Nursing Exam 4 Definitions

Front 1

albumin

Back 1

- plasma protein.
- Provides colloid osmotic pressure, preventing plasma loss from the capillaries.
- Acts as a source for rapid replacement of tissue proteins

Front 2

aldosterone

Back 2

- a hormone released by the adrenal cortex in response to the sensation of a low blood volume.
- Aldosterone starts a process where the body retains salt (sodium) thereby causing the body to retain water, thus increasing the circulating blood volume.
- save salt... save water
- Substances released by the adrenal cortex in response to increased plasma potassium levels or as part of the rennin-angiotensin-aldosterone mechanism to counteract hypovolemia.

Front 3

anion

Back 3

- a negatively charged electrolyte
Cl- HCO3 -- SO4-- HPO4-- proteinate

Front 4

anion gap

Back 4

difference b/w the concentrations of serum cations & anions; determined by measuring the concentrations of sodium cations & chloride and bicarbonate anions

Front 5

antidiuretic hormone (ADH)

Back 5

- a hormone released by the posterior p-gland that decreases the production of urine by increasing the reabsorption of water.
- It is released in response to the sensation of a decreased blood volume or an increased sodium level.
- ADH causes vasoconstriction and an increase in blood volume.
– Substances stored in the posterior pituitary gland that is released in response to changes in blood osmolarity

Front 6

cation

Back 6

- a positively charged electrolyte
Na+ K+ Ca++ Mg++ H+

Front 7

colloid

Back 7

components suspended in blood or another medium (blood & blood components)

Front 8

colloid osmotic pressure

Back 8

- the osmotic pressure of a colloid in solution.
- For example, proteins such as albumin exert pressure which tends to keep fluid in the transvascular compartment.
– Pressure that tends to keep fluid in the intravascular compartment

Front 9

diabetes insipidus

Back 9

- excessive urination caused by either inadequate amounts of ADH in the body, or by failure of the kidney to respond to ADH.
- Urinary output is often massive, which can lead to dehydration.
- Urine is dilute, and the patients serum sodium level & osmolarity rise as free water is dumped into the urine.
- Usually results from hypothalamic injury ( brain trauma/ neurosurgery) or from certain drugs on the renal resorption of water, sickle cell anemia, hypothyroidism, adrenal insufficiency, inherited disorders of ADH production, & sarcoidosis.

Front 10

diffusion

Back 10

- The movement of a solute (particles) across semipermeable membranes from an area of higher concentration to an area of lesser concentration so that there is an even distribution of solute or particles on each side. Diffusion is the movement of particles.
- Factors affecting diffusion; Size of the molecule, temp of the solution, agitation & concentration.

Front 11

electrolyte

Back 11

- an element or compound that when dissolved in water or other solvent, dissociates into ions and is able to conduct an electric current.
- Roles include; Promotion of neuromuscular excitability, maintenance of body fluid osmolarity, regulation of H+ balance & maintenance of body fluid distribution b/w compartments.

Front 12

extracellular fluid (ECF)

Back 12

the fluid located outside of cells (30% of body fluid is ECF), (Portion of body fluids composed of interstitial fluid & blood plasma) found in 3 spaces: (intravascular, interstitial & transcellular)

Front 13

Filtration

Back 13

- the process in which water and diffusible substances move together in response to fluid pressure.
For example, the filtration process is active in capillary beds where hydrostatic pressure differences determines the movement of water.

Front 14

Fluid Volume Deficit (FVD)

Back 14

alteration characterized by the loss of fluids and electrolytes in an isotonic fashion

Front 15

Fluid Volume Excess (FVE)-

Back 15

Alteration characterized by the abnormal retention of fluids & electrolytes in an isotonic fashion

Front 16

Hemodilution

Back 16

an increase in blood plasma colume resulting in reduced relative concentration of RBC

Front 17

Hemolysis

Back 17

breakdown of RBC & release of hemoglobin as may result from the administration of hypotonic intravenous solutions that cause progressive swelling & rupture of the erythrocytes

Front 18

hydrostatic pressure

Back 18

the force of the fluid pressure outward against a surface (the pressure exerted by a liquid)

Front 19

Hyperosmolar fluid

Back 19

has more particles than water.

