Online Companion: Health Assessment and Physical Examination, 3E

Expanded Glossary

* A * B * C * D * E * F * G * H * I * J * K * L * M * N * O * P * Q * R * S * T * U * V * W * X * Y * Z *

A

Ablation An amputation, excision, or removal of a body part, a growth, or a harmful substance.

Abruptio Placenta Separation of the placenta from the uterine wall, which may cause significant internal (and perhaps external) bleeding, pain, and fetal compromise.

Accommodation Visual focusing from a far to a near point as pupils constrict and eyes converge.

Acculturation Informal process of adaptation through which the beliefs, values, norms, and practices of a dominant culture are learned by a new member born into a different culture.

Acini Milk-producing glands located in the lobules; also called alveoli of the breast.

Acrocyanosis Normal phenomenon in light-skinned newborns whereby the hands and feet are blue and the rest of the body is pink.

Acromegaly Abnormal enlargement of the skull, bony facial structures, and bones of the extremities, caused by excessive secretion of growth hormone.

Action Potential An electrical impulse consisting of a self-propagating series of polarizations and depolarizations transmitted across the cell membranes of a nerve fiber or a muscle cell.

Action Response Attempt to stimulate patients to make some change in their thinking and behavior.

Active Listening Act of perceiving what is said both verbally and nonverbally.

Actual Nursing Diagnosis Statement describing human responses that have been validated by the nurse.

Adenoidectomy Surgical removal of adenoid growths in the nasopharynx.

Adnexa Fallopian tubes, ovaries, and their supporting ligaments.

Advance Directive Document (living will or durable medical power of attorney) outlining what should be done if a patient is too ill to self-direct medical care.

Adventitious Breath Sound Added breath sound that is superimposed on normal breath sounds.

Adverse Reaction A harmful, unintended reaction to a drug administered at normal dosage.

Affect The outward manifestation of a person's feelings or emotions.

Afterload Initial resistance that the ventricles must overcome in order to open the semilunar valves to propel the blood into both the systemic and the pulmonary circulation.

Aganglionic Segment of the Colon Hirschsprung's disease; congenital dilation and hypertrophy of the colon resulting from the absence or marked reduction in the number of ganglion cells of the colon.

Ages and Stages Developmental Theory Belief that individuals experience much the same sequential physical, cognitive, socioemotional, and moral changes during the same age periods, each of which is termed a developmental stage.

Ageusia Loss of the sense of taste.

Aggravating Factors Events that worsen the severity of the patient's chief complaint.

Agnosia Inability to recognize the form and nature of objects or persons.

Agnostic Person who is unsure if God exists.

Agonal Respirations Irregularly irregular respirations that signal impending death.

Agraphia Loss of the ability to write.

Air Trapping Abnormal respiratory pattern with rapid, shallow respirations and forced expirations; the lungs have insufficient time to fully exhale and air becomes trapped, leading to over­expansion of the lungs.

Albinism A generalized whiteness of the skin, hair, and eyebrows, which is caused by a congenital inability to form melanin.

Albumin Substance that transports nutrients, blood, and hormones and helps maintain osmotic pressure.

Alexia Loss of the ability to grasp the meaning of written words and sentences; also known as word blindness.

Allen Test Test used to assess for the patency of the radial and ulnar arteries.

Alleviating Factors Events that decrease the severity of the patient's chief complaint.

Alogia Inability to express oneself through speech.

Alopecia Partial or complete loss of hair.

Alveoli (of the Breast) Milk-producing glands located in the lobules; also called acini.

Alveoli (of the Lung) Smallest functional unit of the respiratory system; where gas exchange occurs.

Amblyopia Permanent loss of visual acuity resulting from certain uncorrected medical conditions.

Amenorrhea Absence of menses.

Anal Canal Terminal 3 to 4 cm of the large intestine.

Anal Columns Longitudinal folds of mucosa in the superior portion of the anal canal.

Anal Fissure Linear tear in the epidermis of the anal canal.

Anal Incontinence Involuntary release of rectal contents.

Anal Orifice Exit to the gastrointestinal tract; located at the seam of the gluteal folds.

Anal Sinuses Pockets in the anal canal that lie superior to the anal valves; they secrete mucus when compressed by feces.

Anal Valves Folds in the anal canal that are formed by joining anal columns.

Analgesia Absence of normal sense of pain.

Anaphylaxis An intense hypersensitivity reaction to a previously encountered antigen.

Anemia Decreased number of red blood cells.

Anencephaly Condition where the cerebral cortex or cranium does not develop.

Anergy Diminished reaction to antigens.

Aneroid Manometer Blood pressure measurement equipment with a calibrated dial and indicator that points to numbers representing blood pressure.

Anesthesia Absence of touch sensation.

Angina Myocardial ischemia that manifests as chest, neck, or arm pain.

Angle of Louis (Manubriosternal Junction or Sternal Angle) Junction of the manubrium and the sternum.

Animism Belief that all things in nature have souls.

Anisocoria Difference in pupil sizes.

Anoderm Epithelial tissue that lies in the lower 2 cm of the anal canal.

Anomaly Deviation from the average or norm; anything structurally unusual, irregular, or contrary to a general rule.

Anorectal Abscess Undrained collection of perianal pus of the tissue spaces in and adjacent to the anorectum.

Anorectal Fistula Hollow, fibrous tract lined by granulation tissue and filled with purulent or serosanguineous discharge; it has an opening inside the anal canal or rectum, and one or more orifices in the perianal skin.

Anorectum Area where the anal canal fuses with the rectum.

Anosmia Loss of the sense of smell.

Anterior Axillary Line Vertical line drawn from the origin of the anterior axillary fold along the anterolateral aspect of the thorax.

Anterior Chamber Space anterior to the pupil and iris.

Anterior Triangle Area of the neck formed by the mandible, the trachea, and the sternocleidomastoid muscle; contains the anterior cervical lymph nodes, the trachea, and the thyroid gland.

Anthropometric Measurements Measurements of the human body, including height, weight, and body proportions.

Anticipatory Guidance Approach covering health promotion and education; designed to inform at-risk individuals of physical, cognitive, psychological, and social changes that occur and what their nutritional needs are.

Antigen Skin Testing Test of immune function.

Aortic Stenosis Pathologic narrowing of the aortic valve orifice.

Apex (of the Heart) Lower portion of the heart.

Apex (of the Lung) Top of the lung.

Apgar Score A system for evaluating the newborn at 1 and 5 minutes of age, giving 0–2 points for heart rate, respiratory effort, muscle tone, reflex irritability, and color.

Aphasia Impairment or absence of language function.

Aphonia Total loss of voice.

Apnea Lack of spontaneous respirations for 10 or more seconds.

Apneustic Respirations Prolonged gasping in inspiration followed by a very short, inefficient pause that can last 30 to 60 seconds.

Apocrine Glands Sweat glands that are associated with hair follicles.

Appendicular Skeleton Peripheral skeleton including the limbs, pelvis, scapula, and clavicle.

Apraxia Inability to convert intended speech into the motor act of speech; inability to perform purposeful acts or to manipulate objects.

Arcus Senilis Hazy, gray ring about 2 mm in size and located just inside the ­limbus; most commonly found in older individuals.

Areola Pigmented area approximately 2.5 to 10 cm in diameter that surrounds the nipple.

Arrector Pili Muscle Muscle that causes contraction of the skin and hair, resulting in “goose bumps.”

Arrhythmia Irregular heart rhythm; also known as dys­rhythmia.

Ascites Excess accumulation of fluid in the abdominal cavity.

Assessment First step of the nursing process; the orderly ­collection of objective and subjective data on the patient's health status.

Associated Manifestations Signs and symptoms that accompany a patient's chief complaint.

Astereognosis Inability to recognize the nature of objects by touch.

Asterixis A hand-flapping tremor, often accompanying metabolic disorders.

Asystole Absence of cardia activity, flat line on EKG.

Ataxia Inability to perform coordinated muscular movements.

Ataxic Respirations Irregularly irregular respiratory pattern caused by damage to the medulla; also called Biot's respirations.

Atheist Person who does not believe in God.

Atherosclerosis Development of lipid plaques along the coronary arteries.

Atlantoaxial Instability A condition characterized by excessive movement at the junction between the atlas and axis as a result of a bony or ligamentous abnormality.

Atlas First cervical vertebra.

Atrial Kick Final phase of ventricular diastole, when the atria contract to complete the final 20% to 30% of ventricular filling.

Atrioventricular (A-V) Node One of the heart's pacemakers that delays the impulse from the atria before it goes to the ventricles; inherent rate is 40 to 60 beats per minute.

Atrioventricular (A-V) Valves Valves that prevent blood from entering the ventricles until diastole and prevent retrograde blood flow during systole; composed of the tricuspid and mitral valves.

Atrophy Reduction in muscle size.

Augmentation Mammoplasty Surgical breast augmentation.

Auricle External flap of the ear; also called the pinna.

Auscultation Process of active listening to sounds within the body to gather information on a patient's health status.

Auscultatory Gap A silent interval that may be heard between the systolic and diastolic blood pressures that can occur in hypertensive patients; this can lead to a falsely elevated high diastolic or falsely low systolic blood pressure measurement.

Avolition Lack of motivation for work or other goal-directed activity.

Axial Skeleton Central skeleton, including the facial bones, skull, auditory ossicles, hyoid bone, ribs, sternum, and vertebrae.

