A

Active assist range-of-motion exercise: A client’s joint receiving partial assistance in movement from an outside force. (Chapter 13.2)

Active range-of-motion exercise: Movement of a joint by the individual performing the exercise. (Chapter 13.2)

Active transport: Movement of solutes and ions across a cell membrane against a concentration gradient from an area of lower concentration to an area of higher concentration using energy during the process. (Chapter 15.2)

Acute grief: Grief that begins immediately after the death of a loved one and includes the separation response and response to stress. (Chapter 17.2)

Acute pain: Pain that is limited in duration and is associated with a specific cause. (Chapter 11.2)

Acute, self-limiting infections: Infections that develop rapidly and generally last only 10-14 days. Colds, ear infections, and coughs are considered acute, self-limiting infections. (Chapter 9.4)

Addiction: A chronic disease of the brain’s reward, motivation, memory, and related circuitry reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by several symptoms, such as the inability to consistently abstain from a substance, impaired behavioral control, cravings, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. (Chapter 11.2)

Adjuvant: Medication that is not classified as an analgesic but has been found in clinical practice to have either an independent analgesic effect or additive analgesic properties when administered with opioids. (Chapter 11.4)

Adult day centers: Care that offers people with dementia and other chronic illnesses the opportunity to be social and to participate in activities in a safe environment, while also giving their caregivers the opportunity to work, run errands, or take a much-needed break. (Chapter 6.3)

Advance directives: Legal documents that direct care when the client can no longer speak from themselves, including the living will and the health care power of attorney. (Chapter 17.2)

Advanced Practice Registered Nurse (APRN): An RN who has a graduate degree and advanced knowledge. There are four categories of APRNs: certified nurse-midwife (CNM), clinical nurse specialist (CNS), certified nurse practitioner (CNP), or certified registered nurse anesthetist (CRNA). These nurses can diagnose illnesses and prescribe treatments and medications. (Chapter 1.4)

Ageism: The stereotyping and discrimination against individuals or groups on the basis of their age. Ageism can take many forms, including prejudicial attitudes, discriminatory practices, or institutional policies and practices that perpetuate stereotypical beliefs. (Chapter 6.4, Chapter 19.2)

Alzheimer’s disease: An irreversible, progressive brain disorder that slowly destroys memory and thinking skills and eventually the ability to carry out the simplest tasks. (Chapter 6.3)

Ambulation: The ability of a client to safely walk independently, with assistance from another person, or with an assistive device, such as a cane, walker, or crutches. (Chapter 13.2)

Analgesics: Medications used to relieve pain. (Chapter 11.4)

ANA Standards of Professional Nursing Practice: Authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently. The Standards of Professional Nursing Practice describe a competent level of nursing practice as demonstrated by the critical thinking model known as the nursing process. The nursing process includes the components of assessment, diagnosis, outcomes identification, planning, implementation, and evaluation. (Chapter 1.3)

ANA Standards of Professional Performance: Standards that describe a competent level of behavior in the professional role of the nurse, including activities related to ethics, advocacy, respectful and equitable practice, communication, collaboration, leadership, education, scholarly inquiry, quality of practice, professional practice evaluation, resource stewardship, and environmental health. (Chapter 1.3)

Angiogenesis: The process of wound healing when new capillaries begin to develop within the wound 24 hours after injury to bring in more oxygen and nutrients for healing. (Chapter 10.3)

Anorexia: Loss of appetite or loss of desire to eat. (Chapter 17.4)

Antibodies: Y proteins created by B cells that are specific to each pathogen and lock onto its surface and mark it for destruction by other immune cells. The five classes of antibodies are IgG, IgM, IgA, IgD, and IgE. (Chapter 9.3)

Anticipatory grief: Grief before a loss, associated with diagnosis of an acute, chronic, and/or terminal illness experienced by the client, family, and caregivers. Examples of anticipatory grief include actual or fear of potential loss or health, independence, body part, financial stability, choice, or mental function. (Chapter 17.2)

Anuria: Absence of urine output that is typically found during kidney failure. Can be defined as less than 50 mL of urine over a 24-hour period. (Chapter 16.2)

Aphasia: A communication disorder that results from damage to portions of the brain that are responsible for language. (Chapter 2.3)

Apnea: Temporary cessation of breathing. When apnea occurs during sleep, it is often caused by the condition called Obstructive Sleep Apnea (OSA). (Chapter 8.2)

Approximated edges: The well-closed edges of a wound healing by primary intention. (Chapter 10.3)

Arterial Blood Gas (ABG): Diagnostic test performed on an arterial sample of blood to determine its pH level, oxygenation status, and carbon dioxide status. (Chapter 8.2)

Arterial insufficiency: A condition caused by lack of adequately oxygenated blood supply to specific tissues. (Chapter 10.2)

Art of nursing: Unconditional acceptance of the humanity of others, respecting their need for dignity and worth, while providing compassionate, comforting care. (Chapter 4.2)

Aseptic technique: The purposeful reduction of pathogens to prevent the transfer of microorganisms from one person or object to another during a medical procedure. For example, a nurse administering parenteral medication or performing urinary catheterization uses aseptic technique. When performed properly, aseptic technique prevents contamination and transfer of pathogens to the client from caregiver hands, surfaces, and equipment during routine care or procedures. (Chapter 9.6)

Assertive communication: A way to convey information that describes the facts, the sender’s feelings, and explanations without disrespecting the receiver’s feelings. This communication is often described as using “I” messages: “I feel…,” “I understand…,” or “Help me to understand…” (Chapter 2.2)

Assimilation: The process of adopting or conforming to the practices, habits, and norms of a cultural group. As a result, the person gradually takes on a new cultural identity and may lose their original identity in the process. (Chapter 3.2)

Assistive device: An object or piece of equipment designed to help a client with activities of daily living, such as a walker, cane, gait belt, or mechanical lift. (Chapter 13.2)

Associated conditions: Medical diagnoses, injuries, procedures, medical devices, or pharmacological agents. These conditions are not independently modifiable by the nurse, but support accuracy in nursing diagnosis. (Chapter 4.4)

At-risk behavior: According to the Just Culture model, an error that occurs when a behavioral choice is made that increases risk where risk is not recognized or is mistakenly believed to be justified. (Chapter 5.4)

At-risk populations: Groups of people who share a characteristic that causes each member to be susceptible to a particular human response, such as demographics, health/family history, stages of growth/development, or exposure to certain events/experiences. (Chapter 4.4)

B

Bacteremia: The presence of bacteria in blood. (Chapter 9.4)

Barrel chest: An increased anterior-posterior chest diameter, resulting from air trapping in the alveoli, that occurs in chronic respiratory disease. (Chapter 8.3)

Basic nursing care: Care that can be performed following a defined nursing procedure with minimal modification in which the responses of the client to the nursing care are predictable. (Chapter 1.4)

B cells: Immune cells that mature in the bone marrow. B cells make Y-shaped proteins called antibodies that are specific to each pathogen and lock onto its surface and mark it for destruction by other immune cells. (Chapter 9.3)

Bed mobility: The ability of a client to move around in bed, including moving from lying to sitting and sitting to lying. (Chapter 13.2)

Bedside handoff report: A handoff report in hospitals that involves clients, their family members, and both the off-going and the incoming nurses. The report is performed face to face and conducted at the client’s bedside. (Chapter 2.4)

Behavioral restraints: Restraints used to manage violent, self-destructive behaviors such as hitting or kicking staff or other clients, physically harming themselves or others, or threatening to do so. Behavioral restraints are used in emergency situations where safety concerns need to be immediately addressed to prevent harm. (Chapter 5.7)

Bereavement period: The time it takes for the mourner to feel the pain of the loss, mourn, grieve, and adjust to the world without the presence of the deceased. (Chapter 17.2)

Bias: To carry an attitude, opinion, or inclination (positive or negative) towards a group or members of a group. Bias can be a conscious attitude (explicit), or a person may not be aware of their bias (implicit). (Chapter 3.2)

Black stools: Black-colored stools can be caused by iron supplements or bismuth subsalicylate (Pepto-Bismol) taken for an upset stomach. (Chapter 16.2)

Board of Nursing: The state-specific licensing and regulatory body that sets the standards for safe nursing care, decides the scope of practice for nurses within its jurisdiction, and issues licenses to qualified candidates. (Chapter 1.3)

Body Mass Index (BMI): A measure of weight categories including underweight, normal weight, overweight, and obese taking height and weight into consideration. (Chapter 14.3)

Body mechanics: The coordinated effort of muscles, bones, and the nervous system to maintain balance, posture, and alignment during moving, transferring, and repositioning clients. (Chapter 13.2)

Bowel incontinence: The loss of bowel control, causing the unexpected passage of stool. (Chapter 16.8)

Bowel retraining: Involves teaching the body to have a bowel movement at a certain time of the day. (Chapter 16.8)

Braden Scale: A standardized assessment tool used to assess and document a client’s risk factors for developing pressure injuries. (Chapter 10.5)

Bradypnea: Decreased respiratory rate less than the normal range according to the client’s age. (Chapter 8.3)

Broca’s aphasia: A type of aphasia where clients understand speech and know what they want to say, but frequently speak in short phrases that are produced with great effort. People with Broca’s aphasia typically understand the speech of others fairly well. Because of this, they are often aware of their difficulties and can become easily frustrated. (Chapter 2.3)

Burnout: A caregiver’s diminished caring and cynicism that can be triggered by workplace demands, lack of resources to do work professionally and safely, interpersonal relationship stressors, or work policies that can lead to diminished caring and cynicism. Burnout may be manifested physically and psychologically with a loss of motivation. (Chapter 17.2)

C

Cachexia: Wasting of muscle and adipose tissue due to lack of nutrition. (Chapter 17.4)

Calorie-dense foods: Foods with a substantial number of calories and few nutrients. (Chapter 14.2)