Front 20

hypertonic

Back 20

- a solution of higher osmotic pressure.
- The pressure inside the cell is hyper or higher, thus the fluid moves out of the cell (from higher to lower).
- This process expands the body’s fluid volume without causing a fluid shift from one compartment to another.

Front 21

Hypo-osmolar fluid

Back 21

has fewer particles than water

Front 22

hypotonic

Back 22

- a solution of lower osmotic pressure.
- The pressure inside the cell is hypo or lower, thus the fluid moves into the cell causing it to enlarge.

Front 23

Hypovolemia

Back 23

decreased circulatory blood volume resulting from extracellular fluid losses

Front 24

interstitial fluid

Back 24

the fluid between cells and outside of blood vessels (anything that isn’t intervascular fluid)
ex: Edema

Front 25

intracellular fluid (ICF)

Back 25

The fluid inside cells (70% of body fluid is ICF)

Front 26

Iso-osmolar fluid

Back 26

- the same proportion of weight of particles ex: sodium, glucose, urea, protein & water

Front 27

isotonic imbalances

Back 27

- H2O and electrolytes are lost or gained in equal proportion
- FVD
- FVE

Front 28

isotonic

Back 28

a solution with the same osmolarity as blood plasma

Front 29

milliequivalent (mEq)

Back 29

the number of grams of solute dissolved in 1 gram of a normal solution, an indicator of chemical combining power

Front 30

minerals

Back 30

regulate electrolyte balance & hormone production.

Front 31

Onotic pressure

Back 31

total influence of a protein on the osmotic activity of plasma water

Front 32

osmolality

Back 32

- the osmotic pressure of a solution.
- The normal osmolarity is 275-285mOsm/kg.

Front 33

osmosis

Back 33

- the movement of a pure solvent, such as water, through a semipermeable membrane from an area of lesser solute (particle) concentration to an area of greater solute (particle) concentration.
- Water moves because the membrane doesn’t allow the solute (particle) to pass through, but it allows the solvent (water/fluid) to pass.

Front 34

Phlebitis

Back 34

inflammation of a vein

Front 35

Renin

Back 35

- proteolytic enzyme produced by and stored in the juxtaglomerular apparatus that surrounds each arteriole as it enters a glomerulus.
- The enzyme affects the blood pressure by catalyzing the change of angiotensinogen to angiotensis, a stronger repressor

Front 36

syndrome of inappropriate antidiuretic hormone (SIADH)

Back 36

- A syndrome of increased ADH activity in spite of reduced plasma osmolarity.
- Often first suggested by a relative hyponatremia, it is most commonly associated w/disorders of the CNS, various tumors, anxiety, pain, pneumonia & drugs

Front 37

transcellular

Back 37

- fluid in odd spaces (CSF)
- makes up the rest of it
- only in small amounts

Front 38

Tonicity

Back 38

the effect of fluid on cellular volume

Front 39

water

Back 39

Not found in its purest state in the body; it is the medium in which all chemical products of nutrition, metabolism, & excretion are found.

Front 40

Acromegaly

Back 40

a chronic metabolic condition characterized by a gradual, marked enlargement and elongation of the bones of the face, jaw, and extremities (gigantism)

Front 41

Adventitious sounds

Back 41

breath sounds that are normally not heard, such as crackles and rhonchi

Front 42

Allen’s test

Back 42

- a test for patency of the radial artery after insertion of an indwelling monitoring catheter.
- The patient’s hand is formed into a fist while the nurse compresses the ulnar artery.
- The ulnar artery compression is continued while the fist is opened.
- If blood flow through the radial artery is adequate, the hand will resume its normal pinkish color

Front 43

Aneurysm

Back 43

- a localized dilation of a blood vessel wall (bubbles out).
- Usually caused by atheroschlorsis and hypertension, they are common in the aorta.

