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Aura
Bright light, smell, or taste. Serves as warning or sense that a seizure is about to occur.
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Food and Drug Administration (FDA)
Federal agency responsible for the enforcement of federal regulations regarding the manufacture, processing, and distribution of foods, drugs, and cosmetics to protect consumers against the sale of impure or dangerous substances.
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Immunization
Process by which resistance to an infectious disease is produced or augmented.
Active immunity: injection of small amount of attenuated (weakened) or dead organisms or modified toxins from the organism (toxoids) into the body.
Passive immunity: antibodies produced by other persons or animals are introduced into a person's bloodstream for protection against a pathogen.
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Pathogen
Any microorganism capable of producing an illness
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Poison
Any substance that impairs health or destroys life when ingested, inhaled, or otherwise absorbed by the body.
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Pollutant
Harmful chemical or waste material discharged into the water, soil, or air.
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Restraint
Human, mechanical, and/or physical device that is used with or without the client's permission to restrict his or her freedom of movement or normal access to a person's body and is not a usual part of treatment plans indicated by the person's condition or symptoms.
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Seizure
Hyperexcitation and disorderly discharge of neurons in brain leading to a sudden, violent, involuntary series of muscle contractions that is paroxysmal and episodic.
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Seizure Precautions
All nursing interventions to protect the client from traumatic injury, positioning for adequate ventilation and drainage of oral secretions, and providing privacy and support following the seizure.
Client immediately postseizure: bed in lowest position, pillow under head, padded side rails up, loosened clothing, side-lying position, and privacy curtain.
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Status Epilepticus
Medical emergency whereby a person has continual seizure without interruption.
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Aerobic
Bacteria require oxygen for survival and for multiplication sufficient to cause disease
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Anaerobic
Bacteria that thrive where little or no free oxygen is available
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Asepsis
Absence of pathogenic microorganisms
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Asymptomatic
Clinical signs and symptoms are not present in illness
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Bactericidal
Temperature or chemical that destroys bacteria
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Bacteriostasis
Prevent growth and reproduction of bacteria
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Broad-Spectrum Antibiotics
Kills different types of bacteria
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Colonization
Microorganism is present or invades a host, grows, and/or multiplies but does not cause infection
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Communicable disease
Infectious disease that can be transmitted directly from one person to another.
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Cough Etiquette
- Respiratory hygiene
- 1. education on health care facility staff, client's families, and visitors
- 2. posters and written material for health care facility or agency staff, clients, families, and visitors
- 3. education on how to cover your nose/mouth when you cough, using a tissue, and the prompt disposal of contaminated tissue
- 4. placing surgical mask on client if it will not compromise respiratory function or is applicable
- 5. hand hygiene after contact with contaminated respiratory secretions
- 6. spatial separation greater than 3 ft away from persons with respiratory infections
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Disinfection
Process that eliminates many or all microorganisms from inanimate objects (EXCEPT bacterial spores)
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Endogenous infection
Normal flora or virulent organisms residing that cause infection
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Epidemiology
Cause and effect of health care-associated infections
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Exogenous Infection
Postoperative infection
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Exudates
Fluid and cells that are discharged from cells or blood vessels
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Granulation tissue
Scar tissue that is not as strong as tissue collagen
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Hand Hygiene
Using instant alcohol hand antiseptic before and after providing client care, hand washing with soap when hands are visibly soiled, and performing surgical scrub
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Handwashing
Washing hands with warm water for at least 15 seconds with warm
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Health-care Associated Infections (HAI)
Infections resulting from delivery of health services in a health care facility
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Iatrogenic infections
Type of HAI from a diagnostic or therapeutic procedure
Ex: infection from a GI endoscopy
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Immunocompromised
has impaired immune system
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Infection
Can be infectious or communicable
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Infectious
Type of infection that may not pose a risk for transmission.
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Invasive
Procedures that enter body through openings (surgical, broken skin, orifices)
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Leukocytosis
Increasing number of circulating WBC
- Normal: 5000-10,000/mm3
- Inflammation: 15,000-20,000/mm3 +
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Localized
Pertaining to a specific area of the body
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Medical Asepsis
AKA clean technique
Procedures used to reduce the number of organisms present and prevent the transfer or organisms
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Microorganism
Include bacteria, viruses, fungi, and protozoa
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Normal floras
Different types of microorganisms that live symbiotically and do not cause disease when residing in their usual area of the body but instead participate in maintaining health.
