care services in a health care facility
NPO from the Latin nil per os meaning "nothing by mouth"
NREM (non-REM) sleep a deep restful sleep rate; also called
slow wave sleep
Nuclear family a family of parents and their offspring
Nurse informaticist an expert who combines computer,
information, and nursing science to develop policies and

procedures that promote effective use of computerized
records by nurses and other health care professionals
Nursing the attributes, characteristics, and actions of the nurse
providing care on behalf of, or in conjunction with, the
client
Nursing diagnosSs the nurse's clinical judgment about individual,
family, or community responses to actual and potential
health problems/life processes to provide the basis for
selecting nursing interventions to achieve outcomes for
which the nurse is accountable
Nursing ethics ethical issues that occur in nursing practice
Nursing informatics the science of using computer information
systems in the practice of nursing
Nurse informaticist expert who combines computer,
information, and nursing science
Nursing intervention any treatment, based on clinical judgment
and knowledge, that a nurse performs to enhance patient/
client outcomes
Nursing interventions Classification (NSC) a taxonomy of nursing
actions each of which includes a label, a definition, and a
list of activities
Nursing Outcomes Classification (NOC) a taxonomy for
describing client outcomes that respond to nursing
interventions
Nursing process a systematic rational method of planning and
providing nursing care
Nutrients organic or inorganic substances found in food
Nutrition the sum of all interactions between an organism and
the food it consumes ,
Nutritive value the nutrient content of a specified amount of
food
Nystagmus rapid involuntary rhythmic eye movement
Obese (obesity) when body mass index (BMI) is greater than 30
kg/m2
Objective data information (data) that is detectable by an
observer or can be tested against an accepted standard;
can be seen, heard, felt, or smelled
Obligatory losses essential fluid losses required to maintain body
functioning
Occult blood hidden blood
Occupational exposure skin, eye, mucous membrane, or
parenteral contact with blood or other potentially
infectious materials that may result from the performance
of an employee's duties
Official name the name under which a drug is listed in one of the
official publications (e.g., the United States Pharmacopeia)
Oils lipids that are liquid at room temperature
Olfactory related to smell
Oliguria production of abnormally small amounts of urine by the
kidney
Oncotic pressure see Colloid osmotic pressure
One-point discrimination the ability to sense whether one or
two areas of the skin are being stimulated by pressure
Online connected to a computer network
Onset of action the time after drug administration when the
body initially responds to the drug
Open awareness a type of awareness in which a client and
people around know about the impending death
Open system system in which energy, matter, and information
move into and out of the system through the system
boundary
Open-ended questions questions that specify only the broad
topic to be discussed and invite clients to discover and
explore their thoughts and feelings about the topic
Operational definitions definitions that specify the instruments
or procedures by which concepts will be measured
Ophthalmic referring to the eye
Opportunistic pathogen a microorganism causing disease only in
a susceptible individual
Oral referring to the mouth
Oral-genital sex oral stimulation of either female or male
genitals
16
Organizing determining responsibilities, communicating
expectations, and establishing the chain of command for
authority and communication
Orgasmic phase part of the response cycle, the involuntary
climax of sexual tension, accompanied by physiologic and
psychologic release
Orthopnea ability to breathe only when in an upright position
(sitting or standing)
Orthopneic position a sitting position that relieves respiratory
difficulty; the client leans over and is supported by an
overbed table across the lap
Orthostatic hypotension decrease in blood pressure related to
positional or postural changes from lying to sitting or
standing positions
Osmolality the concentration of solutes in body fluids
Osmosis passage of a solvent through a semipermeable
membrane from an area of lesser solute concentration to
one of greater solute concentration
Osmotic pressure pressure exerted by the number of
nondiffusible particles in a solution; the amount of pressure
bneeded to stop the flow of water across a membrane
Ossicles the three middle ear bones of sound transmission
Osteoporosis demineralization of the bone
Ostomy a suffix denoting the formation of an opening or outlet
such as an opening on the abdominal wall for the
elimination of feces or urine
Otic referring to the ear
Otoscope an instrument used to examine the ears
Outcome evaluation focuses on demonstrable changes in the
client's health status as result of nursing care
Output energy, matter, or information from a system given out
by the system as a result of its processes
Overhydration occurs when water is gained in excess of
electrolytes, resulting in low serum osmolality and low
serum sodium levels, also known as hypo-osmolar
imbalance or water intoxication
Overnutrition a caloric intake in excess of daily energy
requirements, resulting in storage of energy in the form of
adipose tissue
Overweight a BMI of 26-30 kg/m2
Oxyhemoglobin the compound of oxygen and hemoglobin
Pace number of steps taken per minute or the distance taken in
one step when walking
Packing filling an open wound or cavity with a material such as
gauze
Pain whatever the experiencing person says it is, existing
whenever he or she says it does
Pain threshold the amount of pain stimulation a person requires
before feeling pain
Pain tolerance the maximum amount and duration of pain that
an individual is willing to endure
Palliative care symptom care of clients for whom disease no
longer responds to cure-focused treatment
Pallor the absence of underlying red tones in the skin; may be
most readily seen in the buccal mucosa
Palpation the examination of the body using the sense of touch
Papanicolaou (Pap) test a method of taking a sample of cervical
cells for microscopic examination to detect malignancy
Paradigm a pattern of shared understandings and assumptions
about reality and the world
Parasites microorganisms that live in or on another from which it
obtains nourishment
Parasomnia a cluster or pattern of waking behavior that appears
during sleep, such as somnambulism (sleepwalking),
sleeptalking, and enuresis (bed-wetting)
Parenteral drug administration occurring outside the alimentary
tract; injected into the body through some route other than
the alimentary canal (e.g., intramuscularly)
Paresis slight or incomplete paralysis
Parotitis inflammation of the parotid salivary gland
Partial pressure the pressure exerted by each individual gas in a
mixture according to its percentage concentration in the
mixture