Axilla A pyramid-shaped space forming the underside of the shoulder between the upper part of the arm and the side of the chest; armpit.

Axillary Nodes Nodes composed of four groups: central ­axillary, pectoral (anterior), subscapular (posterior), and lateral.

Axis Second cervical vertebra.

B

Balanitis Inflammation of the glans penis.

Ballottement Palpation technique to identify an organ or fluid.

Baroreceptors Receptors located in the walls of most of the great arteries that sense hypotension and initiate reflex vasoconstriction and tachycardia to bring the blood pressure back to normal.

Barrel Chest Abnormal thorax configuration where the ratio of the anteroposterior diameter to the transverse diameter of the chest is approximately 1:1.

Bartholin's Glands (Greater Vestibular Glands) Located in the cleft between the labia minora and the hymenal ring; these glands secrete a clear, viscid, odorless, alkaline mucus that improves the viability and motility of sperm along the female reproductive tract.

Base (of the Heart) Uppermost portion of the heart.

Base (of the Lung) Bottom of the lung.

Bell's Palsy Idiopathic facial palsy of CN VII resulting in asymmetry of the palpebral fissures, nasolabial folds, mouth, and facial expression on the affected side.

Bilingualism Habitual use of two different languages, particularly when speaking.

Biot's (or Ataxic) Respirations Irregularly irregular respiratory pattern caused by damage to the medulla.

Blepharitis Inflamed, scaly, red-rimmed eyelids, sometimes with loss of the eyelashes.

Blood Pressure Vital sign collected to assess cardiac output and vascular resistance; it measures the force ex­erted by the flow of blood pumped into the large arteries.

Body Mass Index (BMI) Measurement that indicates body composition based on a person's height and weight; an increased BMI indicates obesity and a decreased BMI indicates possible malnutrition.

Bone Spicule A sharp body with a needlelike point.

Borborygmi Loud, audible, gurgling bowel sounds.

Bouchard's Node Bony enlargement of the proximal interphalangeal joint of the finger.

Bow Legs Outward deviation away from the midline at the level of the knees; also known as genu varum.

Bradycardia Pulse rate under 60 beats per minute in a resting adult.

Bradypnea Respiratory rate under 12 breaths per minute in a resting adult.

Braxton Hicks Contractions A pattern of intermittent painless uterine contractions that occurs more frequently at the end of pregnancy (every 10–20 minutes or even more frequently). These are not true labor pains.

Breasts Pair of mammary glands located on the anterior chest wall and extending vertically from the second to the sixth rib and laterally from the sternal border to the axillae.

Bregma Junction of the coronal and sagittal sutures.

Bronchial (or Tubular) Breath Sound Breath sound that is high in pitch and loud in intensity and that is heard best over the trachea; has a blowing or hollow quality; heard longer in expiration than inspiration.

Bronchophony Voice sound where the patient says the words “ninety-nine” or “one, two, three” to determine if the lung is filled with air, fluid, or a solid.

Bronchovesicular Breath Sound Breath sound that is moderate in pitch and intensity and that is heard best between the scapula and the first and second intercostal spaces lateral to the sternum; its quality is a combination of bronchial and vesicular breath sounds; heard equally in inspiration and expiration.

Bruit Blowing sound that can be auscultated when the blood flow becomes turbulent because blood is rushing past an obstruction.

Brushfield's Spots Small, white flecks located around the perimeter of the iris, associated with Down syndrome.

Bulbar Conjunctiva Covering of the anterior surface of the sclera.

Bulbourethral Glands Pea-sized glands located below the prostate; secretions are emptied from here at the time of ejaculation.

Bursae Sacs filled with fluids.

C

Cachexia Extreme malnutrition in which the patient exhibits wasting.

Callus Thickening of the skin due to prolonged pressure.

Canthus Nasal or temporal angle where the eyelids meet.

Caput Medusae Venous pattern of congested veins around the umbilicus; attributed to obstruction of the portal vein and seen in liver dysfunction.

Caput Succedaneum Swelling over the occipitoparietal region of the skull that occurs during delivery of the newborn.

Carbohydrate Major source of energy for various functions of the body; supplies fiber and assists in the utilization of fat.

Cardiac Decompensation A failure of compensation in heart disease.

Cardiac Tamponade Compression of the heart produced by the accumulation of fluid or blood in the pericardial sac resulting from the rupture of a blood vessel of the myocardium.

Cardiomegaly Enlargement of the heart.

Caries Destruction or necrosis of teeth.

Carotenemia Orange-yellow coloration of palmar and plantar surfaces caused by elevated levels of serum carotene.

Carpal Tunnel Syndrome Pressure on the median nerve at the carpal tunnel of the wrist, causing numbness, tingling, weakness, and pain.

Caruncle Round, red structure in the inner canthus; contains sebaceous glands.

Castration Anxiety Young boys' fear of having the penis cut off or mutilated.

Catabolism The breaking down in the body of complex chemical compounds into simpler ones.

Cataract Opacity in the lens of the eye that gives the pupil a pearly gray appearance.

Cephalhematoma Localized subcutaneous swelling over one cranial bone that occurs during delivery of the newborn.

Cephalocaudal Head-to-toe approach.

Cerclage The placement of a nonabsorbable suture around an incompetent cervical os.

Cerumen Waxlike substance produced in the ear canal.

Cervix Inferior aspect of the uterus.

Chadwick's Sign A blue, soft cervix, normally during ­pregnancy.

Chalazion Chronic inflammation of the meibomian gland in the upper or lower eyelid.

Chancre Reddish, round ulcer or small papular lesion with a depressed center and raised, indurated edges.

Chancroid Tender, ulcerated, exudative, papular lesion with an erythematous halo, surrounding edema, and a friable base.

Chandelier's Sign Cervical motion tenderness on palpation.

Characteristic Patterns of Daily Living Patient's normal daily routines; includes meal, work, and sleeping schedules and patterns of social interactions.

Chemosis Swelling of the palpebral conjunctiva.

Cherry Angioma Bright-red, circumscribed area that may be flat or raised and that darkens with age.

Cheyne-Stokes Respirations Crescendo or decrescendo respiratory pattern interspersed between periods of apnea.

Chief Complaint Symptom or problem that causes the patient to seek health care.

Chloasma Irregular pigmentation on the face due to pregnancy; also known as m elasma .

Cholelithiasis Presence or formation of bile stone or calculi in the gallbladder or duct.

Cholestasis Arrest of bile excretion.

Cholesterol Lipid found only in animal products; it is transported in the body by high-density lipoproteins (HDLs) and low-density lipoproteins (LDLs).

Choroid Vascular tissue of the posterior uveal tract lining the inner surface of the globe of the eye, beneath the retina; ­provides nutrition to the retina and helps absorb excess light.

Chorionic Villi Sampling (CVS) Intracervical (or less commonly, intra-abdominal) sampling of the chorionic villi for chromosome analysis. It is an alternative to traditional or early amniocentesis and is typically performed at approximately 9–10 weeks.

Ciliary Body Extension of the uveal tract that produces aqueous humor.

Circadian Rhythm Normal fluctuation of body temperature, pulse, and blood pressure during a 24-hour period.

Claudication A weakness of the legs accompanied by cramplike pains in the calves caused by poor circulation of the blood to the leg muscles.

Click Extrasystolic heart sound that is high pitched and can radiate in the chest wall.

Clinical Reasoning A disciplined, creative, and reflective thinking used with critical thinking to establish potential strategies for patients to reach their health goals.

Clitoris Cylindrical, erectile body located at the superior aspect of the vulva, between the labia minora; it contains erectile tissue and has a significant supply of nerve endings.

Clonus Rhythmic oscillation of involuntary muscle contraction.

Clustering Placing similar or related data into meaningful groups.

Cochlea Snail-shaped structure in the bony labyrinth of the inner ear.

Code of Ethics Codified beliefs and lists of mandatory or prohibited acts.

Collaborative Intervention Physician-prescribed orders that are implemented by nurses.

Collaborative Problem Patient problem for which the nurse works jointly with the physician and other health care workers to monitor, plan, and implement treatment.

Colloquialism Word or phrase particular to a community and used in informal conversation and writing.

Collateral Circulation Circulation maintained in small anastomosing vessels when a main artery is obstructed.

Colloid Osmotic Pressure An abnormal condition of the kidney caused by the pressure of concentrations of large particles, such as protein molecules, that will not pass through a membrane.

Coloboma Defect of the choroid and retina resulting when development in utero is interrupted.

Colostrum A thin, milky secretion expressed by the breast during pregnancy and for a few days after parturition; it is rich in antibodies and colostrum corpuscles.

Compartment Syndrome A pathologic condition caused by the progressive development of arterial compression and reduced blood supply.

Complete Health History Comprehensive history of the patient's past and present health status; includes physical, emotional, psychological, developmental, cultural, and spiritual data.

Condyloma Acuminatum Genital wart.

Cones Retinal structures in the macular region that are responsible for color vision.

Confabulation Fabrication of answers, experiences, or situations unrelated to facts.

Conjugate Gaze Movement of the eyes with the visual axes parallel.

Conservation The understanding that altering the physical state of an object does not change the basic properties of that object.

Constructional Apraxia Inability to reproduce figures on paper.

Contralateral Side Pertaining to the opposite side of the body (e.g., side opposite to that of a lesion).

Cooper's Ligaments Ligaments that extend vertically from the deep fascia through the breast to the inner layer of the skin and provide support for the breast tissue.