Front 44

Apical impulse

Back 44

motion in the anterior wall of the thorax in the area of the heart

Front 45

Arcus senilis

Back 45

an opaque ring, gray to white in color, that surrounds the periphery of the cornea (occurs primarily in older people)

Front 46

Aphasia

Back 46

language function is defective or absent because of injury to certain areas of the cerebral cortex

Front 47

Atherosclerosis

Back 47

- a common arterial disorder where yellowish plaques of cholesterol, lipids, and cellular debris form on the inner walls of large and medium-sized arteries.
- Causes reduced blood flow

Front 48

Atrophied

Back 48

decrease in size of an organ, tissue, or body part due to lack of use or disease

Front 49

Basal cell carcinoma

Back 49

a malignant epithelial cell tumor that begins as a papule and enlarges at the edges developing a central crater that erodes, crusts, and bleeds. (skin cancer)

Front 50

Borborygmi

Back 50

an audible abdominal sound produced by hyperactive intestinal peristalsis. (rumbling, gurgling noises)

Front 51

Bronchophony

Back 51

an increase in intensity and clarity of vocal resonance that may result from an increase in lung tissue density such as in the consolidation of pneumonia.

Front 52

Bruit

Back 52

an abnormal sound or murmur heard while listening to the carotid artery

Front 53

Caries

Back 53

cavity, tooth decay (can also be bone decay)

Front 54

Chancres

Back 54

a skin lesion that begins at the site of infection as a papule and develops into a red, bloodless, painless ulcer that has a scooped out appearance

Front 55

Cherry angiomas

Back 55

a bright red tumor on the skin like a mole

Front 56

Cholecystitis

Back 56

acute or chronic inflammation of the gall bladder

Front 57

Cirrhosis

Back 57

a chronic degenerative disease of the liver in which the lobes are covered with fibrous tissue (blood flow is affected)

Front 58

Clubbing

Back 58

an abnormal enlargement of fingers (caused by diminished oxygen)

Front 59

Cyanosis

Back 59

bluish discoloration of the skin or mucous membranes caused by excess deoxygenated hemoglobin in the blood

Front 60

Cystocele

Back 60

a herniation or protrusion of the urinary bladder through the wall of the vagina

Front 61

Dermatitis

Back 61

an inflammatory condition of the skin characterized by erythema (redness), pain, or pruritus (itching).

Front 62

Ecchymosis

Back 62

a bruise that is superficial bleeding under the skin or a mucous membrane

Front 63

Ectropion

Back 63

eversion of the eyelid exposing the conjunctiva and part of the eyeball (lid is turned out like in old people)

Front 64

Eczema

Back 64

superficial dermatitis of unknown cause (crusted scaly skin)

Front 65

Entropion

Back 65

a turning inward or upward of the eyelid

Front 66

Erythema

Back 66

redness or inflammation of the skin or mucous membranes that results in dilation of the superficial capillaries

Front 67

Excoriation

Back 67

an injury to the surface of the skin caused by trauma (scratch, abrasion, burn)

Front 68

Exophthalmos

Back 68

protrusion of the eyeballs (eyes stick out)

Front 69

Exostosis

Back 69

an abnormal benign growth on the surface of a bone

Front 70

Fibrocystic breast disease

Back 70

the presence of a single or multiple cysts that are palpable in the breast

Front 71

GCS (Glasgow Coma Scale)

Back 71

- A scale used to determine a patient’s level of consciousness.
- It is a rating from 3-15 of the patients ability to open his/her eyes, respond verbally, & move normally.
- Used primarily during the examination of patients w/trauma/stroke.
- Repeated examinations can help determine if the patient’s brain function s improving or deteriorating.

Front 72

Goniometer

Back 72

an instrument used to measure angles, particularly ROM angles of a joint

Front 73

Hemorrhoids

Back 73

a varicosity in the veins of the rectum

Front 74

Hepatitis

Back 74

an inflammatory condition of the liver characterized by jaundice, anorexia, abdominal and gastric discomfort, abnormal liver function, gray stools, and tea colored urine

Front 75

Hernia

Back 75

the protrusion of an organ through an abnormal opening in the muscle cavity that surrounds it

Front 76

Hirsutism

Back 76

excessive body hair

Front 77

Hydrocephalus

Back 77

an abnormal accumulation of cerebral spinal fluid in the head

Front 78

Hypertonicity

Back 78

excessive tension of the arteries or muscles (also increased interoccular pressure) due to fluid being pulled out of cells

Front 79

Hypotonicity

Back 79

- cells expand as they take in solution
- abnormally low tension

Front 80

Indurated

Back 80

hardened skin tissue because of edema, inflammation, or infiltration by a neoplasm (abnormal tissue growth)