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Phagocytosis
Process that involved the destruction and absorption of bacteria
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Purulent
Containing WBC and bacteria
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Reservoir
Area for holding
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Sanguineous
Containing RBC
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Serous
Clear, plasma-like
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Standard Precuations
Certain principles and procedures used to prevent and control infection and its spread
Apply to all blood and body fluids (EXCEPT sweat), nonintact skin, and mucous membrance
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Sterile Field
Area free of microorganisms and prepared to receive sterile items
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Sterilization
Complete elimination or destruction of all microorganisms (INCLUDING bacterial spores)
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Suprainfection
Disease-causing microorganisms multiply and cause illness because normal flora has been eliminated due to broad-spectrum antibiotics
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Surgical Asepsis
Sterile technique prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery
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Susceptibility
Degree of immune resistance to a pathogen
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Symptomatic
Pathogens multiply and cause clinical signs and symptoms
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Systemic
Infection that affects the entire body instead of just a single organ or part
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Vector
Mode of transmitting infectious microorganisms
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Virulence
Ability to survive in the host or outside the body
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Antipyretics
Drugs that reduce fever
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Auscultatory Gap
Temporary disappearance of sound, typically between 1st and 2nd korotkoff sound
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Basal Metabolic Rate (BMR)
Rate of metabolism when body is at rest. Accounts for heat produced by body. Affected by thyroid hormone
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Blood Pressure
Force exerted on the walls of an artery by the pulsing blood under pressure from the heart
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Bradycardia
Heart rate >60 bpm
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Cardiac Output
CO = HR x SV
Adult heart: 5L of blood/min
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Conduction
Transfer of heat from one object to another with direct contact
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Convection
Transfer of heat away by air movement
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Core Temperature
Temperature of the deep tissue
Normal 98.6-100.4F
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Diaphoresis
Visible perspiration primarily occurring on forehead and upper thorax
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Diastolic Pressure
Minimal pressure exerted against the arterial walls at all times
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Diffusion
Movement of O2 and CO2 between alveoli and RBC
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Dysrhythmia
Abnormal heart rhythm; irregular or irregularly irregular
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Eupnea
Normal rate and depth of ventilation
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Evaporation
Transfer of heat energy when liquid is changed to gas
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Fever
Rise in body temperature because heat production is greater than heat loss
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Fever of Unknown Origin (UFO)
Fever whose etiology cannot be determined
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Frostbite
Ice crystal form inside cell, and permanent circulatory and tissue damage occurs when body is exposed to subnormal temperatures
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Heat Exhaustion
Profuse diaphoresis results in excess water and electrolyte loss
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Heatstroke
Dangerous heat emergency with a high mortality rate. Hot, dry skin. Patient cannot sweat because of severe electrolyte loss and hypothalamic malfunction
Patient will become unconscious with fixed, nonreactive pupils
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Hematocrit
Percentage of RBC compared to blood volume
Determines blood viscosity
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Hypertension
- High blood pressure; often asymptomatic; thickening and loss of elasticity in arterial walls
- Normal: <119/<80
- Pre-hypertensive: >120/ >80
- Stage 1 Hypertension: >140/ >90
- Stage 2 Hypertension: >160/>100
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Hyperthermia
Elevated body temperature related to body's inability to promote heat loss or reduce heat production
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Hypotension
Systolic blood pressure falls below <90 mmHg
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Hypothermia
Heat loss during prolonged exposure to cold that overwhelms the body's ability to produce heat
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Malignant Hyperthermia
Hereditary condition of uncontrolled heat production, occurring when susceptible persons receive certain anesthetic drugs
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Nonshivering thermogenesis
Primarily in neonates. Metabolizing vascular brown tissue generates heat in neonates
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Orthostatic Hypotension
AKA Postural Hypotension
Normotensive person develops symptoms and low blood pressure when rising to an upright position
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Oxygen saturation
Percent of Hb that is bound with oxygen in arteries; reflect how much oxygen is in blood
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Perfusion
Distribution of RBC to and from pulmonary capillaries
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Postural hypotension
AKA Orthostatic Hypotension
Blood pressure drops when person rises to an upright position
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Pulse deficit
An inefficient contraction of heat that fails to transmit pulse waves to peripheral pulse sites
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Pulse Pressure
Difference between systolic and diastolic pressure
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Pyrogens
Organisms/things that elevate body temperature because they act as antigens that trigger immune system responses
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Radiation
Transfer of heat from surface of one object to another without direct contact between the two
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Shivering
Involuntary body response to temperature differences in body. Requires significant energy but increases heat production 4-5 times greater than normal
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Sphygmomanometer
Instrument used to measure blood pressure with stethoscope
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Systolic Pressure
Peak of maximum pressure when ejection ovvutd