Partially complete proteins proteins that contain less than the
required amount of one or more essential amino acids;
cannot alone support continued growth
Participative leader see Democratic leader
Passive euthanasia allowing a person to die by withholding or
withdrawing measures to maintain life
Passive (Acquired) immunity a resistance of the body to
infection in which the host receives natural or artificial
antibodies produced by another source
Passive ROM exercises another person moves each of a client's
joints through its complete range of movement, maximally
stretching all muscle groups within each plane over each
joint
Pathogenicity the ability to produce disease; a pathogen is a
microorganism that causes disease
Pathologic fractures spontaneous fractures to which elderly
persons are prone
Patient a person who is waiting for or undergoing medical
treatment and care
Patient Self-Determination Act (PSDA) l e g i s l a t i o n r e q u i r i
ng that every competent adult be informed in writing on
admission to a health care institution about his or her rights
to accept or refuse medical care and to use advance
directives
Patient-controlled analgesia (PCA) a pain management
technique that allows the client to take an active role in
managing pain
Patient-focused care delivery model that brings all services and
care providers to the client
Peak level indicates the highest concentration of the drug in the
blood serum
Peak plasma level the concentration of a drug in the blood
plasma that occurs when the elimination rate equals the
rate of absorption
Pedagogy the discipline concerned with helping children learn
Pediculosis infestation with head lice
Peer groups assume great importance and have a number of
functions: provide a sense of belonging, pride, social
learning, and sexual roles; most peer groups have well-
defined, sex-specific modes of acceptable behavior and in
adolescence, the peer groups change with age
Penrose drain a flexible rubber drain
Perceived loss the loss experienced by a" person that cannot be
verified by others
Perception the ability to interpret the environment through the
senses
Percutaneous through the skin
Percussion a method in which the body surface is struck to elicit
sounds that can be heard or vibrations that can be felt
Percutaneous endoscopic gastrostomy (PEG) feeding catheter
inserted into the stomach through the skin and
subcutaneous tissues of the abdomen
Percutaneous endoscopic jejunostomy (PEJ) feeding catheter
inserted into the jejunum through the skin and
subcutaneous tissues of the abdomen
Perfusion passage of blood constituents through the vessels of
the circulatory system
Pericardium double layer of fibroserous membrane of the heart;
the parietal, or outermost, pericardium serves to protect
the heart and anchor it to surrounding structures
Peridural anesthesia see Epidural anesthesia
Periodontal disease disorder of the supporting structures of the
teeth
Perioperative period refers to the three phases of surgery:
preoperative,
intraoperative, and postoperative
Peripheral pulse a pulse located in the periphery of the body
(e.g., foot, wrist)
Peripheral vascular resistance (PVR) i m p e d a n c e or o p p o s i
t i o n to blood flow to the tissues; determined by viscosity,
or thickness, of the blood; blood vessel length; blood vessel
diameter
Peripherally inserted central venous catheter (PICC) catheter
inserted in the basilic or cephalic vein just above or below
the antecubital space
17
Peripheral neuropathic pain pain (e.g., phantom limb pain,
postherpetic neuralgia, carpal tunnel syndrome) that
follows damage and/or sensitization of peripheral nerves
Peripherals at the edge or outward boundary
Peristalsis wavelike movements produced by circular and
longitudinal muscle fibers of the intestinal walls; the
movement propels the intestinal contents onward
Permissive leader see Laissez-faire leader
Personal computers (PCs) individual microcomputer systems
referred to as a desktop, portable, laptop, notebook, or
handheld computer
Personal knowing promotes wholeness and integrity in the
personal encounter to achieve engagement
Personal space the distance people prefer in interactions with
others
Personal values values internalized from the society or culture in
which one lives
Personality the outward expression of the inner self
PES format the three essential components of nursing diagnostic
statements including the terms describing the problem, the
etiology of the problem, and the defining characteristics or
cluster of signs and symptoms
pH a measure of the relative alkalinity or acidity of a solution; a
measure of the concentration of hydrogen ions
Phagocytes cells that ingest microorganisms, other cells, and
foreign particles
Pharmacist a person licensed to prepare and dispense drugs and
prescriptions
Pharmacodynamics the process by which a drug alters cell
physiology
Pharmacogenetics process by which the effect of a drug is
influenced by genetic variations such as gender, size, and
body composition
Pharmacokinetics the study of the absorption, distribution,
biotransformation, and excretion of drugs
Pharmacology the scientific study of the actions of drags on
living animals and humans
Pharmacopoeia a book containing a list of drug products used in
medicine, including their descriptions and formulas
Pharmacy the art of preparing, compounding, and dispensing
drugs; also refers to the place where drugs are prepared
and dispensed
Phenomenology research that investigates people's life
experiences and how they interpret those experiences
Philosophy an early effort to define phenomena that serves as
the basis for later theoretical formulations
Phlebotomist a person from a laboratory who performs
venipuncture, collecting the blood specimen for the tests
ordered by the physician
Physical activity bodily movement produced by skeletal muscles
that requires energy expenditure and produces progressive
health benefits
Physical restraints any manual method or physical or mechanical
device, material, or equipment attached to the client's body
that restrict the client's movement
Physiologic dependence biochemical changes occurring in the
body as a result of excessive use of a drug
Physiologic pain pain experienced when an intact properly
functioning nervous system sends signals that tissues are
damaged
PIE an acronym for a charting model that follows a recording
sequence of problems, interventions, and evaluation of the
effectiveness of the interventions
Piggyback secondary IV setup where the second IV set connects
the second container to the tubing of the primary container
at the upper port
Pilates method of physical movement and exercise designed to
stretch, strengthen, and balance the body, in particular the
core of the body
Pinna see Auricle
Pitch the frequency or number of vibrations heard during
auscultation
Pitting edema edema in which firm finger pressure on the skin
produces an indentation (pit) that remains for several
seconds