Carbohydrates: Sugars and starches that provide an important energy source, providing 4 kcal/g of energy. (Chapter 14.2)

Cardiac output: The amount of blood the heart pumps in one minute. (Chapter 8.2)

Cardiopulmonary Resuscitation (CPR): Emergency treatment initiated when a client’s breathing stops or their heart stops beating. It may involve chest compressions and mouth-to-mouth breathing, electric shocks to restart the heart, breathing tubes to open the airway, or cardiac medications. (Chapter 17.2)

Care relationship: A relationship described as one in which the whole person is assessed while balancing the vulnerability and dignity of the client and family. (Chapter 4.2)

Cataracts: Opacity of the lens of the eye that causes clouded, blurred, or dim vision. Cataracts can be removed with surgery that replaces the lens with an artificial lens. (Chapter 7.2)

Chain of command: A hierarchy of reporting relationships in an agency that establishes accountability and lays out lines of authority and decision-making power. (Chapter 1.4)

Chaplains: Trained professionals in hospitals, nursing homes, assisted living facilities, and hospices that assist with the spiritual, religious, and emotional needs of clients, families, and staff. Chaplains support and encourage people of all religious faiths and cultures and customize their approach to each individual’s background, age, and medical condition. (Chapter 18.2)

Charting by exception (CBE): A type of documentation where a list of “normal findings” is provided and nurses document assessment findings by confirming normal findings and writing brief documentation notes for any abnormal findings. (Chapter 2.5)

Chemical digestion: Breakdown of food with stomach acids, bile, and pancreatic enzymes for nutrient release. (Chapter 14.2)

Chemical restraint: A drug used to manage a client’s behavior, restrict the client’s freedom of movement, or impair the clients ability to appropriately interact with their surroundings that is not a standard treatment or dosage for the client’s condition. (Chapter 5.7)

Chronic infections: Infections that may persist for months. Hepatitis and mononucleosis are examples of chronic infections. (Chapter 9.4)

Chronic pain: Pain that is ongoing and persistent for longer than six months. (Chapter 11.2)

Chvostek’s sign: An assessment sign of acute hypocalcemia characterized by involuntary facial muscle twitching when the facial nerve is tapped. (Chapter 15.4)

Circadian rhythms: Body rhythms that direct a wide variety of functions, including wakefulness, body temperature, metabolism, and the release of hormones. They control the timing of sleep, causing individuals to feel sleepy at night and creating a tendency to wake in the morning without an alarm. (Chapter 12.2)

Client: Individual, family, or group, which includes significant others and populations. (Chapter 4.2)

Clinical judgment: The observed outcome of critical thinking and decision-making. It is an iterative process that uses nursing knowledge to observe and access presenting situations, identify a prioritized client concern, and generate the best possible evidence-based solutions to deliver safe client care. (Chapter 4.2)

Clinical reasoning: A complex cognitive process that uses formal and informal thinking strategies to gather and analyze client information, evaluate the significance of this information, and weigh alternative actions.  (Chapter 4.2)

Clubbing: Enlargement of the fingertips that occurs with chronic hypoxia. (Chapter 8.3)

Clustering data: Grouping data into similar domains or patterns. (Chapter 4.4)

Code of ethics: A code that applies normative, moral guidance for nurses in terms of what they ought to do, be, and seek. A code of ethics makes the primary obligations, values, and ideals of a profession explicit. (Chapter 1.6)

Cognition: A term used to describe our ability to think. (Chapter 6.1)

Cognitive impairment: Impairment in mental processes that drive how an individual understands and acts in the world, affecting the acquisition of information and knowledge. (Chapter 6.2)

Collaborative nursing interventions: Nursing interventions that require cooperation among health care professionals and unlicensed assistive personnel (UAP). (Chapter 4.6)

Colostrum: A thick yellowish-white fluid rich in proteins and immunoglobulin A (IgA) and lower in carbohydrates and fat than mature breast milk secreted within the first 2-3 days after giving birth. (Chapter 14.3)

Comfort care: Care that occurs when the client’s and medical team’s goals shift from curative interventions to symptom control, pain relief, and quality of life. (Chapter 17.2)

Compassion fatigue: A state of chronic and continuous self-sacrifice and/or prolonged exposure to difficult situations that affect a health care professional’s physical, emotional, and spiritual well-being. (Chapter 17.2)

Complete proteins: Proteins with enough amino acids in enough quantities to perform necessary functions such as growth and tissue maintenance. These must be ingested in the diet. (Chapter 14.2)

Complex carbohydrates: Larger molecules of polysaccharides that break down more slowly and release sugar into the bloodstream more slowly than simple carbohydrates. (Chapter 14.2)

Complicated grief: Chronic grief, delayed grief, exaggerated grief, and masked grief are types of complicated grief. (Chapter 17.2)

Constipation: A decrease in normal frequency of defecation accompanied by difficult or incomplete passage of stool and/or passage of excessively hard, dry stool. (Chapter 16.6)

Contrast: A special dye administered to clients before some diagnostic tests so that certain areas show up better on the X-rays. (Chapter 16.9)

Coordination of care: While implementing interventions during the nursing process, includes components such as organizing the components of the plan with input from the health care consumer, engaging the client in self-care to achieve goals, and advocating for the delivery of dignified and person-centered care by the interprofessional team. (Chapter 4.7)

Coughing and deep breathing: A breathing technique where the client is encouraged to take deep, slow breaths and then exhale slowly. After each set of breaths, the client should cough. This technique is repeated 3 to 5 times every hour. (Chapter 8.2)

Critical thinking: Reasoning about clinical issues such as teamwork, collaboration, and streamlining workflow. (Chapter 4.2)

Cues: Subjective or objective data that gives the nurse a hint or indication of a potential problem, process, or disorder. (Chapter 4.2)

Cultural awareness: A deliberate, cognitive process in which health care providers become appreciative and sensitive to the values, beliefs, lifeways, practices, and problem-solving strategies of a client’s culture. Cultural awareness goes beyond a simple awareness of the existence of other cultures and involves an interest, curiosity, and appreciation of other cultures. (Chapter 3.4)

Cultural competence: The process of applying evidence-based nursing in agreement with the preferred cultural values, beliefs, worldview, and practices of clients to produce improved client outcomes. (Chapter 3.1, Chapter 3.4)

Cultural congruent practice: Nursing care that is in agreement with the preferred values, beliefs, worldview, and practices of the health care consumer. (Chapter 3.4)

Cultural desire: Refers to the intrinsic motivation and commitment on the part of a nurse to develop cultural awareness and cultural competency. (Chapter 3.4)

Cultural diversity: Cultural differences in people. (Chapter 3.2)

Cultural encounter: A process where the nurse directly engages in face-to-face cultural interactions and other types of encounters with clients from culturally diverse backgrounds to modify existing beliefs about a cultural group and to prevent possible stereotyping. (Chapter 3.4)

Cultural humility: A humble and respectful attitude toward individuals of other cultures that pushes one to challenge their own cultural biases, realize they cannot know everything about other cultures, and approach learning about other cultures as a lifelong goal and process. (Chapter 3.1, Chapter 3.2)

Cultural knowledge: Seeking information about cultural health beliefs and values to understand clients’ world views. (Chapter 3.4)

Culturally responsive care: Nursing actions that integrate a person’s cultural beliefs into their care. (Chapter 3.1)

Culturally safe environment: A safe space for clients to interact with health professionals, without judgment or discrimination, where the client is free to express their cultural beliefs, values, and identity. (Chapter 3.8)

Cultural negotiation: A process where the client and nurse seek a mutually acceptable way to deal with competing interests of nursing care, prescribed medical care, and the client’s cultural needs. Cultural negotiation is reciprocal and collaborative. When the client’s cultural needs do not significantly or adversely affect their treatment plan, the cultural needs can be accommodated. (Chapter 3.8)

Cultural sensitivity: Being tolerant and accepting of cultural practices and beliefs of people. (Chapter 3.4)

Cultural skill: The ability to gather and synthesize relevant cultural information about their clients while planning care and using culturally sensitive communication skills while doing so. (Chapter 3.4)

Culture: A set of beliefs, attitudes, and practices shared by a group of people or community that is accepted, followed, and passed down to other members of the group. (Chapter 3.2)

Culture of safety: The behaviors, beliefs, and values within and across all levels of an organization as they relate to safety and clinical excellence, with a focus on people. (Chapter 5.4)

Cyanosis: Bluish discoloration of the skin and mucous membranes. (Chapter 8.2)

Cytokines: Plasma proteins that communicate with other body organs and cells in the body to respond to and initiate inflammation. (Chapter 9.3)

Cytokine storm: A severe immune reaction in which the body releases too many cytokines into the blood too quickly. A cytokine storm can occur as a result of an infection, autoimmune condition, or other disease. Signs and symptoms include high fever, inflammation, severe fatigue, and nausea. A cytokine storm can be severe or life-threatening and lead to multiple organ failure. (Chapter 9.3)

D

DAR: A type of documentation often used in combination with charting by exception. DAR stands for Data, Action, and Response. Focused DAR notes are brief, and each note is focused on one client problem for efficiency in documenting, as well as for reading. (Chapter 2.5)

Deductive reasoning: “Top-down thinking” or moving from the general to the specific. Deductive reasoning relies on a general statement or hypothesis—sometimes called a premise or standard—that is held to be true. The premise is used to reach a specific, logical conclusion. (Chapter 4.2)

Deep tissue pressure injuries: Persistent; non-blanchable; deep red, maroon, or purple discoloration of intact or nonintact skin revealing a dark wound bed or blood-filled blister. Pain and temperature change often precede skin color changes. Discoloration may appear differently in darkly pigmented skin. (Chapter 10.4)