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Tachycardia
Heart rate > 100 bpm
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Thermoregulation
Regulation of body temperature via hypothalamus
- Anterior hypothalamus: heat loss
- Posterior hypothalamus: heat production
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Ventilation
Movement of gases in and out of lungs
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Vital Sign
Measurements that indicate health status
- Temperature
- Blood Pressure
- Pulse (Heart Rate)
- Respiratory Rate
- SaO2 (optional)
- Pain
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Adventitious Sounds
Abnormal sounds
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Aphasia
Ineffective communication due to cerebral cortex
Expressive: understand written/verbal speech but cannot write/speak appropriately
Receptive: cannot understand written/verbal speech
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Apical Impulse/ Point of Maximal Impulse (PMI)
Apex of heart touches anterior chest wall at approximately 4th-5th intercostal space;
AKA Mitral
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Arcus Senilis
Thin white ring along the margin of the iris that is common with aging but abnormal under 40
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Atrophied
Reduction in muscle size due to infrequent usage
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Auscultation
Listening to sounds the body makes to detect variations from normal using stethoscope
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Borborygmi
Growling sounds
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Bruit
Blowing, swishing sound caused by narrowing of blood vessel
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Cerumen
Ear wax that is yellow and waxy
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Clubbing
Bulging tissues at nail base due to insufficient oxygenation at periphery resulting from conditions such as chronic emphysema and congenital heart disease
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Conjunctivitis
Inflammation of conjunctiva that indicates allergy or infection; highly contagious
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Cyanosis
Bluish discoloration; cold or lack of O2
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Ectropion
Lids margins that turn out
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Entropion
Lid margins that turn in
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Erythema
Red discoloration
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Excoriation
Local skin breakdown
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Goniometer
Measures degree of motion in particular join and is for patient who has suspected reduction in joint movement
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Hypertonicity
Increased muscle tone; increased muscle resistance to any sudden passive movements
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Hypotonicity
Little or no muscle tone; muscle is flabby
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Inspection
Visual assessment to assess abnormalities
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Integumentary System
Skin, hair, scalp, nails
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Jaundice
Yellow-orange discoloration; usually due to liver impairment
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Kyphosis
Hunchback; exaggeration of posterior curvature of thoracic spine
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Lordosis
Swayback; increased lumbar curvature
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Malignancy
presence of tumor/cancer
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Murmurs
Sustained swishing or blowing sounds heard at beginning, middle, or end of systolic or diastolic phase
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Nystagmus
Involuntary, rhythmical oscillation of eyes
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Olfaction
Detecting abnormalities via smell and body odor
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Orthopnea
Shortness of breath during night time, when sleeping
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Osteoporosis
Metabolic bone disease that causes a decrease in quality and quantity of bone
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Ototoxicity
Injury to auditory nerve due to drugs
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Palpation
Use of the hands to touch body parts to make sensitive assessments
Temperature, moisture, texture, turgor, tenderness, and thickness
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Percussion
Tapping the body with the fingertips to produce a vibration that travels through body tissues
Location, size, and density of underlying structures
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Peristalsis
Movement of contents through the intestines
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Pupils Equal, Round, Reactive to Light, Accommodation
PERRLA
Pupils are 3-7 mm in diameter
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Petechiae
Pinpoint-sized, red/purple spot on skin caused by small hemorrhages in skin layers; may indicate serious blood clotting disorders, drug reactions, or liver disease
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Pigmentation
Coloration of skin; hypo or hyper
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Polyps
Tumor-like growths
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Ptosis
Drooping of eyelids caused by edema or impairment of CN III OR loss of elasticity in older adults
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Scoliosis
A lateral spinal curvature
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Stenosis
Narrowing of blood vessels
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Syncope
Circulatory arrest
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Turgor
Skin elasticity; determines hydration level
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Ventricular Gallop
- S3 that occurs just after S2 at end of ventricular diastole
- I II = Ken tuck-y
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Vocal/Tactile Fremitus
Vibration palpated to assess for abnormailities
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Activities of Daily Living (ADL)
Self-care activities
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Activity Tolerance
Kind and amount of exercise or activity that the person is able to person
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Antagonistic Muscles
Bring about movement at joint
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Antigravity Muscles
Involved with joint stabilization; continuously oppose effect of gravity on body and permit a person to maintain an upright or sitting posture
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Cartilage
Nonvascular, supporting connective tissue with flexibility of firm, plastic material
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Cartilaginous Joints
Joints that have little movement but are elastic and use cartilage to unite separate body surfaces
Ex: Ribs to costal cartilage
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Center of Gravity
Point from which weight of body or system may be considered to act; stable base of support with low center of gravity gives more body balance
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Crutch Gait
- 4 point: weight bearing on both legs