Placebo any form of treatment (e.g., medication) that produces
an effect in the client because of its intent rather than its
chemical or physical properties
Placenta a flat, disc-shaped organ that is highly vascular and
normally forms in the upper segment of the endometrium
of the uterus; exchanges nutrients and gases between the
fetus and the mother
Plaintiff a person claiming infringement of legal rights by one or
more persons
Planned change an intended, purposive attempt by an
individual, group, organization, or larger social system to
influence its own status quo or that of another organism or
situation
Planning an ongoing process that involves (a) assessing a
situation, (b) establishing goals and objectives based on
assessment of a situation or future trends, and (c)
developing a plan of action that identifies priorities,
delineates who is responsible, determines deadlines, and
describes how the intended outcome is to be achieved and
evaluated
Plantar wart a wart on the sole of the foot
Plaque an invisible soft film consisting of bacteria, molecules of
saliva, and remnants of epithelial cells and leukocytes that
adhere to the enamel surface of teeth
Plasma the fluid portion of the blood in which the blood cells are
suspended
Plateau a maintained concentration of a drug in the plasma
during a series of scheduled doses
Pleximeter in percussion, the middle finger of the nondominant
hand placed firmly on the client's skin
Plexor in percussion, the middle finger of the dominant hand or
a percussion hammer used to strike the pleximeter
Pneumothorax collection of air in the pleural space
Point of maxima! impulse (PM!) the point where the apex of the
heart touches the anterior chest wall
Policies rules developed to govern the handling of frequently
occurring situations
Polycythemia a condition in which clients with chronic hypoxia
may develop higher than normal counts of red blood cells
Polydipsia excessive thirst
Polypnea abnormally fast respirations
Polysaccharides a branched chain of dozens, sometimes
hundreds, of glucose molecules; starches
Polysomnography a cluster or pattern of waking behavior that
appears during sleep, such as somnambulism
(sleepwalking),
sleeptalking, and enuresis (bed-wetting)
Polytheism the belief in more than one God
Polyunsaturated fatty acids fatty acid with more than one
double bond (or many carbons not bonded to a hydrogen
atom)
Polyuria see Diuresis
Population includes all possible members of a group who meet
the criteria for a study
Positive feedback feedback that stimulates change
Positive reinforcement giving rewards such as praise for a
learner's achievements
Positron emission tomography (PET) a n o n i n v a s i v e r a d i
ologic study that involves the injection or inhalation of a
radioisotope
Possible nursing diagnosis one in which evidence about a health
problem is incomplete or unclear
Postmortem examination see A u t o p s y
Postoperative phase begins with the admission of the client to
the postanesthesia area and ends when healing is complete
Postural drainage the drainage, by gravity, of secretions from
various lung segments
Potentiating effect the increased effect of one or both drugs
Practice discipline field of study in which the central focus is
performance of professional role (nursing, teaching,
management, making music)
Prayer human communication with divine and spiritual entities
Preceptor an experienced nurse who assists the novice nurse in
improving nursing skill and judgment
18
Precontemplation stage a person typically denies having a
problem and instead views others as having a problem and
therefore wants to change the other person's behavior
Precordium an area of the chest overlying the heart
Preemptive analgesia the administration of analgesics prior to an
invasive or operative procedure in order to treat pain
before it occurs
Preferred provider arrangements (PPAs) s i m i l a r t o P P O s ,
but
PPAs can contract with individual health care providers; the plan
can be limited or unlimited
Preferred provider organization ( P P O ) a g r o u p of p h y s i c i
a n s or a hospital that provides companies with health
services at a discounted rate
Prefilled unit-dose system injectable medications that are
disposable and are available as (a) prefilled syringes ready
for use or (b) prefilled sterile cartridges and needles that
require the attachment of a reusable holder (injection
system) before use
Prejudice a negative belief or preference that is generalized
about a group and that leads to "prejudgment"
Preload the degree to which muscle fibers in the ventricle are
stretched at the end of diastole
Preoperative phase begins when the decision to have surgery is
made and ends when the client is transferred to the
operating table
Preparation stage occurs when the person undertakes cognitive
and behavioral activities that prepare the person for
change
Presbycusis loss of hearing related to aging
Presbyopia loss of elasticity of the lens and thus loss of ability to
see close objects as a result of the aging process
Prescription the written direction for the preparation and
administration of a drug
Presencing being present, being there, or just being with a client
Pressure a compressing downward force on a body area
Pressure ulcers any lesion caused by unrelieved pressure that
results in damage to underlying tissue; formerly called
decubitus ulcers, bed sores, pressure sores
Primary care (PC) the point of entry into the health care system
at which initial health care is given
Primary health care (PHC) essential health care based on
practical, scientifically sound and socially acceptable
methods and technology made universally accessible to
individuals and families in the community through their full
participation and at a cost that the community and country
can afford to maintain at every stage of their development
in the spirit of self-reliance and self-determination
Primary intention healing tissue surfaces are approximated
(closed) and there is minimal or no tissue loss, formation of
minimal granulation tissue and scarring
Primary prevention activities directed toward the protection
from or avoidance of potential health risks
Primary sexual characteristics relate to the organs necessary for
reproduction, such as the testes, penis, vagina, and uterus
Principles-based (deontological) theories e m p h a s i z e
individual rights, duties, and obligations
Priority setting the process of establishing a preferential order
for nursing strategies
Private (civil) law the body of law that deals with relationships
between private individuals
Prn order "as needed order"; permits the nurse to give a
medication when, in the nurse's judgment, the client
requires it
Problem solving obtaining information that clarifies the nature
of the problem and suggests possible solutions
Problem-oriented medical record (POMR) data about the client
are recorded and arranged according to the client's
problems, rather than according to the source of the
information
Problem-oriented record (POR) see Problem-oriented medical
record (POMR)
Procedures steps used in carrying out policies or activities
Process evaluation a component of quality assurance that
focuses on how care was given

Process recording the verbatim (word-for-word) account of a
conversation
Proctoscopy the viewing of the rectum
Proctosigmoidoscopy the viewing of the rectum and sigmoid
colon
Productivity in health care, frequently measured by the amount
of nursing resources used per client or in terms of required
versus actual hours of care provided
Profession an occupation that requires extensive education or a
calling that requires special knowledge, skill, and
preparation
Professional values values acquired during socialization into
nursing from codes of ethics, nursing experiences, teachers,
and peers
Professionalism a set of attributes, a way of life that implies
responsibility and commitment
Professiomalization the process of becoming professional;
acquiring characteristics considered to be professional
Progress notes chart entries made by a variety of methods and
by all health professionals involved in a client's care for the
purpose of describing a client's problems, treatments, and
progress toward desired outcomes
Prompted voiding, supplements habit training by encouraging
the client to try to use the toilet (prompting) and reminding
the client when to void
Prone position face-lying position, with or without a small pillow
Proprioception awareness of posture, movement, and changes
in equilibrium; knowledge of position, weight, and
resistance of objects in relation to body
Proprioceptors sensory receptors that are sensitive to
movement and the position of the body
Protein-calorie malnutrition problem of clients with longterm
deficiencies in caloric intake; characteristics include
depressed visceral proteins (e.g., albumin), weight loss, and
visible muscle and fat wasting
Protocols a predetermined and preprinted plan specifying the
procedure to be followed in a particular situation
Proxemics the study of distance between people in their
interactions
Psychologic dependence a state of emotional reliance on a drug
to maintain one's well-being; a feeling of need or craving
for a drug
Psychologic homeostasis emotional or psychologic balance or
state of mental well-being
Psychomotor domain the "skill" domain; includes motor skills
such as giving an injection
Puberty the first stage of adolescence in which sexual organs
begin to grow and mature
Public law refers to the body of law that deals with relationships
between individuals and the government and governmental
agencies
Pulse the wave of blood within an artery that is created by
contraction of the left ventricle of the heart
Pulse deficit the difference between the apical pulse and the
radial pulse
Pulse oximeter a noninvasive device that measures the arterial
blood oxygen saturation by means of a sensor attached to
the finger
Pulse pressure the difference between the systolic and the
diastolic blood pressure
Pulse rhythm the pattern of the beats and intervals between the
beats
Pulse volume the strength or amplitude of the pulse, the force of
blood exerted with each heart beat
Pureed diet a modification of the soft diet; liquid may be added
to the food, which is then blended to a semisolid
consistency
Purkinje fibers fibers of the ventricular conduction pathways
that terminate in ventricular muscle, stimulating
contraction
Purulent exudates an exudate consisting of leukocytes, liquefied
dead tissue debris, and dead and living bacteria
Pus a thick liquid associated with inflammation and composed of
cells, liquid, microorganisms, and tissue debris
Pyogenic bacteria bacteria that produce pus
19
Pyorrhea purulent periodontal disease
Pyrexia a body temperature above the normal range, fever
Qi body's vital energy reflexology
Qi gong breathing and mental exercises combined with body
movements
Qualifiers words that have been added to some NANDA labels to
give additional meaning to the diagnostic statement
Quality a subjective description of a sound (e.g., whistling,
gurgling)
Quality improvement an organizational commitment and
approach used to continuously improve all processes in the
organization with the goal of meeting and exceeding
customer expectations and outcomes; also known as total
quality management (TQM) and continuous quality
improvement (CQI)
Quality-assurance (QA) program an ongoing systematic process
designed to evaluate and promote excellence in the health
care provided to clients
Race classification of people according to shared biologic
characteristics and physical features
Radiation the transfer of heat from the surface of one object to
the surface of another without contact between the two
objects
Radiopharmaceutical a pharmaceutical (targeted to a specific
organ) labeled with a radioisotope, administered through
various routes, to determine hyperfunction or hypofunction
of the organ
Random access memory (RAM) data and instructions stored on
chips; RAM storage is temporary and cleared when the
computer is turned off
Range a measure of variability, consisting of the difference
between the highest and lowest values in a distribution of
scores
Range of motion (ROM) the degree of movement possible for
each joint
Rapport a relationship between two or more people of mutual
trust and understanding
Rationale the scientific reason for selecting a specific action
RBC indices may be performed as part of the CBC to evaluate the
size, weight, and hemoglobin concentration of red blood
cells
Retrograde pyelography a radiographic study used to evaluate
the urinary tract
Reactive hyperemia a bright red flush on the skin occurring after
pressure is relieved
Readiness behaviors or cues that reflect a learner's motivation
to learn at a specific time
Reagent substance used in a chemical reaction to detect a
specific substance
Recent memory deals with activities of the recent past of
minutes to a few hours
Receptor a location on the surface of a cell membrane or within
a cell (usually a protein) to which a drug chemically binds
Reconstitution the technique of adding a solvent to a
powdered drug to prepare it for injection
Record a written communication providing formal, legal
documentation of a client's progress
Recording the process of making written entries about a client
on the medical record
Red blood cell (RBC) count number of red blood cells per cubic
millimeter of whole blood
Red blood cell (RBC) indices evaluate size, weight, and
hemoglobin concentrations of RBCs
Referred pain pain perceived to be in one area but whose source
is another area
Reflection thinking from a critical point of view, analyzing why
one acted in a certain way, and assessing the results of
one's actions
Reflex an automatic response of the body to a stimulus
Reflexology a treatment based on massage of the feet to relieve
symptoms in other parts of the body