Defining characteristics: Observable cues/inferences that cluster as manifestations of a problem-focused, health-promotion diagnosis, or syndrome. This does not only imply those things that the nurse can see, but also things that are seen, heard (e.g., the client/family tells us), touched, or smelled. (Chapter 4.4)

Dehiscence: The separation of a surgical incision. (Chapter 10.2)

Delegation: The assignment of the performance of activities or tasks related to client care to unlicensed assistive personnel while retaining accountability for the outcome. (Chapter 4.7)

Delirium: An acute state of cognitive impairment that typically occurs suddenly due to a physiological cause, such as infection, hypoxia, electrolyte imbalances, drug effects, or other acute brain injury. (Chapter 6.2)

Dementia: A chronic condition of impaired cognition, caused by brain disease or injury, marked by personality changes, memory deficits, and impaired reasoning. Dementia can be caused by a group of conditions, such as Alzheimer’s disease, vascular dementia, frontal-temporal dementia, and Lewy body disease. It is gradual, progressive, and irreversible. (Chapter 6.2)

Dependent nursing interventions: Interventions that require a prescription from a physician, advanced practice nurse, or physician’s assistant. (Chapter 4.6)

Depression: A brain disorder with a variety of causes, including genetic, biological, environmental, and psychological factors. (Chapter 6.2)

Dermis: The layer of skin underneath under the epidermis, containing hair follicles, sebaceous glands, blood vessels, endocrine sweat glands, and nerve endings. (Chapter 10.2)

Development: Biological changes, as well as social and cognitive changes, that occur continuously throughout our lives. (Chapter 6.2)

Diabetic retinopathy: A complication of diabetes mellitus due to damaged blood vessels in the retina. If found early, treatments, such as laser treatment that can help shrink blood vessels, injections that can reduce swelling, or surgery, can prevent permanent vision loss. (Chapter 7.2)

Diarrhea: More than three unformed stools in 24 hours. (Chapter 16.7)

Dietary Reference Intakes (DRIs): Set requirements or limit amounts of a certain nutrient, including proteins, carbohydrates, fats, vitamins, minerals, and fiber. (Chapter 14.2)

Diffusion: The movement of solute particles from an area of higher concentration to an area of lower concentration. (Chapter 15.2)

Direct care: Interventions that are carried out by having personal contact with a client. (Chapter 4.6)

Discrimination: Unfair and different treatment of another person or group, denying them opportunities and rights to participate fully in society. (Chapter 3.2)

Disease: Infections can lead to disease that causes signs and symptoms resulting in a deviation from the normal structure or functioning of the host. (Chapter 9.4)

Disenfranchised grief: Any loss that is not validated or recognized. (Chapter 17.2)

Disinfection: Removal of organisms from inanimate objects and surfaces. However, disinfection does not typically destroy all spores and viruses. (Chapter 9.6)

Do-Not-Resuscitate (DNR) order: A medical order that instructs health care professionals not to perform cardiopulmonary resuscitation (CPR) if a client’s breathing stops or if the client’s heart stops beating. (Chapter 17.2)

Dysphagia: Impaired swallowing. (Chapter 1.4, Chapter 14.2)

Dyspnea: A subjective feeling of not getting enough air. Depending on severity, dyspnea causes increased levels of anxiety. (Chapter 8.2)

Dysuria: Painful or difficult urination. (Chapter 16.2)

E

Edema: Swelling caused by excessive interstitial fluid retention. (Chapter 15.2)

Electronic Health Record (EHR): A digital version of a client’s paper chart. EHRs are real-time, client-centered records that make information available instantly and securely to authorized users. (Chapter 2.5)

Electronic Medical Record (EMR): An electronic version of the client’s medical record. (Chapter 4.3)

Endotracheal Tube (ET tube): An ET tube is inserted by an advanced practitioner to maintain a secure airway when a client is experiencing respiratory failure or is receiving general anesthesia.

Enteral nutrition: Liquid nutrition given through the gastrointestinal tract via a tube while bypassing chewing and swallowing. (Chapter 14.3)

Enuresis: Incontinence when sleeping (i.e., bedwetting). (Chapter 16.2)

Epidermis: The very thin, top layer of the skin that contains openings of the sweat gland ducts and the visible part of hair known as the hair shaft. (Chapter 10.2)

Epithelialization: The development of new epidermis and granulation tissue in a healing wound. (Chapter 10.3)

Eschar: Dark brown/black, dry, thick, and leathery dead tissue in wounds. (Chapter 10.4)

Essential nutrients: Nutrients that must be ingested from dietary intake. Essential nutrients cannot be synthesized by the body. (Chapter 14.2)

Ethical principle: An ethical principle is a general guide, basic truth, or assumption that can be used with clinical judgment to determine a course of action. Four common ethical principles are beneficence (do good), nonmaleficence (do no harm), autonomy (control by the individual), and justice (fairness). (Chapter 1.6)

Ethnocentrism: The belief that one’s culture (or race, ethnicity, or country) is better and preferable than another’s. (Chapter 3.2)

Evidence-Based Practice (EBP): A lifelong problem-solving approach that integrates the best evidence from well-designed research studies and evidence-based theories; clinical expertise and evidence from assessment of the health consumer’s history and condition, as well as health care resources; and client, family, group, community, and population preferences and values. (Chapter 1.8, Chapter 4.2)

Excoriation: Redness and removal of the surface of the topmost layer of skin, often due to maceration or itching. (Chapter 10.2)

Expected outcomes: Statements of measurable action for the client within a specific time frame and in response to nursing interventions. “SMART” outcome statements are specific, measurable, action-oriented, realistic, and include a time frame. (Chapter 4.5)

Exposure: An encounter with a potential pathogen. (Chapter 9.4)

Expressive aphasia: The impaired ability to form words and speak. (Chapter 1.4, Chapter 2.3)

Extracellular fluids (ECF): Fluids found outside cells in the intravascular or interstitial spaces. (Chapter 15.2)

F

Fading away: A transition that families make when they realize their seriously ill family member is dying. (Chapter 17.2)

Fats: Fatty acids and glycerol that are essential for tissue growth, insulation, energy source, energy storage, and hormone production. Fats provide 9 kcal/g of energy. (Chapter 14.2)

Fat-soluble vitamins: Vitamins that dissolve in fats and oils and are stored in fat tissue and can build up in the liver, resulting in toxicity. Fat-soluble vitamins include vitamins A, D, E, and K. (Chapter 14.2)

Fecal impaction: A condition that occurs when stool accumulates in the rectum usually due to the client not feeling the presence of stool or not using the toilet when the urge is felt. Large balls of soft stool may need to be digitally removed or treated with mineral oil enemas. (Chapter 16.6)

Filtration: Movement of fluids through a permeable membrane utilizing hydrostatic pressure. (Chapter 15.2)

Fowler’s positioning: A position where the client is supine with the head of bed placed at a 45- to 90-degree angle. The bed can be used to slightly flex the hips to help prevent the client from migrating downwards in bed. (Chapter 13.2)

Frequency: Urinary frequency is the need to urinate many times during the day or at night (nocturia) in normal or less-than-normal volumes. It may be accompanied by a feeling of urgency. (Chapter 16.2)

Friction: The rubbing of skin against a hard object, such as the bed or the arm of a wheelchair. This rubbing causes heat that can remove the top layer of skin and often results in skin damage. (Chapter 10.4)

Functional Health Patterns: An evidence-based assessment framework for identifying client problems and risks during the assessment phase of the nursing process. (Chapter 4.4)

Functional incontinence: Occurs in older adults who have normal bladder control but have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly. Clients with dementia also have increased risk for functional incontinence. (Chapter 16.4)

Functional mobility: The ability of a person to move around in their environment, including walking, standing up from a chair, sitting down from standing, and moving around in bed. (Chapter 13.2)

G

Gait belt: A 2-inch-wide (5 mm) belt, with or without handles, that is fastened around a client’s waist used to ensure stability when assisting clients to stand, ambulate, or to transfer from bed to chair. (Chapter 13.2)

Gas exchange: Refers to the exchange of oxygen and carbon dioxide in the alveoli and the pulmonary capillaries; also called respiration. (Chapter 8.2)

Gender expression: A person’s outward demonstration of gender in relation to societal norms, such as in style of dress, hairstyle, or other mannerisms. (Chapter 3.2)

Gender identity: A person’s inner sensibility that they are a man, a woman, or perhaps neither. (Chapter 3.2)

Generalization:  A judgment formed from a set of facts, cues, and observations. (Chapter 4.2)

Gerontology: The study of the social, cultural, psychological, cognitive, and biological aspects of aging. (Chapter 19.2)

Glaucoma: Gradual loss of peripheral vision caused by elevated intraocular pressure that leads to progressive damage to the optic nerve. (Chapter 7.2)

Global aphasia: A type of aphasia that results from damage to extensive portions of the language areas of the brain. Individuals with global aphasia have severe communication difficulties and may be extremely limited in their ability to speak or comprehend language. They may be unable to say even a few words or may repeat the same words or phrases over and over again. They may have trouble understanding even simple words and sentences. (Chapter 2.3)

Glycemic index: A measure of how quickly plasma glucose levels are released into the bloodstream after carbohydrates are consumed. (Chapter 14.2)

Goals: Broad statements of purpose that describe the aim of nursing care. (Chapter 4.5)

Granulation tissue: New connective tissue in a healing wound with new, fragile, thin-walled capillaries. (Chapter 10.3)

Grief: The emotional response to a loss, defined as the individualized and personalized feelings and responses that an individual makes to real, perceived, or anticipated loss. (Chapter 17.2)

Growth: Physical changes that occur during the development of an individual beginning at the time of conception. (Chapter 6.2)

H

Handoff report: A process of exchanging vital client information, responsibility, and accountability between the off-going and incoming nurses in an effort to ensure safe continuity of care and the delivery of best clinical practices. (Chapter 2.4, Chapter 5.3)