Corn Conical area of thickened skin.

Cornea Transparent covering of the iris.

Coronary Circulation The vascular network supplying the heart tissue.

Costal Angle Angle formed by the intersection of the costal margins at the sternum.

Costal Margin Medial border created by the articulation of the false ribs.

Cradle Cap Seborrheic dermatitis manifesting as greasy-appearing scales on an infant's scalp.

Craniosynostosis Abnormal shape of the skull due to premature ossification of one or more suture lines before brain growth is complete.

Craniotabes Softening of the skull.

Creatinine Substance found in muscle and excreted in the urine.

Crepitus Subcutaneous emphysema; beads of air escape from the lungs and create a crackling sound when palpated.

Crescendo Heart murmur configuration that proceeds from soft to loud.

Critical Pathway Map in the case management patient care delivery system that shows the outcome of predetermined patient goals over a period of time.

Critical Thinking A purposeful, goal-directed thinking process that strives to problem-solve patient care issues through clinical reasoning.

Crohn's Disease A chronic inflammatory bowel disease of unknown origin.

Cross-Cultural Nursing Care Nursing care that is provided within the cultural context of a patient who is a member of a culture or subculture other than that of the nurse.

Cryptorchidism Condition in which a testicle has not descended into the scrotum.

Cullen's Sign Bluish discoloration encircling the umbilicus and indicative of blood in the peritoneal cavity.

Cult Organized group centered around religious devotion to a set of beliefs or to a person.

Cultural Beliefs Explanatory ideas and knowledge about various aspects of the world in which members of a given ­culture place their faith and confidence.

Cultural Diversity State of different combinations of cultural and subcultural minorities (e.g., ethnic, racial, national, religious, generational, marital status, socio­economic, occupational, health status, and preference in life partner orientations) coexisting in a given location.

Cultural Identity Subjective sense of cultural definition or cultural orientation with which an individual self-identifies.

Cultural Norms Often unwritten but generally understood prescriptions for acceptable behavior by members of a cultural group.

Cultural Relativism Belief that no culture is either inferior or superior to another; that behavior must be evaluated in relation to the cultural context in which it occurs; and that respect, equality, and justice are basic rights for all racial, ethnic, subcultural, and cultural groups.

Cultural Rituals Highly structured and prescribed patterns of behavior used by a cultural group to respond to or in anticipation of specific life events such as birth, death, illness, healing, marriage, and worship.

Cultural Values Fundamental, often unshakable and unchanging set of principles on which the cultural beliefs, behaviors, and customs of all members of the culture are based.

Culturally Competent Nursing Care Nursing care that is provided by nurses who use cross-cultural nursing models and research to identify health care needs and to plan and evaluate the care provided within the cultural context of their patients.

Culture Learned and socially transmitted orientation and way of life of a group of people that is based on shared values, beliefs, customs, and norms of behavior and that determines how members of the group think, act, and relate to and with others as well as how they perceive and respond to all aspects of their life.

Cultures Any of several techniques for growing colonies of microorganisms to identify a pathogen.

Culture Shock Disorientation and uncertainty that results from the expenditure of mental, emotional, and physical energy during the process of adjusting to a new cultural group; it can lead to frustration, anger, alienation, or depression.

Curandero Male or female folk healer, spiritual healer, or shaman.

Custom Frequent or common practice carried out by tradition; culturally learned behaviors associated with a specific culture, including communication patterns, family and kinship relations, work patterns, dietary and religious practices, and health behaviors and practices.

Cutaneous Hypersensitivity Stimulus detecting specific zones of peritoneal irritation.

Cyanosis Blue coloration of the skin or nails that occurs when more than 5 g/dl of hemoglobin is deoxygenated in the blood.

Cystocele Bulging of the anterior vaginal wall.

Cystourethrocele Bulging of the anterior vaginal wall, bladder, and urethra into the vaginal introitus.

D

Dacryoadenitis Acute inflammation of the lacrimal gland.

Dacryocystitis Inflammation of the lacrimal duct.

Decerebrate Rigidity Rigidity and sustained contraction of the extensor muscle.

Decorticate Rigidity Hyperflexion of the arms, hyperextension and internal rotation of the legs, and plantar flexion.

Decrescendo Heart murmur configuration that proceeds from loud to soft.

Deep Palpation Palpating the body's internal structures to a depth of 4 to 5 cm to elicit information on organs and masses, including position, size, shape, mobility, consistency, and areas of discomfort.

Defecation Expulsion of feces from the rectum.

Defining Characteristics Signs, symptoms, or statements made by the patient that validate the existence of the health problem or situation.

Dehydration Lack of fluid in the tissues.

Depolarize The reduction of a membrane potential to a less negative value.

Dermatome Skin area innervated by afferent spinal nerves from a specific nerve root.

Dermis Corium, or the second layer of the skin.

Descriptor or Qualifier Adjective that describes or qualifies the human response.

Desquamation Shedding of old skin cells as new cells are pushed up from the lower layers of the epidermis.

Development Patterned and predictable increases in the physical, cognitive, socioemotional, and moral capacities of individuals that enable them to successfully adapt to their environments.

Developmental Dislocation of the Hip Dislocated hip found in newborns and young infants and related to familial factors, maternal hormones, firstborn children, and breech presentations.

Developmental Stage One of multiple sequential age periods during which individuals experience the same physical, cognitive, socioemotional, and moral changes.

Developmental Task Specific physical or psychosocial skill that must be achieved during each developmental stage.

Diaphragmatic Excursion Technique used to assess the patient's depth of ventilation.

Diaphragmatic Hernia Protrusion of intestines into the thoracic cavity.

Diaphysis Central shaft of the long bone.

Diastasis Recti Separation of the rectus muscle of the abdominal wall.

Diastole Phase in the cardiac cycle when the heart is at rest.

Dietary Reference Intakes Nutrient reference values developed by the Institute of Medicine that are used to assess a person's diet; comprised of three components: Adequate Intake, tolerable upper intake level, and Recommended Dietary Allowances.

Diethylstilbestrol (DES) A synthetic hormone with estrogenic properties.

Diplopia Double vision caused by defective function of the extraocular muscles or a disorder of the nerves that innervate the muscles.

Direct Fist Percussion Using the ulnar aspect of a closed fist to strike the patient's body to elicit tenderness over specific body areas.

Direct Inguinal Hernia Protrusion of the bowel and/or omentum directly through the external inguinal ring.

Direct (or Immediate) Auscultation Active listening to body sounds via the unaided ear.

Direct (or Immediate) Percussion Striking of an area of the body directly with the index or middle finger pad or fist to elicit sound.

Dislocation Complete dislodgement of a bone from its joint cavity.

Dissection A cutting apart of tissues for visual or microscopic study.

Distress Negative stress that is harmful and unpleasant.

Diuretic An agent that promotes the excretion of urine.

Disuse Atrophy Decrease in muscle mass and strength as a result of immobility.

Diverticulitis Inflammation of one or more diverticula, pouchlike herniations through the muscular wall of the colon.

Dogma Beliefs that are essential to the identity of a religion.

Doppler Device that emits ultrasound waves and senses shifts in frequency as the ultrasound waves are reflected from fetal heart valves.

Down Syndrome Congenital chromosomal aberration marked by slanted eyes with inner epicanthal folds; a short, flat nose; a protruding, thick tongue and mental retardation.

Ductus (Vas) Deferens Tube that permits sperm to exit from the epididymis and pass from the scrotal sac upward into the abdominal cavity.

Dullness Descriptor for a percussable sound that is moderate in intensity, moderate in duration, of high pitch, thudlike, and normally located over organs.

Duration (of Percussion) Time period over which a sound is heard.

Dysarthria Disturbance in muscular control of speech.

Dyscalculia Inability to perform calculations.

Dysdiadochokinesia Inability to perform rapid, alternating movements.

Dysesthesia Abnormal interpretation of a stimulus such as burning or tingling from a stimulus such as touch or superficial pain.

Dyskeratotic Cells Epithelial cells with abnormal or premature keratinization.

Dysmenorrhea Pain or cramping during menses.

Dysmetria Impairment of judgment of distance, range, speed, and force of movement.

Dyspareunia Painful sexual intercourse.

Dysphagia Difficulty swallowing.

Dysphonia Difficulty in making laryngeal speech sounds.

Dyspnea Subjective feeling of shortness of breath.

Dysrhythmia Irregular heart rhythm; also known as arrhythmia .

Dyssynergy Lack of coordinated action of the muscle groups.

Dystrophy Defective nutrition.

Dysuria Painful urination, usually the result of bacterial infection or obstruction.

E

Ecchymosis A red-purple discoloration of varying size caused by extravasation of blood into the skin; a black-and-blue mark.

Eccrine glands Sweat glands that are not associated with hair follicles.

Echolalia Involuntary repetition of a word or sentence that was uttered by another person.

Eclampsia Seizure associated with pregnancy-induced hypertension.

Ecomap A diagram depicting a person's relationship with his or her family, as well as significant friends, peers, neighbors, and work associates.

Ectasia Condition of dilation, extension, or distension of an organ.

Ectodermal Galactic Band Ectodermal galactic band that develops from the axilla to the groin during the fifth week of fetal development; also known as milk line.

Ectopic pregnancy A pregnancy other than intrauterine; nonviable, and often leading to surgical intervention.