Front 81

Jaundice

Back 81

yellow discoloration of the skin or mucous membrane caused by excessive biliruben in the blood

Front 82

Leukoplakia

Back 82

a pre-cancerous slow change in mucous membranes characterized by thick, white, firmly attached patches that are slightly raised.
(can occur on tongue, in mouth, or genitals)

Front 83

Melanoma

Back 83

- malignant neoplasm’s (growths) of the skin.
- composed of melanocytes.
- Black/brown spots with irregular edges (skin cancer)

Front 84

Metastasize

Back 84

spreading of tumor cells to distant parts of the body

Front 85

Murmurs

Back 85

a low pitched fluttering or humming sound (like a heartbeat)

Front 86

Nystagmus

Back 86

involuntary jerking movements of the eyes

Front 87

Obtunded

Back 87

dull or blunt sensitivity to pain

Front 88

Occlusion

Back 88

a blockage in a canal, vessel, or passage of the body

Front 89

Ophthalmoscope

Back 89

a device for examining the interior of the eye

Front 90

Orthopnea

Back 90

- labored breathing that occurs when lying flat & is relieved by sitting up.
- Symptom of Left ventricular heart failure

Front 91

Osteoporosis

Back 91

a disorder characterized by abnormal rarefaction of bone, it occurs most often in post-menopausal women, sedentary or immobilized people, or those on long-term steroid therapy

Front 92

Otoscope

Back 92

an instrument used to examine the external ear, the eardrum, and the middle ear.
(Has a light and magnifying glass)

Front 93

Ototoxicity

Back 93

a substance having a harmful effect on the 8th cranial nerve or the organs of hearing or balance.
(common ototoxic drugs include aminoglycoside antibiotics, aspirin, furosemide, and quinine)

Front 94

Pancreatitis

Back 94

an inflammation of the pancreas

Front 95

Papanicolaou (pap) smear

Back 95

a smear method that examines stained exfoliated cells. It is most commonly used to detect cervical cancer, and is obtained from a routine pelvic exam

Front 96

Paralytic ileus

Back 96

a decrease or absence of intestinal peristalsis

Front 97

Peritonitis

Back 97

an inflammation of the peritoneum (abdominal cavity) produced by bacteria or irritating substances

Front 98

PERRLA

Back 98

abbreviation to Pupils Equal, Round, Reactive to Light, Accommodation…this acronym is used when there are normal findings

Front 99

Petechiae

Back 99

- tiny pinprick like purple or red spots that appear on the skin.
- They are an indication of minute hemorrhages within the dermal or subQ layers.

Front 100

Physical Examination

Back 100

- Is a head-to-toe review of each body system that offers objective information about the client and allows the nurse to make clinical judgments.
- It includes inspection (looking), palpation (feeling), auscultation (listening), percussion (producing sounds) and olfactation (smelling).

Front 101

Polyps

Back 101

small tumor like growths that project from the surface of a mucous membrane surface

Front 102

Ptosis

Back 102

when the eyelid droops

Front 103

Rectocele

Back 103

a protrusion of the rectum and the posterior wall of the vagina into the vagina.
(caused by weakened vagina and pelvic floor muscles due to childbirth, old age, etc)

Front 104

Senile keratosis

Back 104

a slowly developing thickening of the skin as a result of chronic sun exposure

Front 105

Stenosis

Back 105

the constriction or narrowing of an opening or passageway in a body structure

Front 106

Stuporous

Back 106

a state of altered mental status in which the person is arousable only w/vigorous or unpleasant stimulation

Front 107

Syncope

Back 107

a brief lapse of consciousness caused by transient cerebral hypoxia (faint), lightheadedness

Front 108

Tactile fremitus

Back 108

- a vibration of the chest wall during breathing that can be felt upon physical examination.
- It may indicate infection, congestion, or consolidation of a lung or part of a lung.