HCO3: Bicarbonate level of arterial blood indicated in an arterial blood gas (ABG) result. Normal range is 22-26. (Chapter 8.2)

Healthcare-Associated Infection (HAI): An infection that is contracted in a health care facility or under medical care. (Chapter 9.4)

Health care power of attorney: A legal document that identifies a trusted individual to serve as a decision maker for health issues when the client is no longer able to speak for themselves. (Chapter 17.2)

Health disparities: Differences in health outcomes resulting from entrenched economic, sociopolitical, or environmental disadvantages. Health disparities negatively impact groups of people based on their ethnicity, gender, age, mental health, disability, sexual orientation or gender identity, socioeconomic status, geographic location, or other characteristics historically linked to discrimination or exclusion. (Chapter 3.5)

Health teaching and health promotion: Employing strategies to teach and promote health and wellness. (Chapter 4.7)

Health promotion-wellness nursing diagnosis: A clinical judgment concerning motivation and desire to increase well-being and to actualize human health potential. (Chapter 4.4)

Healthy environment: A place of physical, mental, and social well-being supporting optimal health and safety. (Chapter 5.9)

Hematuria: Blood in urine, either visualized or found during microscopic analysis. (Chapter 16.2)

Hemostasis phase of wound healing: The first stage of wound healing when clotting factors are released to form clots to stop the bleeding. (Chapter 10.3)

Holism: Treatment of the whole person, including physical, mental, spiritual, and social needs. (Chapter 3.1)

Hospice care: Care that focuses on providing comfort and dignity at the end of life. It involves care and support services that can be of great benefit to people in the final stages of dementia and to their families. (Chapter 6.3, Chapter 17.2)

Huffing technique: A technique helpful for clients who have difficulty coughing. Teach the client to inhale with a medium-sized breath and then make a sound like “ha” to push the air out quickly with the mouth slightly open. (Chapter 8.2)

Human factors: A science that focuses on the interrelationships between humans, the tools and equipment they use in the workplace, and the environment in which they work. (Chapter 5.2)

Hydrostatic pressure: The pressure that a contained fluid exerts on what is confining it. (Chapter 15.2)

Hypercapnia: Elevated levels of retained carbon dioxide in the body. (Chapter 8.2, Chapter 15.5)

Hypertonic solution: Intravenous fluids with a higher concentration of dissolved particles than blood plasma. (Chapter 15.3)

Hypervolemia: Excess intravascular fluid. Used interchangeably with “excessive fluid volume.” (Chapter 15.3)

Hypodermis: The bottom layer of skin, also referred to as the subcutaneous layer, consisting mainly of adipose tissue or fat, along with some blood vessels and nerve endings. Beneath this layer lies muscles, tendons, ligaments, and bones. (Chapter 10.2)

Hypotonic solution: Intravenous fluids with a lower concentration of dissolved particles than blood plasma. (Chapter 15.3)

Hypovolemia: Intravascular fluid loss. Used interchangeably with “deficient fluid volume” and “dehydration.” (Chapter 15.2)

Hypoxemia: A specific type of hypoxia that is defined as decreased partial pressure of oxygen in the blood (PaO2) indicated in an arterial blood gas (ABG) result. (Chapter 8.2)

Hypoxia: A reduced level of tissue oxygenation. Hypoxia has many causes, ranging from respiratory and cardiac conditions to anemia. (Chapter 8.2)

I

Impaired skin integrity: Altered epidermis and/or dermis. (Chapter 10.2)

Impaired tissue integrity: Damage to deeper layers of the skin or other integumentary structures. The NANDA-I definition of impaired tissue integrity is, “Damage to the mucous membrane, cornea, integumentary system, muscular fascia, muscle, tendon, bone, cartilage, joint capsule, and/or ligament.” (Chapter 10.2)

Incentive spirometer: A medical device commonly prescribed after surgery to reduce the buildup of fluid in the lungs and to prevent pneumonia. While sitting upright, the client should breathe in slowly and deeply through the tubing with the goal of raising the piston to a specified level. The client should attempt to hold their breath for 5 seconds, or as long as tolerated, and then rest for a few seconds. This technique should be repeated by the client 10 times every hour while awake. (Chapter 8.2)

Incident reports: Also called variance reports, incident reports are a specific type of documentation that is completed when there is an unexpected occurrence, such as a medication error, client injury, or client fall, or a near miss, where an error did not actually occur, but was prevented from occurring. (Chapter 2.5)

Incomplete proteins: Proteins that do not contain enough amino acids to sustain life. Incomplete proteins can be combined with other types of proteins to add to amino acids consumed to form complete protein combinations. (Chapter 14.2)

Incubation period: The period of a disease after the initial entry of the pathogen into the host but before symptoms develop. (Chapter 9.4)

Independent nursing interventions: Any intervention that the nurse can provide without obtaining a prescription or consulting anyone else. (Chapter 4.6)

Indirect care: Interventions performed by the nurse in a setting other than directly with the client. An example of indirect care is creating a nursing care plan. (Chapter 4.6)

Inductive reasoning: A type of reasoning that involves forming generalizations based on specific incidents. (Chapter 4.2)

Infection: The invasion and growth of a microorganism within the body. (Chapter 9.4)

Inference: Interpretations or conclusions based on cues, personal experiences, preferences, or generalizations. (Chapter 4.3)

Inflammation: A response triggered by a cascade of chemical mediators that occur when pathogens successfully breach the nonspecific physical defenses of the immune system or when an injury occurs. (Chapter 9.3)

Inflammatory phase of wound healing: The second stage of healing when vasodilation occurs to move white blood cells into the wound to start cleaning the wound bed. (Chapter 10.3)

Insomnia: A common sleep disorder that causes trouble falling asleep, staying asleep, or getting good quality sleep. Insomnia interferes with daily activities and causes the person to feel unrested or sleepy during the day. Short-term insomnia may be caused by stress or changes in one’s schedule or environment, lasting a few days or weeks. Chronic insomnia occurs three or more nights a week, lasts more than three months, and cannot be fully explained by another health problem or a medicine. Chronic insomnia raises the risk of high blood pressure, coronary heart disease, diabetes, and cancer. (Chapter 12.2)

Intellectual disability: A diagnostic term that describes intellectual and adaptive functioning deficits identified during the developmental period prior to the age 18. (Chapter 6.2)

Intracellular fluids (ICF): Fluids found inside cells consisting of protein, water, and electrolytes. (Chapter 15.2)

Intersectionality: The many ways in which a person expresses their cultural identity are not separated but are closely intertwined. (Chapter 3.2)

Interstitial fluids: Fluids found between the cells and outside of the vascular system. (Chapter 15.2)

Intestinal obstruction: A partial or complete blockage of the intestines so that contents of the intestine cannot pass through it. (Chapter 16.6)

Intimate partner violence (IPV): Physical or sexual violence, stalking, and psychological or coercive aggression by current or former intimate partners. (Chapter 5.8)

Intracellular Fluids (ICF): Fluids found inside cells consisting of protein, water, and electrolytes. (Chapter 15.2)

Intravascular fluids: Fluids found in the vascular system consisting of the body’s arteries, veins, and capillary networks. (Chapter 15.2)

Invasion: The spread of a pathogen throughout local tissues or the body. (Chapter 9.4)

ISBARR: A mnemonic for the components of health care team member communication that stands for Introduction, Situation, Background, Assessment, Request/Recommendations, and Repeat back. (Chapter 2.4, Chapter 5.3)

Isotonic solution: Intravenous fluids with a similar concentration of dissolved particles as blood plasma. (Chapter 15.3)

J

Just culture: A quality of an institutional culture of safety where people feel safe raising questions and concerns and reporting safety events in an environment that emphasizes a nonpunitive response to errors and near misses, but clear lines are drawn between human error, at-risk, and reckless behaviors. (Chapter 5.4)

Justice: A principle and moral obligation to act on the basis of equality and equity; a standard linked to fairness for all in society. (Chapter 3.2)

K

Kinesthetic impairment: An altered sense of touch that can cause difficulty in performing fine motor tasks. (Chapter 7.2) 

L

Lactation: Breast milk production. (Chapter 14.3)

Lateral positioning: A position where the client lies on one side of the body with the top leg over the bottom leg. This position helps relieve pressure on the coccyx. (Chapter 13.2)

Learning culture: A quality of an institutional culture of safety where people regularly collect information and learn from errors and successes. Data is openly shared and evidence-based practices are used to improve work processes and client outcomes. (Chapter 5.4)

LGBTQAI+: Lesbian, gay, bisexual, transgender, queer, or questioning in reference to sexual orientation. (Chapter 3.2)

Licensed Practical Nurse/Vocational Nurse (LPN/LVN): An individual who has completed a state-approved practical or vocational nursing program, passed the NCLEX-PN examination, and is licensed by their state Board of Nursing to provide client that describes the client’s wishes if they are no longer able to speak for themselves due to injury, illness, or a persistent vegetative state. The living will addresses issues like ventilator support, feeding tube placement, cardiopulmonary resuscitation, and intubation. (Chapter 17.2)

Local infection: Infection confined to a small area of the body, typically near the portal of entry, and usually presents with signs of redness, warmth, swelling, and pain. Purulent drainage may be present and extensive tissue involvement can cause decreased function. (Chapter 9.4)

Loss: The absence of a possession or future possession with the response of grief and the expression of mourning. (Chapter 17.2)

M

Maceration: A condition that occurs when skin has been exposed to moisture for too long causing it to appear soggy, wrinkled, or whiter than usual. (Chapter 10.2)

Macrominerals: Minerals needed in larger amounts and measured in milligrams, grams, and milliequivalents. (Chapter 14.2)

Macronutrients: Nutrients needed in larger amounts due to energy needs. Macronutrients include carbohydrates, proteins, and fats. (Chapter 14.2)