Ectropion A red, inflamed appearance of the cervix as the columnar epithelium extends from the os past the normal squamocolumnar junction.

Ectropion (of the Eye) Turning outward or eversion of the eyelid, usually the lower.

Ectropion (or Eversion, of the Cervix) Reddish circle around the cervical os.

Edema Accumulation of fluid in the intercellular spaces, leading to swelling of the extremities, usually the feet and hands.

Ego Personality component that is conscious, rational, emerges during the first year of life, and seeks realistic and acceptable ways to meet needs.

Egocentrism Viewing the world in terms of only the self and interpreting one's own actions and all other events in terms of the consequences for the self.

Egophony Voice sound where the patient says the letter “ee” to determine if the lungs are filled with air, fluid, or a solid.

Ejaculatory Ducts Ducts located posterior to the urinary bladder; they eject sperm into the prostatic urethra prior to ejaculation.

Electrocardiogram (EKG) Record of the electrical activity of the heart.

Electrolyte Any compound that, in solution, conducts an electrical current.

Eleidin Translucent substance that aids in the formation of keratin.

Emergency Health History History taken from the patient or other sources when the patient is experiencing a life-threatening state.

Emission A discharge.

Empathy The ability to recognize and share the emotions and states of mind of another and to understand the meaning of that person's behavior.

Enculturation Informal process through which the beliefs, values, norms, and practices of a culture are learned by members born into that culture.

Endemic Illness Disease that is indigenous to a geographic area or population.

Enophthalmos Backward displacement of the globe of the eye.

Entropion Turning inward or inversion of the eyelid, usually the lower.

Epidermis Multilayered outer covering of the skin, consisting of four layers throughout the body, except for the palms of the hands and soles of the feet, where there are five layers.

Epididymis Comma-shaped organ that lies along the posterior border of each testis; consists of a tightly coiled tube where sperm maturation occurs.

Epigastric Area Part of the abdomen in the upper zone between the right and left hypochondriac regions.

Epimysium Connective tissue sheath covering the muscle belly.

Epiphyses Ends of the long bone.

Episodic Health History History taken from the patient for a specific problem or need.

Epispadias Congenital abnormality in which the urethral meatus lies on the dorsal surface of the penis.

Epistaxis Nose bleed.

Epstein's Pearls Small, hard, white cysts found on a newborn's hard palate and gum margins.

Eructation Belching.

Erythema An inflammatory redness of the skin.

Escutcheon Characteristic triangular pattern of coarse, curly hair that develops over the mons pubis at puberty.

Esophoria Latent misalignment of the eye; nasal, or inward, drift.

Esotropia Inward deviation of the eye.

Ethnic Group Classification of individuals based on their unique national or regional origin and social, cultural, and linguistic heritage.

Ethnic Identity Subjective sense of ethnic definition or social orientation with which an individual self-identifies.

Ethnocentrism Condition that occurs when individuals or groups of people perceive their own cultural group and cultural values, beliefs, norms, and customs to be superior to all others and have disdain for the expression of any way of life but their own.

Etiology Cause of a disease.

Eupnea Normal breathing; respirations are 12 to 20 per minute for the resting adult.

Eustachian Tube Auditory tube that serves as an air channel connecting the middle ear to the nasopharynx to allow equalization between the air pressure in the ear and in the atmosphere.

Eustress Positive stress that challenges, provides motivation, and prevents stagnation.

Exacerbation An increase in the seriousness of a disease or disorder manifested by greater intensity in its signs or symptoms.

Evaluation Last step of the nursing process; the patient's progress in achieving the outcomes is determined.

Evidence-Based Practice Uses the outcomes of well-designed and executed scientific studies to guide clinical decision making and clinical care.

Exophoria Latent misalignment of the eye; temporal, or outward, drift.

Exophthalmos Abnormal protrusion of the globe of the eye.

Exotropia Outward deviation of the eye.

F

Faith Orientation to a belief structure.

Fallopian Tubes Site of fertilization; they extend from the cornu of the uterus to the ovaries and are supported by the broad ligaments.

False Ribs Rib pairs 8–10.

Fat-Soluble Vitamins Vitamins stored in dietary fat and absorbed in the fat portions of the body's cells.

Fats Substances that supply essential fatty acids, which form a part of the structure of all cells.

Femoral Hernia Protrusion of the omentum or bowel through the femoral wall.

Fetal Alcohol Syndrome (FAS) A pattern of craniofacial, cardiovascular, and limb defects, with prenatal and postnatal growth retardation associated with material alcohol use.

Fetoscope Special stethoscope for hearing fetal heart beats.

Fibroid Resembling or composed of fibers or fibrous tissue.

Fibroma Fibrous, encapsulated, tumor of connective tissue, often called fibroid or myoma.

Fissure Groove separating the different lobes of the lungs.

Flank Pain Pain in the side of the trunk between the right or left upper abdomen and the back.

Flatness Descriptor for a percussable sound that is soft in intensity, short in duration, of high pitch, and normally located over muscle or bone.

Flatulence Passage of excess gas via the rectum.

Floaters One or more spots that appear to drift in front of the eye, caused by a shadow cast on the retina by vitreous debris.

Floating Ribs Rib pairs 11 and 12; they do not articulate at their anterior ends.

Folk Illness Illness believed to be caused by disharmony, an imbalance, or as a punishment.

Folk Practitioner Healer or other individual who is not part of the scientific care system but is believed to have special knowledge or power to prevent, treat, or provide resources needed to heal folk illnesses.

Follow-Up Health History See Interval Health History .

Fornices Pouchlike recesses around the cervix.

Fourchette Transverse fold of skin of the posterior aspect of the labia minora; also known as frenulum.

Fovea Centralis Center of the macula; the area of sharpest vision.

Fremitus A tremulous vibration of the chest wall that can be palpated by a hand resting on the chest or other part of the body.

Frenulum (of the Mouth) Tissue that connects the tongue to the floor of the mouth.

Friability Susceptibility to bleeding from the cervix.

Fugue State A dissociative state that occurs briefly after an epileptic seizure.

Functional Health Assessment Documents a person's ability to perform instrumental activities of daily living and physical self-maintenance activities.

Functional Health Patterns Groups of human behavior that facilitate nursing care; there are 11 patterns (refer to Table 1-4 on page 8).

Fundus Superior aspect of the uterus.

Fundus of the Eye The back of the eyeball, visible through the ophthalmoscope.

G

Gallop Extra heart sound; an S 3 is a ventricular gallop, whereas an S 4 is an atrial gallop.

Ganglion Benign, cystic growth.

Gastroesophageal Reflux Backward flow of contents of the stomach into the esophagus, often the result of incompetence of the lower esophageal sphincter.

Genogram Pictorial representation of the patient's family health history.

Genomics The study of the genetic makeup of the human cell.

Genu Valgum Inward deviation toward the midline at the level of the knees; also known as knock knees.

Genu Varum Outward deviation away from the midline at the level of the knees; also known as bow legs.

Gestational Age The age of a fetus or newborn, usually expressed in weeks from the first day of the mother's last menstrual period.

Glans Penis Bulbous end of the penis.

Glasgow Coma Scale International scale used in grading neurological response.

Glaucoma Disease in which intraocular pressure is elevated.

Glycosuria Glucose in the urine.

God Concept of a deity or personal, present being.

Goiter Enlargement of the thyroid gland.

Goniometer Device used to measure the angle of the skeletal joint during range of motion; it is a protractor with two movable arms.

Gout A disease associated with an inborn error of uric acid metabolism that may result in the deposition of sodium urate crystals in joints and other tissues.

Granulation Tissue Inflamed tissue, new vessels, and white blood cells at the base of a wound in the process of healing.

Granulomatous Reaction (in the Breast) Development of small, nodular, inflammatory lesions and capsular membranes over the breasts.

Graphanesthesia Inability to identify numbers, letters, or shapes drawn on the skin.

Graphesthesia Ability to identify numbers, letters, or shapes drawn on the skin.

Growth Increase in body size and function to the point of optimum maturity.

Gubernacular Defect A defect in the gubernaculum, a mesenchymal column of tissue that connects the fetal testis to the developing scrotum.

Gynecomastia Enlargement of male breast tissue; may occur normally in adolescent and elderly males.

H

Hallux Valgus Lateral deviation of the big toe and medial deviation of the first metatarsal; also known as bunion.

Hammer Toe Flexion of the proximal interphalangeal joint and hyperextension of the distal metatarsophalangeal joint.

Harlequin Color Change Condition in which one-half of a newborn's body is red or ruddy and the other half appears pale.

Health Maintenance Activities Practices that a person incorporates into a lifestyle that can promote healthy ­living.

Heave Lifting of the cardiac area secondary to an increased workload and force of left ventricular contraction; also known as a lift.

Heaven Blissful resting place for souls after death, according to Christianity.

Heberden's Node Bony enlargement of the distal interphalangeal joint of the finger.

HELLP Syndrome Complication of pregnancy-induced hypertension; the acronym represents hemolysis, elevated liver enzymes, and low platelets.

Hematemesis Vomiting of blood.

Hematocrit Measurement to determine the percentage of red blood cells to the volume of whole blood.

Hemiparesis Unilateral weakness or paralysis; also known as hemiplegia.

Hemiplegia See Hemiparesis .

Hemoglobin Measurement of the iron component that transports oxygen in the blood.

Hemorrhoids Dilatation of hemorrhoidal veins in the anorectum.