Reflux backward flow
Regeneration renewal, regrowth, the replacement of destroyed
tissue cells by cells that are identical or similar in structure
and function
Regional anesthesia the temporary interruption of the
transmission of nerve impulses to and from a specific area
or region of the body; the client loses sensation in an area
of the body but remains conscious
Registry private duty agency which contracts with individual
practioners
Regression a defense mechanism in which one adapts behavior
that was comforting earlier in life to overcome the
discomfort and insecurity of the present situation
Regurgitation the spitting up or backward flow of undigested
food
Relapsing fever the occurrence of short febrile periods of a few
days interspersed with periods of 1 or 2 days of normal
temperature
Relationship-based (caring) theories stress courage, generosity,
commitment, and the need to nurture and maintain
relationships
Relaxation response physiologic state achieved through deep
relaxation breathing
Reliability the degree to which an instrument produces
consistent results on repeated use
Religion an organized system of worship
REM sleep sleep during which the person experiences rapid eye
movements
Remission a period during a chronic illness when there is a
lessening of severity or cessation of symptoms
Remittent fever the occurrence of a wide range of temperature
fluctuations, more than 2°C (3.6°F) over the 24-hour period,
all of which are above normal
Renin-angiotensin-aldosterone system system initiated by
specialized receptors in the juxtaglomerular cells of the
kidney nephrons that respond to changes in renal perfusion
Report whether oral or written, it should be concise, including
pertinent information but no extraneous detail
Repression a defense mechanism in which painful thoughts,
experiences, and impulses are removed from awareness
Res ipsa loquitur "the thing that speaks for itself'; a legal
doctrine that relates to negligence in which the harm
cannot be traced to a specific health care provider or
standard but does not normally occur unless there has
been a negligent act
Researchability the problem can be subjected to scientific
investigation
Reservoir a source of microorganisms
Resident flora microorganisms that normally reside on the skin
and mucous membranes, and inside the respiratory and
gastrointestinal tracts
Residual urine the amount of urine remaining in the bladder
after a person voids
Resolution phase the part of the response cycle period of return
to the unaroused state, which may last 10 to 15 minutes
after orgasm, or longer if there is no orgasm
Resonance a low-pitched, hollow sound produced over normal
lung tissue when the chest is percussed
Respiration the act of breathing; transport of oxygen from the
atmosphere to the body cells and transport of carbon
dioxide from the cells to the atmosphere
Respiratory acidosis (hypercapnia) a state of excess carbon
dioxide in the body
Respiratory alkalosis a state of excessive loss of carbon dioxide
from the body
Respiratory character see Respiratory quality
Respiratory membrane where gas exchange occurs between the
air on the alveolar side and the blood on the capillary side;
the alveolar and capillary walls form the respiratory
membrane
Respiratory quality refers to those aspects of breathing that are
different from normal, effortless breathing, includes the
amount of effort exerted to breathe and the sounds
produced by breathing
20
Respiratory rhythm refers to the regularity of the expirations
and the inspirations
Respondeat superior a legal term meaning "let the master
answer"; the employer assumes responsibility for the
conduct of the employee and can also be held responsible
for malpractice by the employee
Responsibility the specific accountability or liability associated
with the performance of duties of a particular role
Resting energy expenditure (REE) the amount of energy required
to maintain basic body functions
Resting tremor a tremor that is apparent when the client is at
rest and diminishes with activity
Restraints protective-devices used to limit physical activity of the
client or a part of the client's body
Retrograde pyelography radiographic study of the urinary tract
where contrast medium is instilled directly into the kidney
pelvis via the urethra, bladder, and ureters
Retrospective audit evaluation of a client's record after
discharge from an agency
Review of systems see Screening examination
Rhizotomy interruption of the anterior or posterior nerve root
between the ganglion and the cord; generally performed on
cervical nerve roots to alleviate pain of the head and neck
Right (legal) a privilege or fundamental power to which an
individual is entitled unless it is revoked by law or given up
voluntarily
Right of self-determination subjects feel free from constraints,
coercion, or any undue influence to participate in a study
Rigor mortis the stiffening of the body that occurs after death
Risk factors factors that cause a client to be vulnerable to
developing a health problem
Risk management having in place a system to reduce danger to
clients and staff
Risk nursing diagnosis clinical judgment that a problem does not
exist, but the presence of risk factors indicates that a
problem is likely to develop unless nurses intervene
Risk of harm exposure to the possibility of injury going beyond
everyday situations
Role the set of expectations about how a person occupying a
specific position behaves
Role ambiguity unclear role expectations; people do not know
what to do or how to do it and are unable to predict the
reactions of others to their behavior
Role conflict a clash between the beliefs or behaviors imposed
by two or more roles fulfilled by one person
Role development involves socialization into a particular role
Role mastery performance of role behaviors that meet social
expectations
Role model providing an example of acceptable behavior(s)
through demonstration
Role performance what a person does in a particular role in
relation to the behaviors expected of that role
Role strain a generalized state of frustration or anxiety
experienced with the stress of role conflict and ambiguity
Root cause analysis process for identifying factors that bring
about deviations in practices that lead to an event
S, the first heart sound; occurs when the atrioventricular valves
(mitral and tricuspid) close
S2 the second heart sound; occurs when the semilunar valves
(aortic and pulmonic) close
Safety monitoring device a position-sensitive switch that triggers
an audio alarm when a client attempts to get out of the bed
or chair
Sairy Gamp a character in the Charles Dickens book Martin
Chizzlewit who represented the negative image of nurses in
the early 1800s
Saliva the clear liquid secreted by the salivary glands in the
mouth, sometimes referred to as spit
Sample segment of the population from whom data will actually
be collected
Sanguineous exudate an exudate containing large amounts of
red blood cells
Sarcopenia steady decrease in muscle fibers