Macular degeneration: Loss of central vision with symptoms such as blurred central vision, distorted vision that causes difficulty driving and reading, and the requirement for brighter lights and magnification for close-up visual activities. (Chapter 7.2)

Malpractice: A specific term that looks at a standard of care, as well as the professional status of the caregiver. (Chapter 1.6)

Maslow’s Hierarchy of Needs: A theory used to prioritize the most urgent client needs to address first. The bottom levels of the pyramid represent the most important physiological needs intertwined with safety. (Chapter 4.4)

Mastication: The chewing of food in the mouth. (Chapter 14.2)

Maturation phase of wound healing: The final stage of wound healing when collagen continues to be created to strengthen the wound and prevent it from reopening. (Chapter 10.3)

Mechanical digestion: Breaking food down into small chunks through chewing prior to swallowing. (Chapter 14.2)

Mechanical lift: A hydraulic lift with a sling used to move clients who cannot bear weight or have a medical condition that does not allow them to stand or assist with moving. It can be a portable device or permanently attached to the ceiling. (Chapter 13.2)

Meconium: The black to dark green, sticky first bowel movement of a newborn. (Chapter 16.2)

Medical diagnosis: A disease or illness diagnosed by a physician or advanced health care provider such as a nurse practitioner or physician’s assistant. Medical diagnoses are a result of clustering signs and symptoms to determine what is medically affecting an individual. (Chapter 4.3)

Medical restraints: Restraints used to manage nonviolent, non-self-destructive behaviors such as the client attempting to remove life-sustaining tubes, drains, IV catheters, urinary catheters, or endotracheal tubes. (Chapter 5.7)

Melena: Black, sticky, tar-looking stools. Melena is typically caused by bleeding in the upper part of the gastrointestinal tract, such as the esophagus, stomach, or the first part of the small intestine, or due to the client swallowing blood. The blood appears darker and tarry-looking because it undergoes digestion on its way through the GI tract. (Chapter 16.2)

Microbiome: Every human being carries their own individual suite of microorganisms in and on their body referred to as their microbiome. A person’s microbiome is acquired at birth and evolves over their lifetime. It is different across body sites and between individuals. (Chapter 9.2)

Microsleep: Brief moments of sleep that occur when a person is awake. A person can’t control microsleep and might not be aware of it. (Chapter 12.2)

Minimum Data Set (MDS): A federally mandated assessment tool used in skilled nursing facilities to track a client’s goal achievement, as well as to coordinate the efforts of the health care team to optimize the resident’s quality of care and quality of life. (Chapter 2.5)

Misuse: Taking prescription pain medications in a manner or dose other than prescribed; taking someone else’s prescription, even if for a medical complaint such as pain; or taking a medication to feel euphoria (i.e., to get high). (Chapter 11.2)

Mixed urinary incontinence: Urinary frequency, urgen­cy, and stress incontinence. (Chapter 16.4)

Mobility: The ability of a client to change and control body position. Mobility exists on a continuum ranging from no impairment (i.e., the client can make major and frequent changes in position without assistance) to being completely immobile (i.e., the client is unable to make even slight changes in body or extremity position without assistance). (Chapter 13.2)

Morality: Personal values, character, or conduct of individuals within communities and societies. (Chapter 1.6)

Mourning: The outward, social expression of loss. Individuals outwardly express loss based on their cultural norms, customs, and practices, including rituals and traditions. (Chapter 17.2)

N

Narcolepsy: An uncommon sleep disorder that causes periods of extreme daytime sleepiness and sudden, brief episodes of deep sleep during the day. (Chapter 12.2)

Narrative note: A type of documentation that chronicles all of the client’s assessment findings and nursing activities that occurred throughout the shift. (Chapter 2.5)

National Patient Safety Goals: Annual safety goals and recommendations tailored for seven different types of health care agencies based on client safety data from experts and stakeholders. (Chapter 5.5)

Near misses: An unplanned event that did not result in a client injury or illness but had the potential to. (Chapter 5.2)

Necrosis: Tissue death. (Chapter 10.2)

Necrotic: Dead tissue that is black. (Chapter 10.2)

Negligence: A “general term that denotes conduct lacking in due care, carelessness, and a deviation from the standard of care that a reasonable person would use in a particular set of circumstances.” (Chapter 1.6)

Never events: Adverse events that are clearly identifiable, measurable, serious (resulting in death or significant disability), and preventable. (Chapter 5.2)

Nitrogen balance: The net loss or gain of nitrogen excreted compared to nitrogen taken into the body in the form of protein consumption; an indicator of protein status where a negative nitrogen balance equates to a protein deficit in the diet and a positive nitrogen balance equates to a protein excess in the diet. (Chapter 14.2)

Nociceptor: A sensory receptor for painful stimuli. (Chapter 11.2)

Nocturia: The need for a client to get up at night on a regular basis to urinate. Nocturia often causes sleep deprivation that affects a person’s quality of life. (Chapter 16.2)

Nonblanchable erythema: Skin redness that does not turn white when pressed. (Chapter 10.4)

Non-REM sleep: Slow-wave sleep when restoration takes place and the body’s temperature, heart rate, and oxygen consumption decrease. (Chapter 12.2)

Nonspecific innate immunity: A system of defenses in the body that targets invading pathogens in a nonspecific manner that is present from the moment we are born. Nonspecific innate immunity includes physical defenses, chemical defenses, and cellular defenses. (Chapter 9.3)

Nontherapeutic responses: Responses to clients that block communication, expression of emotion, or problem-solving. (Chapter 2.3)

Normal flora: Microorganisms that live on our skin and in the nasopharynx and gastrointestinal tracts and don’t cause an infection unless the host becomes susceptible. (Chapter 9.2)

Normal grief: The common feelings, behaviors, and reactions to loss. (Chapter 17.2)

Nurse Licensure Compact (NLC): Allows a nurse to have one multistate license with the ability to practice in the home state and other compact states. (Chapter 1.5)

Nurse Practice Act (NPA): Legislation enacted by each state that establishes regulations for nursing practice within that state by defining the requirements for licensure, as well as the scope of nursing practice. (Chapter 1.3)

Nursing: Nursing integrates the art and science of caring and focused on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence. Nursing is the diagnosis and treatment of human responses and advocacy in the care of individuals, families, groups, communities, and populations in recognition of the connection of all humanity. (Chapter 1.3, Chapter 4.2)

Nursing care plan: Specific documentation of the planning and delivery of nursing care that is required by The Joint Commission. (Chapter 4.2)

Nursing process: A systematic approach to client-centered care with steps including assessment, diagnosis, outcome identification, planning, implementation, and evaluation; otherwise known by the mnemonic “ADOPIE.” (Chapter 4.1)

Nutrient-dense foods: Foods with a high proportion of nutritional value relative to calories contained in the food. (Chapter 14.2)

O

Objective data: Data that the nurse can see, touch, smell, or hear or is reproducible such as vital signs. Laboratory and diagnostic results are also considered objective data. (Chapter 4.3)

Obstructive sleep apnea (OSA): A common sleep condition that occurs when the upper airway becomes repeatedly blocked during sleep, reducing or completely stopping airflow. If the brain does not send the signals needed to breathe, the condition may be called central sleep apnea. (Chapter 12.2)

Occult blood: Hidden blood in the stool not visible to the naked eye. (Chapter 16.9)

Oliguria: Decreased urine output, defined as less than 500 mL urine in adults in a 24-hour period. In hospitalized clients, oliguria is further defined as less than 0.5 mL of urine per kilogram per hour for adults and children or less than 1 mL of urine per kilogram per hour for infants. (Chapter 16.2)

Oncotic pressure: Pressure inside the vascular compartment created by protein content of the blood (in the form of albumin) that holds water inside the blood vessels. (Chapter 15.2)

Opioid intoxication: Significant behavioral or psychological changes (e.g., apathy, dysphoria, psychomotor agitation or retardation, or impaired judgment) that occur during or shortly after opioid use. Symptoms of opioid intoxication include drowsiness or coma, slurred speech, or impairment in attention or memory. (Chapter 11.2)

Opportunistic pathogen: A pathogen that only causes disease in situations that compromise the host’s defenses, such as the body’s protective barriers, immune system, or normal microbiota. Individuals susceptible to opportunistic infections include the very young, the elderly, women who are pregnant, clients undergoing chemotherapy, people with immunodeficiencies (such as acquired immunodeficiency syndrome [AIDS]), clients who are recovering from surgery, and those who have had a breach of protective barriers (such as a severe wound or burn). (Chapter 9.4)

Orthopnea: Difficulty in breathing that occurs when lying down and is relieved upon changing to an upright position. (Chapter 8.3)

Orthostatic hypotension: Low blood pressure that occurs when a client changes position from lying to sitting or sitting to standing that causes symptoms of dizziness or light-headedness. Orthostatic hypotension is defined as a drop in systolic blood pressure of 20 mm Hg or more or a drop of diastolic blood pressure of 10 mm Hg or more within three minutes of sitting or standing. (Chapter 13.2)

Osmolality: Proportion of dissolved particles in a specific weight of fluid. (Chapter 15.2, Chapter 15.3)

Osmolarity: Proportion of dissolved particles or solutes in a specific volume of fluid. (Chapter 15.3)

Osmosis: Movement of fluid through a semipermeable membrane from an area of lesser solute concentration to an area of greater solute concentration. (Chapter 15.2)

Outcome: A measurable behavior demonstrated by the client that is responsive to nursing interventions. (Chapter 4.5)

Overdose: The biological response of the human body when too much of a substance is ingested. (Chapter 11.2)

Overflow incontinence: Occurs when small amounts of urine leak from a bladder that is always full. This condition tends to occur in males with enlarged prostates that prevent the complete emptying of the bladder. (Chapter 16.4)

P

PaCO2: Partial pressure of carbon dioxide level in arterial blood indicated in an ABG result. Normal range is 35-45 mmHg. (Chapter 8.2)