Hepatojugular Reflux An elevation of venous pressure visible in the jugular veins and measurable in the veins of the arm; produced in congestive heart failure by firm pressure with the flat hand over the abdomen.

Heretic Person who rejects the official teachings or dogma of a religion or belief system.

Herniated Disc Protruded or ruptured disc.

High-Density Lipoprotein Substance that carries cholesterol away from the heart and arteries and toward the liver.

Hirsutism Excessive body hair.

History of the Present Illness Chronological account of the patient's chief complaint and the events surrounding it.

Holistic Nursing A form of nursing that addresses all aspects of a patient's health and well-being, including spirituality and religion.

Holosystolic Murmur that is heard throughout all of systole; also known as pansystolic.

Homan's Sign Pain in the calf when the foot is dorsiflexed; sign of venous thrombosis of the deep veins of the calf.

Homeopathy A system of therapeutics based on the theory that “like cures like”; states that some medicines that cause disease in large amounts may treat the disease symptoms when used in very small amounts.

Hordeolum Infection of a sebaceous gland in the eyelid.

Human Response Patterns Groups of human behavior that facilitate nursing care; there are nine patterns.

Hydatidiform Mole Molar or trophoblastic pregnancy. Often requires careful monitoring of HCG after dilation and curettage of the uterus. If HCG remains elevated, chemotherapy may be indicated.

Hydramnios An abnormal condition of pregnancy characterized by an excess of amniotic fluid.

Hydrocele Fluid collection within the tunica vaginalis of the testis.

Hydrocephalus Enlargement of the head without enlargement of the facial structures; it is due to increased accumulation of cerebrospinal fluid within the ventricles of the brain.

Hymen Avascular, thin fold of connective tissue surrounding the vaginal introitus; it may be annular or crescentic in shape.

Hypalgesia Diminished sensitivity to pain.

Hyperalgesia Increased sensitivity to pain.

Hyperemesis Gravidarum Excessive nausea and vomiting during pregnancy.

Hyperesthesia Abnormal acuteness to the sensitivity of touch.

Hyperglycemia Increase in serum glucose.

Hyperkinetic Increased movement.

Hyperopia Farsightedness.

Hyperpnea Breath that is greater in volume than the resting tidal volume.

Hyperprolactinemia Condition of an elevated level of prolactin, a normal physiological reaction during lactation.

Hyperresonance Descriptor for a percussable sound that is very loud in intensity, long in duration, of very low pitch, boomlike, and normally not found in the healthy adult.

Hypertelorism Abnormal width between the eyes.

Hypertension Blood pressure remaining consistently above 140 mm Hg systolic or 90 mm Hg diastolic in an adult.

Hyperthermia Generalized or localized excessive warming of the skin; body temperature that exceeds 38.5°C, or 101.5°F.

Hypertrophy Increase in muscle size due to an increase in the bulk of muscle fibers.

Hypesthesia Diminished sense of touch; also known as hypoesthesia.

Hyphema Condition in which there is blood in the anterior chamber of the eye.

Hypoesthesia See Hypesthesia .

Hypogeusia Diminution of taste.

Hypoglycemia Decrease in serum glucose.

Hypokinetic Decreased movement.

Hypospadias Congenital abnormality in which the urethral meatus lies on the ventral surface of the penis.

Hypotension Blood pressure that is lower than what is needed to maintain adequate tissue perfusion and oxygenation.

Hypothermia Generalized or localized cooling of the skin; body temperature that is below 34°C, or 93.2°F.

Hypotonicity Decrease in normal muscle tone (flaccidity).

I

Id Personality component that is inborn, unconscious, and driven by biological instincts and urges to seek immediate gratification of needs such as hunger, thirst, and physical comfort.

Iliopsoas Muscle Test Technique used to assess for an inflamed appendix.

Immediate Auscultation See Direct Auscultation .

Immediate Percussion See Direct Percussion .

Implementation Fifth step of the nursing process; the execution of the nursing interventions that were devised during the planning stage to help the patient meet predetermined outcomes.

Impotence Inability to achieve or maintain an erection.

Independent Nursing Interventions Actions that the nurse is legally capable of implementing based on education and experience.

Indirect Fist Percussion Using the closed ulnar aspect of the fist of the dominant hand to strike the nondominant hand to elicit tenderness over specific body areas.

Indirect Inguinal Hernia Portions of the bowel or omentum that enter the inguinal canal through the internal inguinal ring and exit at the external inguinal ring.

Indirect (or Mediate) Auscultation Active listening to body sounds via some amplification or mechanical device, such as a stethoscope or Doppler transducer.

Indirect (or Mediate) Percussion Using the plexor to strike the pleximeter to elicit sound.

Inductive Reasoning A system of argument that moves from the specific to the general.

Induration Having the features of firmness or hardness.

Infarction (Myocardial) Necrosis of cardiac muscle due to decreased blood supply.

Injection Redness around the cornea.

Inspection Use of one's senses to consciously observe the patient; in physical assessment, vision, hearing, smell, and touch are used.

Insufficiency See Regurgitation .

Integumentary System Skin, or cutaneous tissue.

Intensity (of Percussion) Relative loudness or softness of sound; amplitude.

Intercostal Space Area between the ribs.

Intermediary Individual who serves to assist with communication between the patient and another individual, usually a member of the health care team.

Intermittent Claudication A condition characterized by attacks of lameness and pain; caused by ischemia of the muscles due to sclerosis with narrowing of the arteries.

Interpleural Space See Mediastinum .

Interval (or Follow-Up) Health History History that builds on the patient's last health care visit and documents resolution or nonresolution of a problem or health care need.

Intervention Nursing action designed to achieve patient outcomes.

Intussusception Formation of a sausage-shaped mass in the upper abdomen resulting when the ileocecal region of the intestine telescopes into the ileum.

Intermittent Claudication A condition characterized by attacks of lameness and pain; caused by ischemia of the muscles due to sclerosis with narrowing of the arteries.

Iris Most anterior portion of the uveal tract; provides a distinctive color for the eye.

Ischemia (Myocardial) Local and temporary lack of blood supply to the heart; may progress to an infarction if left untreated.

Isoelectric Line Electrical resting period after the T-wave on the EKG.

Iso-immunization Most common Rh hemolytic disease, now almost completely eliminated by the antepartum administration of Rh gamma globulin to Rh negative mothers, and readministration after delivery if newborn is Rh positive.

Isthmus (of the Thyroid) Narrow portion of the thyroid gland that connects the two lobes and lies over the tracheal rings.

Isthmus (of the Uterus) Constricted area between the body of the uterus and the cervix.

IUGR (intrauterine growth retardation) An abnormal process in which the development and maturation of a fetus is impeded by genetic factors, maternal disease, or fetal malnutrition.

J

Jaundice Yellow-green to orange cast or coloration of skin, sclera, or mucous membranes; caused by an elevated bilirubin level.

Joining Stage Introduction or first stage of the interview pro­cess, during which the nurse and patient establish rapport.

Joint Union between two bones.

K

Keratosis Lesions on the epidermis characterized by overgrowth of the horny layer.

Ketosis A condition characterized by the increased production of ketone bodies.

Kilocalorie Amount of heat required to raise 1 gram of water 1 degree centigrade; also called calorie.

Knock Knees See Genu Valgum .

Korotkoff Sounds Sounds generated when the flow of blood through an artery is altered by the inflation of a blood pressure cuff around the extremity.

Kussmaul's Respirations Respirations characterized by ex­treme increased rate and depth, as in diabetic ketoacidosis.

Kwashiorkor Severe deficiency of protein.

Kyphosis Excessive convexity of the thoracic spine; known as “humpback.”

L

Labia Majora Two longitudinal folds of adipose and connective tissue that extend from the clitoris anteriorly and gradually narrow to merge and form the commissure of the perineum posteriorly.

Labia Minora Two thin folds of skin that enclose the vulval vestibule and extend to form the prepuce, or hood, of the clitoris anteriorly and a transverse fold of skin that forms the fourchette posteriorly.

Labyrinth Bony and membranous system of interconnecting tubes in the inner ear; essential for hearing and equilibrium.

Lacrimal Apparatus Lacrimal gland and ducts.

Lactiferous Ducts Openings at the nipple through which milk and colostrum are excreted.

Lagophthalmos Condition in which the patient is unable to completely close the eyelid.

Lanugo Fine, downy hair present during gestational life and that gradually disappears toward the end of pregnancy; it remains in smaller quantities over the temples, back, shoulders, and upper arms after birth.

Lens Crystalline structure of the eye that changes shape to refract light from various focusing distances.

Lentigo Areas of hyperpigmentation resulting from the inability of melanocytes to produce even pigmentation of the skin; known as “liver spots.”

Lesion Circumscribed, pathological change in tissue.

Lichenification Localized thickening, hardening, and roughness of the skin; can be a result of chronic pruritus.

Life Event or Transitional Developmental Theory Belief that development occurs in response to specific events, such as new roles (e.g., parenthood), and life transitions (e.g., career changes).

Life Review Reflection on the experiences, relationships, and events of one's life as a whole, viewing successes and failures from the perspective of age, and accepting one's life and accompanying life choices and outcomes in their entirety.

Lift See Heave .

Ligament Strong, fibrous, connective tissue that connects bones to each other at a joint.

Light Palpation Superficial palpation; depressing the skin 1 cm to elicit information on skin texture and moisture, masses, fluid, muscle guarding, and tenderness.