Saturated fatty acids those in which all carbon atoms are filled to
capacity (i.e., saturated) with hydrogen
Scabies a contagious skin infestation caused by an arachnid, the
itch mite
Scald a bum from a hot liquid or vapor, such as steam
Scientific health belief based on the belief that life and life
processes are controlled by physical and biochemical
processes that can be manipulated by humans
Screening examination (review of systems) a brief review of
essential functioning of various body parts or systems
Scrub person person who assists the surgeon
Sebaceous glands active under the influence of androgens in
both males and females, which secrete sebum and become
most active on the face, neck, shoulder, upper back, and
chest; are often the cause of an increased incidence of acne
Sebum the oily, lubricating secretion of sebaceous glands in the
skin
Secondary intention healing wound in which the tissue surfaces
are not approximated and there is extensive tissue loss;
formation of excessive granulation tissue and scarring
Secondary prevention activities designed for early diagnosis and
treatment of disease or illness
Secondary sexual characteristics physical characteristics that
differentiate the male from the female but do not relate
directly to reproduction
Seizure a sudden onset of a convulsion or other paroxysmal
motor or sensory activity
Seizure precautions safety measures taken by the nurse to
protect clients from injury should they have a seizure
Selectively permeable cell membranes that allow substances to
move across them with varying degrees of ease
Self-awareness the relationship between one's perception of
oneself and others' perceptions of oneself
Self-concept the collection of ideas, feelings, and beliefs one has
about oneself
Self-esteem the value one has for oneself; self-confidence
Self-regulation homeostatic mechanisms that come into play
automatically in the healthy person
Semicircular canals in the inner ear; contain the organs of
equilibrium
Semi-Fowler's position see Low Fowler's position
Semilunar valves crescent moon-shaped valves between the
cardiac ventricles and the pulmonary artery (pulmonic
valve) and the aorta (aortic valve)
Sensorineural hearing loss the result of damage to the inner ear,
the auditory nerve, or the hearing center in the brain
Sensoristasis the need for sensory stimulation
Sensory deficit partial or complete impairment of any sensory
organ
Sensory deprivation insufficient sensory stimulation for a person
to function
Sensory memory momentary perception of stimuli by the senses
Sensory overload an overabundance of sensory stimulation
Sensory perception the organization and translation of stimuli
into meaningful information
Sensory reception process of receiving environmental stimuli
Sentinel event an unexpected occurrence involving death or
serious physical or psychological injury, or the risk thereof
Separation anxiety the fear and frustration experienced by
young children that comes with parental absences
Sepsis the presence of pathogenic organisms or their toxins in
the blood or body tissues
Septicemia occurs when bacteremia results in systemic infection
Septum a dividing structure such as that between the cardiac
chambers or between the two sides of the nose
Serosanguineous exudate inflammatory material consisting of a
combination of clear and blood-tinged drainage
Serous exudates inflammatory material composed of serum
(clear portion of blood) derived from the blood and serous
membranes of the body such as the peritoneum, pleura,
pericardium, and meninges; watery in appearance and has
few cells
Serum osmolality a measure of the solute concentration of the
blood
21
Sexual aversion disorder severe distaste for sexual activity or
thought of sexual activity
Sexual health the integration of the somatic, emotional,
intellectual, and social aspects of sexuality, in ways that are
positively enriching and that enhance personality,
communication, and love
Sexual orientation the preference of a person for one sex or the
other
Sexual pain disorders include dyspareunia, vaginismus, and
genital pain
Sexual self-concept how one values oneself as a sexual being
Shaft the part of a needle that is attached to the hub
Shaken baby syndrome (SBS) violent shaking of the infant by the
arms or shoulders causing a whiplash, which can lead to
severe injury in infants
Shared governance a method that aims to distribute decision
making among a group of people
Shared leadership a contemporary theory of leadership that
recognizes the leadership capabilities of each member in a
professional group and assumes that appropriate
leadership will emerge in relation to the challenges that
confront the group
Shearing force a combination of friction and pressure that, when
applied to the skin, results in damage to the blood vessels
and tissues
Shock phase first part of the alarm reaction in which the stressor
may be perceived consciously or unconsciously by the
person
Short-term memory information held in the brain for immediate
use or what one has in mind at a given moment
Shroud a large piece of plastic or cotton material used to enclose
a body after death
Side effect the secondary effect of a drug that is unintended;
usually predictable and may be either harmless or
potentially harmful
Significance the potential to contribute to nursing science by
enhancing client care, testing or generating a theory, or
resolving a day-to-day clinical problem
Signs see Overt data
Sims' position side-lying position with lowermost arm behind the
body and uppermost leg flexed
Single order common medication order that is a "one-time
order"; medication is to be given once at a specified time
Sinoatrial (SA or sinus) node t h e p r i m a r y p a c e m a k e r of
the heart located where the superior vena cava enters the
right atrium
Situational leader adapts style according to consideration of the
staff members' abilities, knowledge of the nature of the
task to be done, and sensitivity to the context or
environment in which the task takes place
Sitz bath used to soak a client's pelvic area; also referred to as a
hip bath
Skinfold measurement an indicator of the amount of body fat,
the main form of stored energy
Slander defamation by the spoken word, stating unprivileged
(not legally protected) or false words by which a reputation
is damaged
Sleep an altered state of consciousness in which the individual's
perception of and reaction to the environment are
decreased
Sleep apnea periodic cessation of breathing during sleep
Sleep architecture basic organization of normal sleep
Sleep hygiene refers to interventions used to promote sleep
Small calorie (c, cal) the amount of heat required to raise the
temperature of 1 g of water P C
SOAP an acronym for a charting method that follows a recording
sequence of subjective data, objective data, assessment,
and planning
Socialization a process by which a person learns the ways of a
group or society in order to become a functioning
participant
Socratic questioning a technique one can use to look beneath
the surface, recognize" and examine assumptions, search
for inconsistencies, examine multiple points of view, and