Pain: An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. (Chapter 11.2)

Palliative care: Client and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care occurs throughout the continuum of care and involves the interdisciplinary team collaboratively addressing physical, intellectual, emotional, social, and spiritual needs and facilitating client autonomy, access to information, and choice. (Chapter 17.2)

PaO2: Partial pressure of oxygen level in arterial blood indicated in an ABG result. Normal range is 80-100 mmHg. (Chapter 8.2)

Paralytic ileus: A condition where peristalsis is not propelling the contents through the intestines. (Chapter 16.6)

Parenteral nutrition: An intravenous solution containing glucose, amino acids, minerals, electrolytes, and vitamins, along with supplemental lipids. (Chapter 14.3)

Partially complete proteins: Proteins that have enough amino acids to sustain life, but not enough for tissue growth and maintenance. Typically interchanged with incomplete proteins. (Chapter 14.2)

PASS: A mnemonic for actions to take when using a fire extinguisher, including Pull, Aim, Squeeze, and Sweep. (Chapter 5.9)

Passive range-of-motion exercises: Movement applied to a joint solely by another person or a passive motion machine. When passive range of motion is applied, the joint of an individual receiving exercise is completely relaxed while the outside force moves the body part. (Chapter 13.2)

Passive transport: Movement of fluids or solutes down a concentration gradient where no energy is used during the process. (Chapter 15.2)

Pathogens: Microorganisms that cause disease. (Chapter 9.2)

Pathogenicity: The ability of a microorganism to cause disease. (Chapter 9.4)

Patient confidentiality: Keeping your client’s Protected Health Information (PHI) protected and known only by those health care team members directly providing care for the client (Chapter 1.6)

Patient-Controlled Analgesia (PCA): A method of pain management that allows hospitalized clients with severe pain to safely self-administer opioid medications using a programmed pump according to their level of discomfort. (Chapter 11.4)

Perception: The interpretation of sensation during the sensory process. (Chapter 7.2)

Perfusion: The passage of blood through the arteries to an organ or tissue. (Chapter 8.2)

Peristalsis: Coordinated muscle movements in the esophagus that move food or liquid through the esophagus and into the stomach or coordinated muscle movements in the intestines that move food/waste products through the intestines. (Chapter 9.3, Chapter 14.2, Chapter 16.2)

Personal Protective Equipment (PPE): Gloves, gowns, face shields, goggles, and masks used to prevent the spread of infection to and from clients and health care providers. (Chapter 9.6)

PES format:  The format of a nursing diagnosis statement that includes:

• Problem (P) – statement of the client problem (i.e., the nursing diagnosis)
• Etiology (E) – related factors (etiology) contributing to the cause of the nursing diagnosis
• Signs and Symptoms (S) – defining characteristics manifested by the client of that nursing diagnosis (Chapter 4.4)

Ph level: A measurement of acidity or alkalinity of the blood. The normal range of pH level for arterial blood is 7.35-7.45. (Chapter 8.2)

Physical dependence: Withdrawal symptoms that occur when chronic pain medication is suddenly reduced or stopped because of physiological adaptations that occur from chronic exposure to the medication. (Chapter 11.2)

Polyuria: Greater than 2.5 liters of urine output over 24 hours; also referred to as diuresis. Urine is typically clear with no color. (Chapter 16.2)

Portal of entry: An anatomic site through which pathogens can pass into a host, such as mucous membranes, skin, respiratory, or digestive systems. (Chapter 9.4)

Post-void residual: A measurement of urine left in the bladder after a client has voided by using a bladder scanner or straight catheterization. (Chapter 16.5)

Prejudice: To “prejudge”; a preconceived idea, often unfavorable, about a person or group of people. (Chapter 3.2)

Presbycusis: Age-related hearing loss. (Chapter 7.2)

Presbyopia: The impairment of near vision and accommodation as the lens of the eye gradually becomes thicker and loses flexibility as a person ages. (Chapter 7.2)

Prescription: Orders, interventions, remedies, or treatments ordered or directed by an authorized primary health care provider. (Chapter 4.2)

Pressure injuries: Localized damage to the skin or underlying soft tissue, usually over a bony prominence, as a result of intense and prolonged pressure in combination with shear. (Chapter 10.4)

Primary care: Care that is provided to clients to promote wellness and prevent disease from occurring. This includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. (Chapter 1.4)

Primary data: Information collected from the client. (Chapter 4.3)

Primary health care provider: Member of the health care team (usually a medical physician, nurse practitioner, etc.) licensed and authorized to formulate prescriptions on behalf of the client. (Chapter 4.6)

Primary intention: A type of wound that is sutured, stapled, glued, or otherwise closed so the wound heals beneath the closure. (Chapter 10.3)

Primary pathogen: A pathogen that can cause disease in a host regardless of the host’s resident microbiota or immune system. (Chapter 9.4)

Prioritization: The skillful process of deciding which actions to complete first, second, or third for optimal client outcomes and to improve client safety. (Chapter 4.4)

Problem-focused nursing diagnosis: A clinical judgment concerning an undesirable human response to health condition/life processes that exist in an individual, family, group, or community. (Chapter 4.4)

Prodromal period: The disease stage after the incubation period when the pathogen continues to multiply and the host begins to experience general signs and symptoms of illness that result from activation of the immune system, such as fever, pain, soreness, swelling, or inflammation. Usually, such signs and symptoms are too general to indicate a particular disease. (Chapter 9.4)

Progressive relaxation: Types of relaxation techniques that focus on reducing muscle tension and using mental imagery to induce calmness. (Chapter 2.2)

Proliferative phase of wound healing: The third stage of wound healing that begins a few days after injury and includes four processes: epithelialization, angiogenesis, collagen formation, and contraction. (Chapter 10.3)

Prone positioning: A position where the client lies on their stomach with their head turned to the side. (Chapter 13.2)

Proprioception: The sense of the position of our bones, joints, and muscles. (Chapter 7.2)

Proteins: Sources of peptides, amino acids, and some trace elements that provide 4 kcal/g of energy. Proteins are necessary for tissue repair, tissue function, growth, fluid balance, and clotting, as well as energy in the absence of sufficient intake of carbohydrates. (Chapter 14.2)

Protocol: A precise and detailed written plan for a regimen of therapy. (Chapter 1.3)

Provider: A physician, podiatrist, dentist, optometrist, or advanced practice nurse provider. (Chapter 1.4)

Pursed-lip breathing: A breathing technique that encourages a person to inhale through the nose and exhale through the mouth at a slow, controlled flow. (Chapter 8.2)

Purulent: Drainage that is thick; opaque; tan, yellow, green, or brown in color. New purulent drainage should always be reported to the health care provider. (Chapter 10.6)

Purulent sputum: Yellow or green sputum that often indicates a respiratory infection. (Chapter 8.3)

Pyuria: At least ten white blood cells in each cubic millimeter of urine in a urine sample that typically indicates infection. In some cases, pus may be visible in the urine. (Chapter 16.2)

Q

Quality: The degree to which nursing services for health care consumers, families, groups, communities, and populations increase the likelihood of desirable outcomes and are consistent with evolving nursing knowledge.” (Chapter 1.8)

Quality improvement: The “combined and unceasing efforts of everyone — health care professionals, clients and their families, researchers, payers, planners, and educators — to make the changes that will lead to better client outcomes (health), better system performance (care), and better professional development (learning).” (Chapter 4.7)

R

Race: A socially constructed idea; there are no truly genetically or biologically distinct races. Humans are biologically similar to each other, not different. (Chapter 3.2)

RACE: A mnemonic for actions to immediately take during a fire, standing for Rescue, Activate, Confine, and Extinguish. (Chapter 5.9)

Racism: The presumption that races are distinct from one another and there is a hierarchy to race, implying that races are unequal. In racism, expression of one’s cultural beliefs is viewed as a heritable trait. (Chapter 3.2)

Range-of-motion (ROM) exercises: Activities aimed to facilitate movement of specific joints and promote mobility of extremities. (Chapter 13.2)

Rapport: Developing a relationship of mutual trust and understanding. (Chapter 4.2)

Reaction: The response that individuals have to a perception of a received stimulus. (Chapter 7.2)

Reception: The initial part of the sensory process when a nerve cell or sensory receptor is stimulated by a sensation. (Chapter 7.2)

Receptive aphasia: A type of aphasia where the client has difficulty in understanding what is being communicated to them. The client may be able to verbalize their thoughts and feelings but does not understand what is spoken to them. (Chapter 2.3)

Reckless behavior: According to the Just Culture model, an error that occurs when an action is taken with conscious disregard for a substantial and unjustifiable risk. (Chapter 5.4)

Rectal bleeding: Bright red blood in the stools; also referred to as hematochezia. (Chapter 16.2)

Referred pain: Pain perceived at a location other than the site of the painful stimulus. For example, pain from retained gas in the colon can cause pain to be perceived in the shoulder. (Chapter 11.2)

Refined grains: Grains that have been processed to remove parts of the grain kernel and supply little fiber. (Chapter 14.2)

Registered Nurse (RN): An individual who has graduated from a state-approved school of nursing, passed the NCLEX-RN examination, and is licensed by a state board of nursing to provide client care. (Chapter 1.4, Chapter 1.5, Chapter 4.3)

Related factors: The underlying cause (etiology) of a nursing diagnosis when creating a PES statement. (Chapter 4.4)

Relaxation breathing: A breathing technique used to reduce anxiety and control the stress response. (Chapter 2.2)

Religion: A unified system of beliefs, values, and practices that a person holds sacred or considers to be spiritually significant. Spiritual practices often unite a moral community called a church. Some people associate religion with a place of worship (e.g., a synagogue or church), a practice (e.g., attending religious services, receiving communion, or going to confession), or a concept that guides one’s daily life (e.g., sin or karma). (Chapter 18.3)