Lightening Descent of the presenting fetal part into the pelvis.

Limbus Junction of the sclera and cornea.

Linea Alba Tendinous tissue that extends from the sternum to the symphysis pubis in the middle of the abdomen.

Linea Nigra Darkening of the abdominal linea alba during pregnancy.

Linear Raphe Linear ridge in the middle of the hard palate.

Lipoma Nonmobile, fatty mass with a smooth, circular edge.

List Leaning of the spine.

Listening Response Attempt made by the nurse to accurately receive, process, and respond to the patient's messages.

Lobes (of the Breast) Glandular breast tissue arranged radially in the form of 12 to 20 spokes.

Lobules (of the Breast) Grapelike bunches that are clustered around several lactiferous ducts; each lobe is composed of 20 to 40 lobules that contain milk-producing glands called alveoli or acini.

Long-Term Outcome Goal that a patient strives to achieve and having a time frame of weeks or months.

Lordosis Excessive concavity of the lumbar spine.

Low-Density Lipoprotein Substance that carries cholesterol toward the heart.

Lunula White, crescent-shaped area at the proximal end of each nail.

Lymphatic Drainage Yellow, alkaline drainage originating in the lymph vessels and composed primarily of lymphocytes.

M

Macromineral Major mineral needed by the body in large amounts.

Macrosomia Newborn weighing more than 4,000 grams.

Macula Tiny, darker area in the temporal area of the retina.

Major Defining Characteristics Signs and symptoms that must be present in the patient to use a specific NANDA-approved diagnostic label.

Manubriosternal Junction See Angle of Louis .

Manubrium Upper bone of the sternum; it articulates with the clavicles and the first pair of ribs.

Marasmus Form of protein calorie malnutrition.

Mast cells Body's major source of tissue histamine, which triggers the body's reaction to invasive allergens.

Mastectomy Excision, or surgical removal, of the breast.

Maternal Serum Alpha-Fetal Protein (MSAFP) A blood test to screen for certain fetal abnormalities.

Matrix Undifferentiated epithelial tissue from which keratinized cells arise to form the nail plate.

McBurney's Point Anatomic location that is approximately at the normal location of the appendix in the right lower quadrant; point of increased tenderness in appendicitis.

Meconium Dark-green, sticky, stool-like material ex­creted from the rectum of the newborn within the first 24 hours after birth.

Mediastinum (Interpleural Space) Area between the lungs.

Mediate Auscultation See Indirect Auscultation .

Mediate Percussion See Indirect Percussion .

Medullary Cavity Interior of the diaphysis; contains the bone marrow.

Melanocytes Cells that produce pigmented substances that provide color to the hair, skin, and choroid of the eye.

Melasma Irregular pigmentation on the face due to pregnancy; also known as chloasma.

Melena Black, tarry stool.

Menarche Onset of menstruation.

Ketosis A condition characterized by the increased production of ketone bodies.

Menopause Cessation of menstruation.

Menorrhagia Heavy menses.

Mercury Manometer Blood pressure measurement equipment that uses a calibrated column of mercury that corresponds to blood pressure values.

Meridian Therapy Mode of therapy based on the circulation of electromagnetic energy that flows along defined pathways called meridians (e.g., acupuncture, acupressure).

Mesentery A double layer of peritoneum attached to the abdominal wall and enclosing in its fold a portion or all of one of the abdominal viscera.

Metatarsus Varus Medial forefoot misalignment

Microcephaly Small brain with a resultant small head.

Micromineral Trace mineral needed by the body in small amounts.

Microphallus Small penis for developmental stage.

Mid-Arm Circumference (MAC) Anthropometric mea­surement that provides information on skeletal muscle mass and adipose tissue.

Mid-Arm Muscle Circumference (MMAC) Anthropometric measurement derived from mid-arm circumference; provides information on skeletal muscle mass and adipose tissue.

Midaxillary Line Vertical line drawn from the apex of the axilla; it lies midway between the anterior and the posterior axillary lines.

Midclavicular Line Vertical line drawn from the midpoint of the clavicle.

Midspinal (or Vertebral) Line Vertical line drawn from the midpoint of the spinous processes.

Midsternal Line Vertical line drawn from the midpoint of the sternum.

Milia Plugged sebaceous glands manifesting as small, white papules and appearing on the infant's head, especially on the cheeks and nose.

Milk Line Ectodermal galactic band that develops from the axilla to the groin during the fifth week of fetal development.

Mineral Inorganic element that regulates body processes and builds body tissue; classified into macro­minerals and micro­minerals.

Minor Defining Characteristics Signs and symptoms that need not be present in the patient to use a specific NANDA-approved diagnostic label but add validity to the diagnosis.

Minority Group Members Individuals who are considered by themselves and others to be members of a minority because they have a different racial, ethnic, cultural, gender, socioeconomic, or sexual orientation than the members of the dominant cultural group.

Molding Condition in which the newborn's parietal bone overrides the frontal bone as a result of increased pressure during delivery.

Mongolian Spots Various, irregularly sized areas of deep bluish pigmentation on the upper back, shoulders, buttocks, and lumbosacral area of newborns of African, Latino, and Asian descent.

Monotheism Belief in one all-powerful, omnipresent, and omnipotent god.

Monounsaturated Fats Fatty acids that contain one double bond between carbon atoms.

Mons Pubis Pad of subcutaneous fatty tissue lying over the anterior symphysis pubis.

Montgomery's Tubercles Sebaceous glands present on the surface of the areola.

Morbidity Illness or abnormality rate; the number of cases per unit of population.

Mortality Death rate; the number of deaths per unit of population.

Multicultural Identity Unique combination of cultural influences that result from membership in a variety of subcultures within the primary culture.

Multiparous Any number of prior deliveries.

Multiculturalism The act of living and functioning in two or more cultures simultaneously.

Murphy's Sign Abnormal finding elicited during abdominal palpation in the right upper quadrant and revealing gallbladder inflammation; characteristically, the patient will abruptly stop inspiration and complain of sharp pain with palpation.

Myopia Nearsightedness.

N

Nabothian Cysts Small, round, yellow lesions on the cervical surface.

Nailbed Vascular bed located beneath the nail plate.

Nail Plate Tissue that covers and protects the distal portion of the fingers and toes.

Nail Root Nail portion that is posterior to the cuticle and attached to the matrix.

NANDA North American Nursing Diagnosis Association; the professional nursing organization that sets the standards for the development, clinical testing, and approval of nursing diagnoses.

Naturalistic Illness Illness believed to be caused by an imbalance or disequilibrium between essentially impersonal factors, for example, hot and cold.

Neologism Word coined by a patient that is meaningful only to the patient.

Nevi Pigmented moles that may be flat or elevated.

New Age A popular, heterogeneous, free-flowing spiritual movement that has no holy book, organization, membership, clergy, geographic center, dogma, or creed, but includes a cluster of common beliefs that may be grafted onto an existing religion.

Nipple A round, hairless, pigmented protrusion of erectile tissue approximately 0.5 to 1.5 cm in diameter located in the center of the breast.

Nirvana Buddhist belief of the perfect blessedness and peace of the soul.

Nitrogen Component of amino acids.

Nociception A multistep process that involves the nervous system and other body systems in perceiving pain.

Nociceptors Receptive neurons of pain sensation that are located in the skin and various viscera.

Nocturia Excessive urination at night.

Nonverbal Communication Communicating a message without using words.

Normocephalic Having a head of medium length.

Nulliparous Descriptor for a woman who has not given birth.

Nursing Care Plan Patient care record that uses the nursing process as its framework.

Nursing Diagnosis “A clinical judgment about individual, family, or community responses to actual or potential health problems/life processes” (NANDA, 2005, p. 277).

Nursing Process Dynamic, six-step process that uses information in a meaningful way through the use of problem-solving strategies to place the patient, family, or community in an optimal health state; includes assessment, nursing diagnosis, planning, outcome identification, implementation, and evaluation.

Nutrient Substance found in food that is nourishing or useful to the body.

Nutrition Processes of the human body that metabolize and utilize nutrients.

Nystagmus Involuntary oscillation of the eye.

O

Obesity Weight greater than 120% of ideal body weight.

Object Permanence Ability to form a mental image of an object and to recognize that, although removed from view, the object still exists.

Objective Data Data that are tangible or visible and can be corroborated by others; unbiased data not based on opinion or feeling.

Obturator Sign Differential technique for assessing appendicitis, indicative of an irritated obturator internus muscle.

Oedipus Complex Boys' sexual attraction toward their mothers and feelings of rivalry toward their fathers.

Oncology The branch of medicine concerned with the study of tumors and cancerous malignancies.

Onychomycosis A fungus infection of the nails.

Oogenesis Development and formation of an ovum.

Optic Disc Round area on the nasal side of the retina, where retinal fibers join to form the optic nerve.

Orchitis Acute onset of testicular swelling.

Orthopnea Difficulty breathing except in an upright position.

Orthostatic Hypotension Hypotension that occurs when changing from a supine to an upright position.

Osmotic Pressure The pressure exerted on a semipermeable membrane separating a solution from a solvent.

Ossicles Three tiny bones in the middle ear that play a crucial role in the transmission of sound: the malleus, the incus, and the stapes.

Osteoporosis Disease characterized by reduced bone mass.

Otitis Media Inflammation or infection of the middle ear.

Outcome Identification The fourth step of the nursing process.