differentiate what one knows from what one merely
believes
Sojourner Truth an abolitionist, Underground Railroad agent,
preacher, and women's rights advocate, she was a nurse for
more than 4 years during the Civil War and worked as a
nurse and counselor for the Freedman's Relief Association
after the war
Solutes substances dissolved in a liquid
Solvent the liquid in which a solute is dissolved
Somatic pain pain that originates in the skin, muscles, bone, or
connective tissue
Somnology the study of sleep
Sordes accumulation of foul matter (food, microorganisms, and
epithelial elements) on the teeth and gums
Source-oriented clinical record a record in which each person or
department makes notations in a separate section or
sections of the client's chart
Spastic describing the sudden, prolonged involuntary muscle
contractions of clients with damage to the central nervous
system
Specific defenses immune functions directed against identifiable
bacteria, viruses, fungi, or other infectious agents
Specific gravity the weight or degree of concentration of a
substance compared with that of an equal volume of
another, such as distilled water, taken as a standard
Specific self-esteem how much one approves of a certain part of
oneself
Spinal anesthesia anesthesia produced by injecting an anesthetic
agent into the subarachnoid space surrounding the spinal
cord; also referred to as a subarachnoid block (SAB)
Spinal cord stimulation (SCS) involves the insertion of a cable
that allows the placement of an electrode directly on the
spinal cord and is used with nonmalignant pain that has not
been controlled with less invasive therapies
Spiritual distress a disturbance in or a challenge to a person's
belief or value system that provides strength, hope, and
meaning to life
Spiritual health see Spiritual well-being
Spiritual we81-being a feeling of inner peace and of being
generally
alive, purposeful, and fulfilled; the feeling is rooted
in spiritual values and/or specific religious beliefs
Spirituality belief in or relationship with some higher power,
creative force, driving being, or infinite source of energy
Spreadsheet programs that manipulate primarily numbers
Sputum the mucous secretion from the lungs, bronchi, and
trachea
Stage of exhaustion the third stage in the adaptation syndromes
that occurs when the adaptation that the body made during
the second stage cannot be maintained
Stage of resistance the second stage in the adaptation
syndromes when the body's adaptation takes place
Standard a generally accepted rule, model, pattern, or measure
Standard deviation the most frequently used measure of
variability, indicating the average to which scores deviate
from the mean; commonly symbolized as SD or S
Standardized case plan formal plan that specifies the nursing
care for groups of clients with common needs (e.g., all
clients with myocardial infarction)
Standards of care the skills and learning commonly possessed by
members of a profession
Standards of practice descriptions of the responsibilities for
which nurses are accountable
Standards of professional performance as set by the American
Nurses Association (ANA), describe behaviors expected in
the professional nursing role
Standing order a written document about policies, rules,
regulations, or orders regarding client care; gives nurses the
authority to carry out specific actions under certain
circumstances
Stapes stirrups bone of the middle ear
Stat order common medication order which indicates that the
medication is to be given immediately and only once
Statistically significant term applied after data have been
analyzed to determine whether the results had a
22
probability less than 0.05, which is considered the
acceptable level of significance
Statutory law a law enacted by any legislative body
Steatorrhea an excessive amount of fat in the stool, which can
indicate faulty absorption of fat from the small intestine
Stereognosis the ability to recognize objects by touching and
manipulating them
Stereotyping assuming that all members of a culture or ethnic
group are alike
Sterile field a specified area that is considered free from
microorganisms
Sterile technique practices that keep an area or object free of all
microorganisms
Sterilization a process that destroys all microorganisms,
including spores and viruses
Sternum the breastbone
Stimulus-based stress model stress is defined as a stimulus, life
event, or set of circumstances that arouses physiologic
and/or psychologic reactions that may increase the
individual's vulnerability to illness
Stoma an artificial opening in the abdominal wall; it may be
permanent or temporary
Stool see Feces
Strabismus squinting or crossing of the eyes; uncoordinated eye
movements
Stress an event or set of circumstances causing a disrupted
response; the disruption caused by a noxious stimulus or
stressor
Stress electrocardiography uses ECGs to assess a client's
response to an increased cardiac workload during exercise
Stressor any factor that produces stress or alters the body's
equilibrium
Stridor a harsh, crowing sound made on inhalation caused by
constriction of the upper airway
Strike an organized work stoppage by a group of employees to
express a grievance, enforce a demand for changes in
condition of employment, or solve a dispute with
management
Stroke volume (SV) the amount of blood ejected with each
cardiac contraction
Structure evaluation focuses on the setting in which care is given
Subarachnoid block (SAB) see Spinal anesthesia
Subculture usually composed of people who have a distinct
identity and yet are related to a larger cultural group
Subcutaneous beneath the layers of the skin; hypodermic
Subjective data data that are apparent only to the person
affected; can be described or verified only by that person
Sublingual under the tongue
Subsystems system components
Suctioning the aspiration of secretions by a catheter connected
to a suction machine or wall outlet
Sudden infant death syndrome (SIDS) t h e s u d d e n a n d u n e
xpected death of an infant
Sudoriferous sweat glands glands of the dermis that secrete
sweat
Superego the conscience of personality; the source of feelings of
guilt, shame, and inhibition
Supine position see Dorsal position
Supplemental Security Income (SSI) s p e c i a l p a y m e n t s for
people with disabilities, those who are blind, and people
who are not eligible for Social Security; these payments are
not restricted to health care costs
Suppositories solid, cone-shaped, medicated substances
inserted into the rectum, vagina, or urethra
Suppuration the formation of pus
Suprapubic catheter catheter inserted through the abdominal
wall above the symphysis pubis into the urinary bladder
Suprasystem the system above another system
Surface anesthesia see Topical anesthesia
Surface temperature the temperature of tissue, the
subcutaneous tissue, and fat
Surfactant a surface-active agent (e.g., soap or a synthetic
detergent); in pulmonary physiology, a mixture of
phospholipids secreted by alveolar cells into the alveoli and
respiratory air passages that reduces the surface tension of