REM sleep: Rapid eye movement (REM) sleep when heart rate and respiratory rate increase, eyes twitch, and brain activity increases. Dreaming occurs during REM sleep, and muscles become limp to prevent acting out one’s dreams. (Chapter 12.2)

Renin-Angiotensin-Aldosterone System (RAAS): A body system that regulates extracellular fluids and blood pressure by regulating fluid output and electrolyte excretion. (Chapter 15.2)

Respite care: Care provided at home (by a volunteer or paid service) or in a care setting, such as adult day centers or residential facilities, that allows the caregiver to take a much-needed break. (Chapter 6.3)

Reporting culture: A quality of an institutional culture of safety where people realize errors are inevitable and are encouraged to speak up for client safety by reporting errors and near misses. (Chapter 5.4)

Respiration: Gas exchange occurs at the alveolar level where blood is oxygenated, and carbon dioxide is removed. (Chapter 8.2)

Restraint: A device, method, or process that is used for the specific purpose of restricting a client’s freedom of movement without the permission of the person. (Chapter 5.7)

Risk nursing diagnosis: A clinical judgment concerning the vulnerability of an individual, family, group, or community for developing an undesirable human response to health conditions/life processes. (Chapter 4.4)

Root cause analysis: A structured method used to analyze serious adverse events to identify underlying problems that increase the likelihood of errors, while avoiding the trap of focusing on mistakes by individuals. (Chapter 5.2)

S

Safety culture: A culture established within health care agencies that empowers nurses, nursing students, and other staff members to speak up about risks to clients and to report errors and near misses, all of which drive improvement in client care and reduce the incident of client harm. (Chapter 1.3)

Safety Data Sheets (SDS): Safety Data Sheets, formerly referred to as Material Safety Data Sheets (MSDS), are hazardous communication sheets that let workers know certain information about chemicals they encounter in the workplace. OSHA requires that SDS’s are readily available and easily readable for each chemical in the workplace. (Chapter 5.9)

Sanguineous: Drainage from a wound that is fresh bleeding. (Chapter 10.6)

SaO2: Calculated oxygen saturation level in an ABG result. Normal range is 95-100%. (Chapter 8.2)

Saturated fats: Fats derived from animal products, such as butter, tallow, and lard for cooking, or from meat products such as steak. Saturated fats are generally solid at room temperature and can raise cholesterol levels, contributing to heart disease. (Chapter 14.2)

Scheduled hourly rounds: Scheduled hourly visits to each client’s room to integrate fall prevention activities with the rest of a client’s care. (Chapter 5.6)

Scope of practice: Services that a qualified health professional is deemed competent to perform and permitted to undertake – in keeping with the terms of their professional license. (Chapter 1.1)

Seclusion: The confinement of a client in a locked room from which they cannot exit on their own. It is generally used as a method of discipline, convenience, or coercion. (Chapter 5.7)

Secondary care: Care that occurs when a person has contracted an illness or injury and is in need of medical care. (Chapter 1.4)

Secondary data: Information collected from sources other than the client. (Chapter 4.3)

Secondary infection: An infection occurring as a result of treatment for a primary infection, or an infection in addition to the primary infection as a result of a diminished immune system or the elimination of normal flora. For examples, a yeast infection that occurs after treatment with antibiotics for pneumonia is a secondary infection. (Chapter 9.4)

Secondary intention: A type of healing that occurs when the edges of a wound cannot be brought together, so the wound fills in from the bottom up by the production of granulation tissue. An example of a wound healing by secondary intention is a pressure ulcer. (Chapter 10.3)

Self-determination: Refers to a person’s right to determine what will be done with and to their own body. (Chapter 3.8)

Semi-Fowler’s positioning: A position where the head of the bed is placed at a 30- to 45-degree angle. The client’s hips may or may not be flexed. (Chapter 13.2)

Sensory deprivation: A condition that occurs when there is a lack of sensations due to sensory impairments or when the environment has few quality stimuli. (Chapter 7.2)

Sensory impairment: Any type of difficulty that an individual has with one of their five senses or sensory function. (Chapter 7.2)

Sensory overload: A condition that occurs when an individual receives too many stimuli or cannot selectively filter meaningful stimuli. (Chapter 7.2)

Sentinel event: An unexpected occurrence involving death or serious physiological or psychological injury or the risk thereof. (Chapter 5.2)

Sepsis: An existing infection that triggers an exaggerated inflammatory reaction called SIRS throughout the body. If left untreated, sepsis causes tissue damage and quickly spreads to multiple organs. It is a life-threatening medical emergency. (Chapter 9.4)

Septicemia: Bacteria that are both present and multiplying in the blood. (Chapter 9.4)

Septic shock: Severe sepsis that leads to a life-threatening decrease in blood pressure (systolic pressure <90 mm Hg), preventing cells and other organs from receiving enough oxygen and nutrients. It can cause multi-organ failure and death. (Chapter 9.4)

Serosanguineous: Serous drainage with small amounts of blood present. (Chapter 10.6)

Serous: Drainage from a wound that is clear, thin, watery plasma. It’s normal during the inflammatory stage of wound healing, and small amounts are considered normal wound drainage. (Chapter 10.6)

Sexuality: Encompasses sex, sexual orientation, gender identity, gender roles, among other topics. (Chapter 3.6)

Sexual orientation: A person’s physical and emotional interest or desire for others. Sexual orientation is on a continuum and is manifested in one’s self-identity and behaviors. (Chapter 3.2)

Shear: Damage that occurs when tissue layers move over the top of each other, causing blood vessels to stretch and break as they pass through the subcutaneous tissue. (Chapter 10.4)

Simple carbohydrates: Small molecules of monosaccharides or disaccharides that break down quickly and raise blood glucose levels quickly. (Chapter 14.2)

Simple human error: According to the Just Culture model, this is an error that occurs when an individual inadvertently does something other than what should have been done. Most errors are the result of human error due to poor processes, programs, education, environmental issues, or situations. These are managed by correcting the cause, looking at the process, and fixing the deviation. (Chapter 5.4)

Sim’s positioning: A position where the client is positioned halfway between the supine and prone positions with their legs flexed. (Chapter 13.2)

Sit to stand lifts: Mobility devices that assist weight-bearing clients who are unable to transition from a sitting position to a standing position by using their own strength. They are used to safely transfer clients who have some muscular strength, but not enough strength to safely change positions by themselves. Some sit to stand lifts use a mechanized lift whereas others are nonmechanized. (Chapter 13.2)

Sleep apnea: A common sleep condition that occurs when the upper airway becomes repeatedly blocked during sleep, reducing or completely stopping airflow. If the brain does not send the signals needed to breathe, the condition may be called central sleep apnea. (Chapter 12.2)

Sleep diary: A record of the time a person goes to sleep, wakes up, and takes naps each day for 1-2 weeks. Timing of activities such as exercising and drinking caffeine or alcohol are also recorded, as well as feelings of sleepiness throughout the day. (Chapter 12.2)

Sleep study: A diagnostic test that monitors and records data during a client’s full night of sleep. A sleep study may be performed at a sleep center or at home with a portable diagnostic device. (Chapter 12.2)

Sleep-wake homeostasis: The homeostatic sleep drive keeps track of the need for sleep, reminds the body to sleep after a certain time, and regulates sleep intensity. This sleep drive gets stronger every hour a person is awake and causes individuals to sleep longer and more deeply after a period of sleep deprivation. (Chapter 12.2)

Slider board: A board (also called a transfer board) used to transfer an immobile client from one surface to another while the client is lying supine (e.g., from a stretcher to hospital bed). (Chapter 13.2)

Slough: Inflammatory exudate in wounds that is usually light yellow, soft, and moist. (Chapter 10.4)

SOAPIE: A mnemonic for a type of documentation that is organized by six categories: Subjective, Objective, Assessment, Plan, Interventions, and Evaluation. (Chapter 2.5)

Social determinants of health: Nonmedical factors that influence health outcomes, including conditions in which people are born, grow, work, live, and age, and the wider sets of forces and systems shaping the conditions of daily life. (Chapter 3.2)

Social justice: Equal rights, equal treatment, and equitable opportunities for all. (Chapter 3.2)

Somatosensation: Sensory receptors that respond to specific stimuli such as pain, pressure, temperature, and vibration; includes vestibular sensation and proprioception. (Chapter 7.2)

Specific adaptive immunity: The immune response that is activated when the nonspecific innate immune response is insufficient to control an infection. There are two types of adaptive responses: the cell-mediated immune response, which is carried out by T cells, and the humoral immune response, which is controlled by activated B cells and antibodies. (Chapter 9.3)

SPICES tool: Focuses on areas of common problems for aging individuals and can lead to early intervention and treatment. (Chapter 19.3)

Spiritual distress: A state of suffering related to the impaired ability to experience meaning in life through connections with self, others, the world, or a superior being. (Chapter 18.2)

Spirituality: A dynamic and intrinsic aspect of humanity through which persons seek ultimate meaning, purpose, and transcendence and experience relationships to self, family, others, community, society, nature, and the significant or sacred. Spirituality is expressed through beliefs, values, traditions, and practice. (Chapter 18.2)

SpO2: Hemoglobin saturation level measured by pulse oximetry. Normal range is 94-98%. (Chapter 8.2)

Sputum: Mucus and other secretions that are coughed up and expelled from the mouth. (Chapter 8.3)

Stage 1 pressure injuries: Intact skin with a localized area of nonblanchable erythema where prolonged pressure has occurred. (Chapter 10.4)

Stage 2 pressure injuries: Partial-thickness loss of skin with exposed dermis. The wound bed is viable and may appear like an intact or ruptured blister. (Chapter 10.4)