Ovaries Pair of almond-shaped glands, approximately 3 to 4 cm in length, in the upper pelvic cavity; oogenesis and ­hormonal production are the ovaries' principal function.

Oxidation The process in which the body draws oxygen from the atmosphere.

P

Pack/Year History Term used to describe the quantity of ­cigarettes smoked over a period of time.

Pagan A person who does not belong to a monotheistic religion, or a person whose principles reflect an animistic and usually polytheistic, spirit-filled belief system.

Paget's Disease Malignant breast neoplasm, which is usually uni­lateral in its involvement and presents as persistent eczematous dermatitis of the areola and nipple.

Pain An unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage.

Pallor Lack of color.

Palpation Touching the patient in a diagnostic manner to elicit specific information.

Palpebral Conjunctiva Mucous membrane covering the interior surface of the eyelid.

Palpebral Fissure Opening between the eyelids.

Palpitation Irregular and rapid heart beat, or sensation of fluttering of the heart.

Pansystolic See Holosystolic .

Pantheism A religion in which god is believed to be in everything that exists, reincarnation, auras, energy fields, ecology, personal transformation, and evolution toward a “new age” in which wars and discrimination will not exist, and all will be peace and harmony.

Papilla Small projection on the dorsal surface of the tongue and containing opening to taste buds.

Papillary Layer Upper layer of the dermis; composed ­primarily of loose connective tissue, small elastic fibers, and an extensive network of capillaries that serve to nourish the ­epidermis.

Papule Red, solid, circumscribed, elevated area of the skin.

Paralytic Ileus Nonmechanical obstruction of the bowel resulting from paralysis of bowel wall, usually caused by peritonitis or shock.

Parameters Limits or boundaries.

Paranasal Sinuses Air-filled cavities in the cranial bones and lined with mucous membranes.

Paraphimosis Condition in which the retracted foreskin develops a fixed constriction proximal to the glans penis.

Paresthesia An abnormal sensation, such as numbness, pricking, or tingling.

Parietal Pericardium Pericardial layer that lies close to the fibrous tissues.

Parietal Pleura Lining of the chest wall and the superior ­surface of the lung.

Parish Nursing A movement in which nurses work within worship communities to promote spiritual and physical health.

Parous Descriptor for a woman who has given birth to one or more neonates.

Paroxysmal Nocturnal Dyspnea Acute shortness of breath appearing suddenly at night; caused by pulmonary congestion and edema that result from left-sided heart failure.

Past Health History History that covers the patient's health from birth to the present.

Pastoral Care Care and response needed when a person is in spiritual crisis.

Patient Goal Broad, unmeasurable statement directed toward removal of related factors or patient response to an adverse condition.

Patient Outcome Measureable statement of the ex­pected change in patient behavior.

Patient Profile Demographics that may be linked to health status.

Peau d'Orange Thickening or edema of the breast tissue or nipple; may present itself as enlarged skin pores that give the appearance of an orange rind.

Pectus Carinatum Abnormal thorax configuration in which there is a marked protrusion of the sternum; known as “pigeon chest.”

Pectus Excavatum Abnormal thorax configuration in which there is a depression in the lower body of the sternum; known as “funnel chest.”

Pediculosis Infestation with blood-sucking lice.

Penis Cylindrical male organ of copulation and urination.

Penis Envy Young girls' desire to have a penis.

Percussion Striking one object against another to cause vibrations that produce sound.

Pericarditis Inflammation of the pericardium.

Perineum External surface located between the fourchette and the anus.

Peripheral Vascular Resistance Opposing force against which the left ventricle must contract to pump blood into the aorta; also known as systemic vascular resistance.

Periungual Tissue Tissue that surrounds the nail plate and the free edge of the nail.

Personalistic Illness Illness that is believed to occur either because an individual committed some offense and is being punished, or as a result of acts of aggression (sometimes unintentional) by other individuals.

Pertinent Negatives Manifestations that are expected in the patient with a suspected pathology but that are denied or absent.

Pes Cavus Foot with an exaggerated height to the arch.

PES Method Acronym for problem, etiology, and signs or symptoms; the nursing diagnosis comprises these elements.

Pes Planus Foot with a low longitudinal arch; also known as “flatfoot.”

Pes Valgus Foot that is turned laterally away from the midline.

Pes Varus Foot that is turned inward toward the midline.

Petechiae Reddish purple skin discoloration that is less than 0.5 cm in diameter and does not blanch.

Philtrum The infranasal depression; the groove in the midline of the upper lip.

Phimosis Constriction of the distal penile foreskin that prevents normal retraction over the glans.

Phonophobia Abnormal sensitivity to, or fear of, sound.

Phoria Latent misalignment of an eye.

Photophobia Abnormal sensitivity to light, especially by the eyes.

Physiologic Cup Pale, central area of the optic disc.

Physiological Weight Loss Tendency of a neonate to lose approximately 10% of birth weight within a few days after birth and regain it by 2 weeks of age.

Pica Craving for substances other than food (e.g., dirt, clay, starch, ice cubes).

Pinguecula Yellow nodule on the nasal, or temporal, side of the bulbar conjunctiva.

Pinna External flap of the ear; also called the auricle.

Pitch (of Percussion) Highness or lowness of a sound.

Placenta Previa Placenta implantation partially (partial previa) or totally (complete previa) covering the cervical os.

Planning Third step of the nursing process; involves the ­prioritization of nursing diagnoses, formulation of patient goals, and selection of nursing interventions.

Pleura Serous sac that encases the lung.

Pleural Friction Fremitus Palpable grating that feels more pronounced on inspiration when there is an inflammatory process between the pleura.

Pleural Friction Rub Continuous adventitious breath sound caused by inflamed parietal and visceral pleura; it resembles a creaking or grating sound.

Pleximeter Stationary finger of the nondominant hand used in indirect percussion.

Plexor Middle finger of the dominant hand; used to strike the pleximeter to elicit sound in indirect percussion.

Polycythemia Elevated number of red blood cells.

Polydactyly Extra digits on the hand or foot.

Polydipsia Frequent drinking caused by extreme thirst.

Polyphagia Excessive eating; gluttony.

Polytheism Belief in many gods of different levels of power and status.

Posterior Axillary Line Vertical line drawn from the posterior axillary fold.

Posterior Chamber Space immediately posterior to the iris.

Posterior Triangle Area of the neck between the sterno­cleidomastoid and the trapezius muscles, with the clavicle at the base; contains the posterior cervical lymph nodes.

Postprandial After a meal.

Postictal Of or pertaining to the period after a convulsion.

Prayer Communication with a higher, spiritual power.

Prealbumin (also called thyroxine-binding prealbumin) The transport protein for thyroxine and retinol-binding protein.

Precordium Anterior area of the body that lies over the heart, its great vessels, the pericardium, and some pulmonary tissue.

Preload Resting force on the myocardium as determined by the pressure in the ventricles at the end of diastole.

Preprandial Before a meal.

Prepuce Foreskin covering the glans penis.

Presbycusis Hearing loss commonly found in older individuals.

Presbyopia Impaired near vision occurring in middle-aged or older individuals.

Priapism Abnormal prolonged penile erection unrelated to sexual desire.

Prioritize Ranking the patient's nursing diagnoses; the most critical concerns should be dealt with first.

Proprioception Position sense.

Prostate Glandular organ that lies anterior to the wall of the rectum and encircles the urethra; an accessory male sex organ.

Protein Group of complex nitrogenous compounds, each containing amino acids.

Proteinuria Presence of protein in the urine.

Prurigo Itchy skin eruptions of unknown cause.

Pruritus Severe itching.

Pterygium Triangular, yellow thickening of the bulbar conjunctiva, extending from the nasal side of the cornea to the pupil.

Ptosis Drooping of the eyelid.

Ptyalism Excessive secretion of saliva.

Puddle Sign Percussion technique that identifies an ascitic abdomen.

Pulmonary Vasculature The vascular network of the lungs.

Pulse Palpable expansion of an artery in response to cardiac functioning; used to determine heart rate, rhythm, and estimated volume of blood being pumped by the heart.

Pulse Deficit Apical pulse rate greater than radial pulse rate; occurs when some heart contractions are too weak to ­produce a palpable pulse at the radial site.

Pulse Pressure Difference between systolic and diastolic blood pressures.

Pulsus Paradoxus Pathological decrease in systolic blood pressure by 10 mm Hg or more on inspiration.

Puncta Opening at the inner canthus of the eye through which tears drain.

Punctum A minute, round spot differing in color or other appearance from surrounding tissues.

Pupil Opening in the center of the iris; regulates the amount of light entering the eye.

Purpura Condition characterized by the presence of confluent petechiae or confluent ecchymosis over any part of the body.

Pyelonephritis Kidney infection or inflammation.

Q

Qualifier See Descriptor .

Quality (of Percussion) Timbre; how a sound is perceived musically.

Quickening First fetal movements felt by the pregnant woman.

R

Race Classification of individuals based on shared inherited biological traits such as skin color, facial features, and body build.

Rash Cutaneous skin eruption that may be localized or ­generalized.

Reason for Seeking Health Care Problem or health care need that brought the patient to seek health care.

Rebound Tenderness Pain elicited during deep palpation, frequently associated with peritoneal inflammation or ­appendicitis.

Recommended Dietary Allowance Recommended amount of nutrients to be eaten daily; recommendations differ according to sex, age, and pregnancy or lactation status.