pulmonary fluids and thus contributes to the elastic
properties of pulmonary tissue
Surgical asepsis see Sterile technique
Suture a thread used to sew body tissues together
Sutures junction lines of the skull bones
Sweat glands see Sudoriferous glands
Sympathectomy severance of the pathways of the sympathetic
division of the autonomic nervous System; eliminates
vasospasm, improves peripheral blood supply, and is
effective in treating painful vascular disorders
Sympathetically maintained pain pain that occurs with abnormal
connections between pain fibers and the sympathetic
nervous system
Symptoms see Covert data
Syndrome diagnosis a diagnosis that is associated with a cluster
of other diagnoses
Synergistic when two different drugs increase the action of one
or another drug
System a set of interacting identifiable parts or components
Systemic infection occurs when pathogens spread and damage
different parts of the body
Systole the period during which the ventricles contract
Systolic pressure the pressure of the blood against the arterial
walls when the ventricles of the heart contract
T'ai chi discipline that combines physical fitness, meditation, and
self-defense
Tachycardia an abnormally rapid pulse rate; greater than 100
beats per minute
Tachypnea abnormally fast respirations; usually more than 24
respirations per minute
Tactile related to touch
Tandem secondary IV setup in which the second container is
attached to the line of the first contai ner at the lower,
secondary port
Tartar a visible, hard deposit of plaque and dead bacteria that
forms at the gum lines
Taxonomy a classification system or set of categories, such as
nursing diagnoses, arranged on the basis of a single
principle or consistent set of principles
Teacher a nurse who helps clients learn about their health and
the health care procedures they need to perform to restore
or maintain their health
Teaching system of activities intended to produce learning
Team nursing the delivery of individualized nursing care to
clients by a team led by a professional nurse
Technical skills "hands-on" skills such as those required to
manipulate equipment, administer injections, and move or
reposition patients
Telecommunications the transmission of information from one
site to another, using equipment to transmit information in
the forms of signs, signals, words, or pictures by cable,
radio, or other systems
Telemedicine technology used to transmit electronic medical
data about clients to persons at distant locations
Temperament the way individuals respond to their external and
internal environment
Teratogen anything that adversely affects normal cellular
development in the embryo or fetus
Termination stage the ultimate goal where the individual has
complete confidence that the problem is no longer a
temptation or threat
Territoriality a concept of the space and things that individuals
consider their own
Tertiary intention healing that occurs in wounds left open for 3
to 5 days and then closed with sutures, staples, or adhesive
skin closures
Tertiary prevention activities designed to restore individuals
with disabilities to their optimal level of functioning
Theory a system of ideas that is proposed to explain a given
phenomenon (e.g., theory of gravity)
Therapeutic baths given for physical effects, such as to soothe
irritated skin or to treat an area (e.g., the perineum)
23
Therapeutic communication an interactive process between
nurse and client that helps the client overcome temporary
stress, to get along with other people, to adjust to the
unalterable, and to overcome psychologic blocks that stand
in the way of self-realization
Therapeutic effect the primary effect intended of a drug; reason
the drug is prescribed
Third space syndrome fluid shifts from the vascular space into an
area where it is not readily accessible as extracellular fluid
Thoracentesis insertion of a needle into the pleural cavity for
diagnostic or therapeutic purposes
Thrill a vibrating sensation over a blood vessel that indicates
turbulent blood flow
Thrombophlebitis inflammation of a vein followed by formation
of a blood clot
Thrombus a solid mass of blood constituents in the circulatory
system; a clot (plural: thrombi)
Throughput a transformation that occurs after input is absorbed
by the system and is then processed in a way that is useful
to the system
Ticks small gray-brown parasites that bite into tissue and suck
blood and transmit several diseases to people, in particular
Rocky Mountain spotted fever, Lyme disease, and tularemia.
Tidal volume ihe volume of air that is normally inhaled and
exhaled
Tinea pedis athlete's foot (ringworm of the foot), which is
caused by a fungus
Tissue perfusion passage of fluid (e.g., blood) through a specific
organ or body part
Top-level manager organizational executive primarily
responsible for establishing goals and developing strategic
plans
Topical applied externally (e.g., to the skin or mucous
membranes)
Topical anesthesia (surface anesthesia) applied directly to the
skin and mucous membranes, open skin surfaces, wounds,
and burns
Torr millimeters of mercury
Tort a civil wrong committed against a person or a person's
property
Tort law law that defines and enforces duties and rights among
private individuals that are not based on contractual
agreements
Trade name name given a drug by the manufacturer
Traditional observance of the beliefs and practices of one's
heritage or cultural belief system
Traditional Chinese medicine (TCWI) b a s e d o n t h e p r e m i s
e t h a t the body's vital energy circulates through pathways
or meridians and can be accessed and manipulated through
specific anatomical points along the surface of the body
Tragus the cartilaginous protrusion at the entrance to the ear
canal
Transactional leader a contemporary theory of leadership in
which resources are exchanged as an incentive for loyalty
and performance
Transactional stress theory a theory that encompasses a set of
cognitive, affective, and adaptive (coping) responses that
arise out of person-environment transactions; the person
and the environment are inseparable and affect each other
Transcellular fluid compartment of extracellular fluids; includes
cerebrospinal, pericardial, pancreatic, pleural, intraocular,
biliary, peritoneal, and synovial fluids
Transcendence a person's recognition that there is something
other or greater than the self and a seeking and valuing of
that greater other, whether it is an ultimate being, force, or
value
Transcultural nursing providing care within the differences and
similarities of the beliefs, values, and patterns of cultures
Transcutaneous electrical nerve stimulation (TENS) a n o n i
nvasive, nonanalgesic pain control technique that allows
the client to assist in the management of acute and chronic
pain
Transdermal patch a particular type of topical or dermatologic
medication delivery system