Stage 3 pressure injuries: Full-thickness tissue loss in which fat is visible, but cartilage, tendon, ligament, muscle, and bone are not exposed. The depth of tissue damage varies by anatomical location. Undermining and tunneling may be present. If slough or eschar obscures the wound so that tissue loss cannot be assessed, the pressure injury is referred to as unstageable. (Chapter 10.4)

Stage 4 pressure injuries: Full-thickness tissue loss like Stage 3 pressure injuries but also have exposed cartilage, tendon, ligament, muscle, or bone. (Chapter 10.4)

Standard precautions: The minimum infection prevention practices that apply to all client care, regardless of suspected or confirmed infection status of the client, in any setting where health care is delivered. (Chapter 9.6)

Stereotyping: Assuming that a person has the attributes, traits, beliefs, and values of a group because they are a member of that group. (Chapter 3.2)

Sterile technique: A process, also called surgical asepsis, used to eliminate every potential microorganism in and around a sterile field while also maintaining objects as free from microorganisms as possible. It is the standard of care for surgical procedures, invasive wound management, and central line care. Sterile technique requires a combination of meticulous hand washing, creating a sterile field, using long-lasting antimicrobial cleansing agents such as Betadine, donning sterile gloves, and using sterile devices and instruments. (Chapter 9.6)

Sterilization: A process used to destroy all pathogens from inanimate objects, including spores and viruses. (Chapter 9.6)

Stress urinary incontinence: The involuntary loss of urine on intra-abdominal pressure (e.g., laughing and coughing) or physical exertion (e.g., jumping). (Chapter 16.4)

Subculture: A smaller group of people within a larger culture, often based on a person’s occupation, hobbies, interests, or place of origin. (Chapter 3.2)

Subjective data: Information obtained from the client and/or family members that offers important cues from their perspectives. When documenting subjective data stated by a client, it should be in quotation marks and start with verbiage such as, “The client reports…” Chapter 4.3)

Substance abuse: A maladaptive pattern of continued use of alcohol or a drug despite it causing persistent social, occupational, psychological, or physical problems that can be physically hazardous. (Chapter 5.8)

Substance abuse disorder: Significant impairment or distress from a pattern of substance use (i.e., alcohol, drugs or misuse of prescription medications). (Chapter 11.2)

Sundowning: Increased confusion, anxiety, agitation, pacing, or disorientation in clients with dementia that typically begins at dusk and continues throughout the night. (Chapter 6.3)

Supine positioning: A position where the client lies flat on their back. (Chapter 13.2)

Syndrome nursing diagnosis: A clinical judgment concerning a specific cluster of nursing diagnoses that occur together and are best addressed together and through similar interventions. (Chapter 4.4)

Systemic infection: An infection that becomes disseminated throughout the body. (Chapter 9.4)

Systemic Inflammatory Response Syndrome (SIRS): An exaggerated inflammatory response to a noxious stressor (including, but not limited to, infection and acute inflammation) that affects the entire body. (Chapter 9.4) 

T

Tachypnea: Elevated respiratory rate above normal range according to the client’s age. (Chapter 8.3)

T cells: Immune cells that mature in the thymus. T cells are categorized into three classes: helper T cells, regulatory T cells, and cytotoxic T cells. Helper T cells stimulate B cells to make antibodies and help killer cells develop. Killer T cells directly kill cells that have already been infected by a pathogen. T cells also use cytokines as messenger molecules to send chemical instructions to the rest of the immune system to ramp up its response. (Chapter 9.3)

Tarry stools: Stools that are black and sticky that appear like tar; also referred to as melena. (Chapter 16.2)

Tertiary care: A type of care that deals with the long-term effects from chronic illness or condition, with the purpose to restore physical and mental function that may have been lost. The goal is to achieve the highest level of functioning possible with this chronic illness. (Chapter 1.4)

Tertiary intention: The healing of a wound that has had to remain open or has been reopened, often due to severe infection. (Chapter 10.3)

Therapeutic communication: The purposeful, interpersonal information transmitting process through words and behaviors based on both parties’ knowledge, attitudes, and skills, which leads to client understanding and participation. (Chapter 2.3)

Therapeutic communication techniques: Techniques that encourage clients to explore feelings, problem solve, and cope with responses to medical conditions and life events. (Chapter 2.3)

Timed get up and go test: A mobility assessment by nurses that begins by having the client stand up from an armchair, walk three yards, turn, walk back to the chair, and sit down. As the client performs these maneuvers, their posture, alignment, balance, and gait are analyzed as the client’s mobility status is assessed. (Chapter 13.2)

Tinnitus: Hearing ringing in the ears. (Chapter 7.2)

Tolerance: A reduced response to pain medication when the same dose of a drug has been given repeatedly, requiring a higher dose of the drug to achieve the same level of response. (Chapter 11.2)

Trace minerals: Minerals needed in tiny amounts. (Chapter 14.2)

Transcendence: An understanding of being part of a greater picture or of something greater than oneself, such as the awe one can experience when walking in nature. It can also be expressed as a search for the sacred through subjective feelings, thoughts, and behaviors. (Chapter 18.2)

Transcultural nursing: Incorporating cultural beliefs and practices of people to help them maintain and regain health or to face death in a meaningful way. (Chapter 3.4)

Trans fats: Fats that have been altered through hydrogenation and as such are not in their natural state. Fat is changed to make it harder at room temperature and to make it have a longer shelf life and contributes to increased cholesterol and heart disease. (Chapter 14.2)

Transferring: The action of a client moving from one surface to another. This includes moving from a bed into a chair or moving from one chair to another. (Chapter 13.2)

Transmission-based precautions: Precautions used for clients with documented or suspected infection, or colonization, of highly transmissible pathogens, such as C. difficile (C-diff), Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE), Respiratory Syncytial Virus (RSV), measles, and tuberculosis (TB). Three categories of transmission-based precautions are contact precautions, droplet precautions, and airborne precautions. (Chapter 9.6)

Trendelenburg positioning: A position where the head of the bed is placed lower than the client’s feet. This position is used in situations such as hypotension and medical emergencies because it helps promote venous return to major organs such as the brain and heart. (Chapter 13.2)

Tripod position: A position that enhances air exchange when a client sits up and leans over by resting their arms on their legs or on a bedside table; also referred to as a three-point position. (Chapter 8.2, Chapter 13.2)

Trousseau’s sign: A sign associated with hypocalcemia that causes a spasm of the hand when a blood pressure cuff is inflated. (Chapter 15.4)

Tunneling: Passageways underneath the surface of the skin that extend from a wound and can take twists and turns. (Chapter 10.4)

U

Undermining: A condition that occurs in wounds when the tissue under the wound edges becomes eroded, resulting in a pocket beneath the skin at the wound’s edge. (Chapter 10.4)

Universal fall precautions: A set of interventions to reduce the risk of falls for all clients and focus on keeping the environment safe and comfortable. (Chapter 5.6)

Unlicensed Assistive Personnel (UAP): Any unlicensed person, regardless of title, who performs tasks delegated by a nurse. This includes certified nursing aides/assistants (CNAs), patient care assistants (PCAs), patient care technicians (PCTs), state tested nursing assistants (STNAs), nursing assistants-registered (NA/Rs) or certified medication aides/assistants (MA-Cs). Certification of UAPs varies between jurisdictions. (Chapter 1.4, Chapter 4.3)

Unsaturated fats: Fats derived from oils and plants, though chicken and fish contain some unsaturated fats as well. Unsaturated fats are healthier than saturated fats, and some containing omega-3 fatty acids are considered polyunsaturated fats and help lower LDL cholesterol levels. (Chapter 14.2)

Unstageable pressure injuries: Full-thickness skin and tissue loss in which the extent of tissue damage within the ulcer cannot be confirmed because it is obscured by slough or eschar. (Chapter 10.4)

Urgency: A sensation of an urgent need to void. Urgency may be associated with urge incontinence. (Chapter 16.2)

Urge urinary incontinence: Also referred to as “overactive bladder”; urine leakage accompanied by a strong desire to void. It can be caused by increased sensitivity to stimulation of the detrusor in the bladder or decreased inhibitory control of the central nervous system. (Chapter 16.4)

Urinary retention: A condition when the client cannot empty all of the urine from their bladder. (Chapter 16.5)

Urine specific gravity: A measurement of hydration status that measures the concentration of particles in urine. (Chapter 15.6)

V

Venous insufficiency: A condition that occurs when the cardiovascular system cannot adequately return blood and fluid from the extremities to the heart. (Chapter 10.2)

Ventilation: Mechanical movement of air into and out of the lungs. (Chapter 8.2)

Verbal communication: Exchange of information using words understood by the receiver. (Chapter 2.2)

Vertigo: A sensation of dizziness as if the room is spinning. (Chapter 13.2)

Vestibular sensation: A sense of spatial orientation and balance. (Chapter 7.2)

Vibratory Positive Expiratory Pressure (PEP) Therapy: Handheld devices such as flutter valves or Acapella devices used with clients who need assistance in clearing mucus from their airways. (Chapter 8.2)

Virulence: The degree to which a microorganism is likely to become a disease. (Chapter 9.4)

W

Water-soluble vitamins: Vitamins that are not stored in the body and include vitamin C and B-complex vitamins: B1 (thiamine), B2 (riboflavin), B3 (niacin), B6 (pyridoxine), B12 (cyanocobalamin), and B9 (folic acid, biotin, and pantothenic acid). Toxicity is rare as excess water-soluble vitamins are excreted in the urine. (Chapter 14.2)

Whole grains: Grains with the entire grain kernel that supply more fiber than refined grains. (Chapter 14.2)

Withdrawal: Symptoms that cause significant distress after stopping or reducing the use of substances (including opioids), with symptoms such as dysphoric mood, nausea, vomiting, muscle aches, rhinorrhea or lacrimation, pupillary dilation, piloerection, sweating, diarrhea, yawning, fever, or insomnia. (Chapter 11.2)