- 3 point: weight bearing on one foot only
- 2 point: partial weight bearing on each foot
- Swing-through gait: weight placed on supported leg and swing through crutches while they support pt weight
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Exercise
Activity requiring physical effort to sustain or improve health and fitness
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Fibrous Joints
Joints that fit closely together that permit little to no movement
Ex: tibia and fibula syndesmosis
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Footboards
Board placed at food of bed for patients to push against to move up in bed
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Friction
Force that occurs in a direction to oppose movement
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Gait
Manner of style of walking, including cadence, rhythm, and speed
Assess balance, posture, and ability to walk without assistance
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Hemiparesis
Muscle weakness of partial paralysis on one side of body
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Hemiplegia
Paralysis of one side of body due to cerebral damage
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Isometric Contraction
Tightening or tensing of muscles without moving body parts
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Isotonic Contraction
Muscle contraction and change in muscle length
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Joint
Articulation; connection between bones
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Ligaments
White, shiny flexible bands of fibrous tissue that bind joints and connect bones and cartilage; elastic and aid joint flexibility and support
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Mobility
Movement involving ROM, gait, and exercise
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Muscle Tone
Balanced muscle tension
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Posture
Position of body alignment during lifting, bending, moving, and performing ADLs
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Proprioception
Awareness of the position of the body and its parts
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Range of Motion (ROM)
Range of mobility used to assess degree of damage or injury to joint
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Synergistic Muscles
Contract to accomplish same movement
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Synovial Joints
AKA True Joints
Freely moveable joints, most mobile, numerous, and anatomically complex joint
EX: elbow (hinge joint)
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Tendons
White, glistening, fibrous bands of tissue that connect muscle to bone
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Acupressure
Points that influences nerve pathways to face and head
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Acute Pain
Protective, identifiable cause, short duration, and has limited tissue damage and emotional response. Eventually resolves with or without treatment after a damaged area heals
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Addiction
Primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations
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Adjuvants
Variety of medications that enhance analgesics or have analgesic properties that were originally unknown
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Analgesics
Common and effect method of pain relief
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Biofeedback
Distraction to help control your body's responses to pain
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Breakthrough Pain
Transient flare of moderate to severe pain superimposed on continuous or persistent pain
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Chronic Pain
Lasts longer than anticipated, does not always have an identifiable cause, and leads to great personal suffering.
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Cutaneous stimulation
Stimulation of skin helps to relieve pain; gate theory
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Drug Tolerance
State of adaptation in which exposure to a drug induces changes that result in a dimunition of one or more of the drug's effects over time
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Epidural Analgesia
Anesthesia inserted into the level of vertebral interspace nearest to area requiring anesthesia
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Guided Imagery
Alter affective-motivational and cognitive pain perception through relaxation
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Idiopathic Pain
Chronic pain in the absence of an identifiable physical or psychological cause or pain perceived as excessive for the extent of an organic pathological condition
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Local Anesthesia
Local infiltration of an anesthetic medication to induce loss of sensation to a body part
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Modulation
Inhibition of pain impulse; gate theory
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Neurotransmitters
Chemicals, thermal, mechanical stimuli that relea
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Nociceptors
Peripheral pain nerve fiber
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Pain Threshold
Point at which a person feels pain
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Pain tolerance
Level of pain a person is willing to put up with
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Patient-Controlled Analgesia (PCA)
Safe method for pain management that many clients prefer; goal is to maintain constant level of analgesic to avoid problems of prn dosing
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Perception
Point at which a person is aware of pain
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Perinueral Infusion
Unsutured catheter from a surgical wound placed near a nerve or groups of nerves connects to a pump containing a local anesthetic
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Physical Dependence
State of adaptation that is manifested by a drug class specific withdrawal syndrome produced by abrupt cessation, rapid dose reduction, decreasing blood level of drug, and/or administration of an antagonist
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Placebos
Medications or procedures that produce positive or negative effects in clients
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Prostaglandins
NT released by cellular damage; thought to increase sensitivity to pain
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Pseudoaddiction
Drug seeking behaviors that occur when pain is under-treated
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Regional Anesthesia
Injection of a local anesthetic to block a group of sensory nerve fibers
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Relaxation
Mental and physical freedom from tension or stress that provides individuals a sense of self-control
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Transcultural Electrical Nerve Stimulation (TENS)
Stimulation of skin with a mild electrical current passed through external electrodes
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Transduction
Energy of these stimuli is converted to electrical energy
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Transmission
Pain impulse is sent after transduction
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