Front 109

Thrill

Back 109

a fine vibration felt by the examiners hand on the body of a patient over the site of an aneurysm

Front 110

Tugor

Back 110

the normal resiliency of the skin caused by the outward pressure of the cells and interstitial fluid.
(dehydration =’s decreased turgor, edema =’s increased turgor)

Front 111

Ventricular gallop (S3 gallop)

Back 111

- an abnormal low-pitched extra heart sound heard early in the S3 diastole.
- Indicates myocardial failure in the old adult, in a healthy young child, it normally disappears with age

Front 112

Vocal fremitus (VF)

Back 112

- the vibration of the chest wall as a person speaks or sings that allows the person’s voice to be heard by the examiner during auscultation of the chest with a stethoscope.
- VF is decreased when there is a lung problem such as edema

Front 113

Whispered Pectoriloquy

Back 113

the transmission of a whisper through the pulmonary structures so that it is heard as normal audible speech on auscultation

Front 114

Accommodation

Back 114

gradual decline of acute grief and the beginning of an emotional and social reentry into the everyday world

Front 115

Actual loss

Back 115

any loss of a person or object can no longer be felt, heard, known, or experienced by the individual. The tangible loss is usually understood by all who are aware of its value to the grieving client.
Examples: loss of arm, leg, hair, spouse, child, relationship, object, personal possessions.

Front 116

Advance directives

Back 116

- special medical directives or medical powers of attorney identifying health care surrogates.
- Medical institutions provide written information to clients concerning client’s rights under the state law to make decisions, including but not limited to the right to refuse treatment
Patient Self Determination Act- gives patient the right under state law to make decisions, including refusal of treatment

Front 117

Anticipatory grief

Back 117

process of grieving before death or loss has occurred

Front 118

Burnout

Back 118

term used when the stressors exceed the rewards of the job and the individual nurse lacks the support of peers.

Front 119

Disenfranchised grief

Back 119

occurs when societal norms don’t define the loss as a loss within its traditional definition

Front 120

Do Not Resuscitate (DNR)

Back 120

- order written by the doctor with the client’s consent not to be resuscitated in case of cardiopulmonary failure.
- A DNR order needs to be reviewed by the MD every 72 hours for hospitalized clients and 60 days for those residential facilities.

Front 121

Durable power of attorney

Back 121

Documents executed by the client to appoint someone to make health care decisions if and when they are no longer able to make decisions on their own behalf.

Front 122

Dysfunctional grief

Back 122

occurs when there is prolonged emotional instability

Front 123

Grief

Back 123

- emotional and behavioral response to loss.
- Grief is manifested based on an individual’s personal experiences, cultural background, cultural expectations, and religious beliefs.
- Involves process of gradual acceptance of moving on with life without that which was lost.

Front 124

Grief work

Back 124

concept in which the individual responds, feels and behaves in reaction to a loss.

Front 125

Hope

Back 125

- characterized by a confident, yet uncertain, expectation of achieving a goal.
- A complex series of thoughts, feelings and actions that enhance the coping skills and even survival.
- May be viewed negatively by clients who do not see any other outcomes but futility.

Front 126

Living Will

Back 126

documents instructing physicians to withhold or withdraw life-sustaining procedures when death is imminent.

Front 127

Loss

Back 127

includes issues beyond the actual death experience, not only physical death.
(e.g. loss of an external object, known environment, a significant other, an aspect of self, and life)

Front 128

Maturational loss

Back 128

- Any change in the developmental process that is normally expected during a lifetime.
Example: Feeling of loss as the child goes to school for the first time.
- Expected changes that occur with aging:
Example: impaired mobility, memory.
- Independence becomes a safety issue for older adults as their physical health declines.

Front 129

Mourning

Back 129

- the process that follows a loss and includes working through the grief.
- The process of grief and mourning is intense, internal, painful and lengthy.

Front 130

Palliative treatment

Back 130

control symptoms rather than curative treatment of the disease.

Front 131

Perceived loss

Back 131

- any loss that is less tangible and uniquely defined by the grieving client, such as the loss of confidence, or prestige.
- By individual interpretation, there is no actual loss that takes place.
- Loss is in the eye of the beholder.
Example: parents expecting a boy, then a baby girl is born.

Front 132

Personal loss

Back 132

- any significant loss of someone or something that can no longer be seen, felt, heard, known or experienced that requires individual adaptation through the grieving process.
- Tangible or Intangible
e.g. perceived beauty, roles, pleasures and satisfaction with life in general.

Front 133

Situational loss

Back 133

- any sudden, unexpected, and definable event that is not predictable.
- Often includes multiple situational losses rather than single loss.
Example: survivors of plane crash need to cope with the severity of the lives lost, in addition to the reasons for their survival.