Transgenderisrn gradation of human characteristics that run
from female to male
Transformational leader leader who fosters creativity, risk
taking, commitment, and collaboration by empowering the
group to share in the organization's vision
Translator a person who converts written material (such as
patient education pamphlets) from one language into
another
Transsexual individual who feels his or her sexual anatomy is not
consistent with his or her gender identity
Tremor an involuntary trembling of a limb or body part
Trial the period during which all relevant facts are presented to a
jury or judge
Triangular fossa a depression of the antihelix
Triglycerides substances that have three fatty acids; they
account for more than 90% of the lipids in food and in the
body
Trigone a triangular area at the base of the bladder marked by
the ureter openings at the posterior corners and the
opening of the urethra at the anterior corner
Trimesters the 3-month periods during pregnancy marking
certain landmarks for developmental changes in mother
and the fetus; three trimesters occur during a pregnancy
Tripod (triangle) position the proper standing position with
crutches; crutches are placed about 15 cm (6 in.) in front of
the feet and out laterally about 15 cm (6 in.), creating a
wide base of support
Trocar a sharp pointed instrument that fits inside a cannula and
is used to pierce body tissues
Troponin enzyme that is released into the blood during a
myocardial infarction (MI)
Trough level represents the lowest concentration of a drug in
the blood serum
Tuberculin syringe originally designed to administer tuberculin; a
narrow syringe, calibrated in tenths and hundredths of a
milliliter (up to 1 mL) on one scale and in sixteenths of a
minim (up to 1 minim) on the other scale
Two-point discrimination see One-point discrimination
Tympanic membrane t h e e a r d r u m
Tympany a musical or drumlike sound produced during
percussion over an air-filled stomach and abdomen
Ultrasonography the use of ultrasound to produce an image of
an organ or tissue
Unconscious mind the mental life of a person of which the
person is unaware
Undernutrition an intake of nutrients insufficient to meet daily
energy requirements because of inadequate food intake or
improper digestion and absorption of food
Undertaker see Mortician
Universal precautions (UP) techniques to be used with all clients
to decrease the risk of transmitting unidentified pathogens;
currently, Standard Precautions incorporate UP and BSI
Unplanned change haphazard change that occurs without
control by any person or group
Unprofessional conduct one of the grounds for action against
the nurse's license; includes incompetence or gross
negligence, conviction of practicing without a license,
falsification of client records, and illegally obtaining, using,
or possessing controlled substances
Unsaturated fatty acid a fatty acid that could accommodate
more hydrogen atoms than it currently does
Upper-level managers organizational executives who are
primarily responsible for establishing goals and developing
strategic plans
Urea a substance found in urine, blood, and lymph; the main
nitrogenous substance in blood
Ureterostomy type of urinary diversion that involves surgery of
the ureters
Urgency the feeling that one must urinate
Urinary frequency the need to urinate often
Urinary hesitancy a delay and difficulty in initiating voiding;
often associated with dysuria
24
Urinary incontinence a temporary or permanent inability of the
external sphincter muscles to control the flow of urine from
the bladder
Urinary reflux backward flow of urine
Urinary retention the accumulation of urine in the bladder and
inability of the bladder to empty itself .
Urinary stasis stagnation of urinary flow
Urination (micturition, voiding) the process of emptying the
bladder
Urine osmolality a measure of the solute concentration of urine,
a more exact measurement of urine concentration than
specific gravity
Utilitarianism a specific, consequence-based, ethical theory that
judges as right the action that does the most good and least
amount of harm for the greatest number of persons; often
used in making decisions about the funding and delivery of
health care
Utility see Utilitarianism
Vaginismus involuntary spasm of outer one-third of vaginal
muscles; makes penetration of vagina painful
Validation the determination that the diagnosis accurately
reflects the problem of the client, that the methods used
for data gathering were appropriate, and that the
conclusion or diagnosis is justified by the data
Validity the degree to which an instrument measures what it is
intended to measure
Valsalva maneuver forceful exhalation against a closed glottis,
which increases intrathoracic pressure and thus interferes
with venous blood return to the heart
Value set all of the values (e.g., personal, professional, religious)
that a person holds
Value system the organization of a person's values along a
continuum of relative importance
Values something of worth; a belief held dearly by a person
Values clarification a process by which individuals define their
own value
Vaporization continuous evaporation of moisture from the
respiratory tract and from the mucosa of the mouth and
from the skin
Variance a variation or deviation from a critical pathway; goals
not met or interventions not performed according to the
time frame
Vasoconstriction a decrease in the caliber (lumen) of blood
vessels
Vasodilation an increase in the caliber (lumen) of blood vessels
Vector-borne transmission a vector is an animal or flying or
crawling insect that serves as an intermediate means of
transporting the infectious agent
Vehicle-borne transmission a vehicle is any substance that
serves as an intermediate means to transport and introduce
an infectious agent into a susceptible host through a
suitable portal of entry
Venipuncture puncture of a vein for collection of a blood
specimen or for infusion of therapeutic solutions
Ventilation the movement of air in and out of the lungs; the
process of inhalation and exhalation
Ventricles two lower chambers of the heart
Veracity a moral principle that holds that one should tell the
truth and not lie
Verbal communication use of verbal language to send and
receive messages
Verdict the outcome made by a jury
Vernix caseosa a protective covering that develops over the
unborn fetus's skin; a white, cheese-like substance that
adheres to the skin and can become 1/8-inch thick by birth
Vesicostomy surgical production of an opening into the bladder
Vestibule contains the organs of equilibrium; found in the inner
ear
Vestibulitis severe pain on touch or attempted vaginal entry
Vial a medication container with a sealed rubber cap, for single
or multiple doses
 25

Vibration a series of vigorous quiverings produced by hands that

are placed flat against the chest wall to loosen thick
secretions
Virulence ability to produce disease
Viruses nucleic acid-based infectious agents
Visceral internal organs
Visceral pain results from stimulation of pain receptors in the
abdominal cavity, cranium, and thorax
Viscous thick, sticky
Vision the mental image of a possible and desirable future state
Visiting nursing delivery of services in the client's home
Visual related to sight
Visual acuity the degree of detail the eye can discern in an image
Visual fields the area an individual can see when looking straight
ahead
Vital capacity the maximum amount of air that can be exhaled
after a maximum inhalation
Vital signs measurements of physiologic functioning, specifically
body temperature, pulse, respirations, and blood pressure;
may include pain and pulse oximetry
Vitamin an organic compound that cannot be manufactured by
the body and is needed in small quantities to catalyze
metabolic processes
Vitiligo patches of hypopigmented skin, caused by the
destruction of melanocytes in the area
Voiding see Urination
Volume control infusion set small fluid containers (100 to 150
mL in size) attached below the primary infusion container
so that the medication is administered through the client's
IV line
Volume expanders used to increase the blood volume following
severe loss of blood (e.g., from hemorrhage) or loss of
plasma (e.g., from severe burns, which draw large amounts
of plasma from the bloodstream to the burn site)
Vulvodynia constant and unremitting burning of vulva

Water-soluble vitamins vitamins that the body cannot store, so

people must get a daily supply in the diet; include C and B-
complex vitamins
Weil-being a subjective perception of balance, harmony, and
vitality
Wellness a state of well-being; engaging in attitudes and
behaviors that enhance quality of life and maximize
personal potential
Wellness diagnosis (NANDA) describes human responses to
levels of wellness in an individual, family, or community
that have a readiness for enhancement
White blood cells (WBCs) body cells that are part of the body's
defense against infection and disease
Wide area network (WAN) computers linked across large
distances
World Wide Web (WWW) refers to the complex links among
webpages or websites, accessed through "addresses" called
universal resource locators (URLs)

Xenophobia the fear or dislike of people different from one's self

Xerostomia dry mouth

Yoga a type of meditation that is a system of exercises for

attaining bodily or mental control and well-being