Rectal Prolapse Protrusion of the rectum through the anal orifice.

Rectocele Bulging of the posterior vaginal wall with a portion of the rectum.

Rectouterine Pouch Deep recess formed by the outer layer of the peritoneum; the lowest point in the pelvic cavity, encompassing the lower posterior wall of the uterus, the upper ­portion of the vagina, and the intestinal surface of the rectum.

Rectovaginal Septum Surface that separates the rectum from the posterior aspect of the vagina.

Rectum Lower portion of the large intestine; passes downward in front of the sacrum.

Reepithelialization Reformation of epithelium over denuded skin.

Regurgitation Backward flow of blood through a diseased heart valve; also known as insufficiency.

Reincarnation Belief that, after death, a person lives another life on earth in another body.

Related Factors “Factors that appear to show some type of patterned relationship with the nursing diagnosis” (NANDA, 2005, p. 278).

Religion Organized system of beliefs that is usually centered around the worship of a supernatural force or being and that, in turn, defines the self and the self's purpose in life.

Resonance Descriptor for a percussable sound that is loud in intensity, moderate to long in duration, low in pitch, hollow, and normally located in healthy lungs.

Respiration Breathing act that supplies oxygen to the body and occurs in response to changes in the concentration of oxygen, carbon dioxide, and hydrogen in the arterial blood.

Reticular Layer Lower layer of the dermis that is formed by a dense bed of vascular connective tissue; it also includes nerves and lymphatic tissue.

Reticuloendothelial System A functional, rather than anatomic, system of the body engaged primarily in defense against infection and disposal of the products of cell breakdown.

Retina Innermost layer of the eye.

Retraction A shrinking, drawing back, or pulling apart.

Retroflexed Uterus A condition in which the main body of the uterus is tipped back at the cervix.

Retromammary Adipose Tissue Tissue that composes the bulk of the breast.

Retroverted Uterus A uterus that is displaced backward, with the cervix pointing upward toward the symphysis pubis.

Reversibility The understanding that an action does not need to be experienced before one can anticipate the results or consequences of the action.

Review of Systems The patient's subjective response to a series of body-system–related questions; serves as a double-check that vital information is not overlooked.

Rhonchal Fremitus Coarse, palpable vibration produced by the passage of air through thick exudate in the large bronchi or the trachea.

Rinne Test Method of evaluating hearing loss by comparing air and bone conduction of tuning fork vibrations.

Risk Nursing Diagnosis “ Describes human responses to health conditions/life processes that may develop in a vulnerable individual, family, or community” (NANDA, 2005, p. 277).

Ritual Solemn, ceremonial act that reinforces faith.

Rod Retinal structure responsible for peripheral vision and dark or light discrimination.

Rovsing's Sign Technique to elicit referred pain indicative of peritoneal inflammation.

S

Saturated Fats Lipids derived from animal or vegetable sources.

Scapular Line Vertical line drawn from the inferior angle of the scapula.

Schismatic Person who shares the essential beliefs or dogma of a religion but who is separated from the group because of political or other disagreements.

Scientific Illness Illness in which the presence of pathology is the defining characteristic.

Sclera Opaque covering of the eye; appears white.

Scoliosis Lateral curvature of the thoracic or lumbar ­vertebrae.

Scrotum Pouchlike supporting structure of the testes.

Sebaceous Glands Sebum-producing glands that are found almost everywhere in the dermis except for the palmar and plantar surfaces.

Seborrhea Dandruff.

Sebum Oily secretion that is thought to retard evaporation and water loss from the epidermal surface.

Seizure Transient disturbance of cerebral function caused by an excessive discharge of neurons.

Semicircular Canals Anterior, posterior, and lateral canals in the bony labyrinth of the inner ear that provide balance and equilibrium.

Seminal Vesicles Paired pouches located posteriorly to and at the base of the bladder; fluid from here forms 60% of the volume of semen.

Septum (of the Heart) Wall that divides the left side of the heart from the right side.

Sequela A morbid condition occurring as a consequence of a disease; (plural is sequelae).

Sequelae Aftermath.

Serum Iron Amount of transferrin-bound iron.

Shaman A magico-religious phenomenon appearing in Europe, Asia, the Americas, and Australia; shamanic healers make use of trance states and spirit helpers.

Shifting Dullness Abnormal finding elicited during percussion and corresponding to positive identification of ascites.

Short-Term Outcome Goal that a patient strives to achieve in a relatively brief time frame (hour, day, or week).

Sickle Cell Anemia A severe, chronic, anemic condition in which abnormal hemoglobin results in distortion and fragility of the erythrocytes.

Sighing Normal respiration interrupted by a deep inspiration and followed by a deep expiration.

Sign Objective finding.

Sin Deliberate and conscious act against the teachings of a belief system.

Sinoatrial (S-A) Node Normal pacemaker of the heart; intrinsic adult rate is approximately 70 beats per minute.

Sjögren's Syndrome A congenital condition characterized by ichthyosis, mental deficiency, and spastic paralysis.

Skene's Glands (Paraurethral Glands) Glands that open in a posterolateral position to the urethral meatus and provide lubrication to protect the skin.

Skinfold Thickness Anthropometric measurement to determine body fat stores and nutritional status.

Smegma White, cottage cheese-type substance sometimes found under the female labia minora or the male foreskin.

Snap High-pitched sound that is heard in early diastole; ­usually occurs in mitral stenosis.

Snellen Chart Chart used for testing distance vision; contains letters of various sizes with standardized visual acuity numbers at the end of each line of letters.

Social History Information that is related to the patient's lifestyle that can have an impact on health.

Soul Essential, spiritual part of a person; thought to continue after physical death.

Spasticity Increase in muscle tension on passive stretching, especially rapid or forced stretching of a muscle.

Spermatic Cord Connective tissue sheath made up of arteries, nerves, veins, lymphatic vessels, and the cremaster ­muscle.

Spermatocele Well-defined cystic mass on the superior testes.

Spermatogenesis Production of sperm.

Sphygmomanometer Gauge used to measure blood ­pressure; consists of a blood pressure cuff with an inflatable bladder, connecting tubes, bulb air pump, and a manometer.

Spider Angioma Bright-red, star-shaped vascular marking that often has a central pulsation; it blanches in the extensions when pressure is applied.

Spinnbarkeit Elasticity of cervical mucus during ovulation.

Spirit Soul, being, or supernatural force.

Spiritual Distress State in which a person feels that the belief system, or her or his place within it, is threatened.

Spirituality A person's concern for the meaning and purpose of life.

Sputum Substance that is produced by the respiratory tract and can be expectorated or swallowed; it is composed of mucus, blood, purulent material, microorganisms, cellular debris, and, occasionally, foreign objects.

Squamocolumnar Junction Cervical area between the squamous epithelial surface and the columnar epithelial ­surface.

Stadiometer An instrument for measuring standing or sitting height.

Standard Deviation (In statistics) a mathematic statement of the dispersion of a set of values or scores from the mean.

Standard Precautions Practices health care providers use to prevent the exchange of blood and body fluids when coming into contact with a patient; outlined by the Centers for Disease Control and Prevention (CDC).

Steatorrhea Pale-yellow, greasy, fatty stool.

Stenosis Narrowing or constriction (e.g., diseased heart valve).

Stensen's Ducts Openings from the parotid glands; located just opposite the upper second molars.

Stereognosis Ability to identify objects by manipulating and touching them.

Sternal Angle See Angle of Louis .

Stork Bites See Telangiectatic Nevi .

Strabismus True deviation of gaze due to extraocular muscle dysfunction.

Stratum Corneum Horny layer, or outer layer of the epidermis.

Stratum Germinativum Basal cell layer, or deepest layer of the epidermis.

Stratum Granulosum Epidermal layer where skin cell death occurs; it overlays the stratum spinosum.

Stratum Lucidum Additional skin layer found exclusively on the palmar and plantar surfaces.

Stratum Spinosum Epidermal layer that overlays the stratum germinativum and consists of layers of polyhedral cells.

Stress Physiologically defined response to changes that disrupt the resting equilibrium of an individual.

Striae Atrophic lines or scars commonly found on the abdomen, breasts, thighs, or buttocks.

Striae Gravidarum Stretch marks that occur in pregnancy.

Stroke Cerebrovascular accident; a condition of occlusion or hemorrhage of blood vessels of the brain, resulting in ischemia of brain tissues normally perfused by the damaged vessels.

Stroke Volume The amount of blood ejected by the ventricle during a ventricular contraction.

Subculture Within a larger cultural group, a smaller group whose members share most of the beliefs and ways of life of the larger cultural group but differ on others.

Subcutaneous Tissue Superficial fascia, composed of loose areolar connective tissue or adipose tissue, depending on its location in the body; it lies below the dermis.

Subjective Data Information perceived by the patient to be real; such data cannot always be verified by an independent observer.

Subluxation Partial dislodgement of a bone from its place in the joint cavity.

Sulcus Terminalis Midline depression separating the anterior two-thirds from the posterior one-third of the tongue.

Superego Personality component that represents the internalization of the moral values formed as children interact with their parents and significant others.

Supernumerary Nipples Extra nipples or breast tissue along the milk line resulting from incomplete atrophy of the galactic band.

Suprapubic Located above the symphysis pubis.

Suprasternal Notch Visible and palpable depression in the midsternal line superior to the manubrium.

Sutures Immovable joints connecting the cranial bones.

Sweat Glands Glands that produce perspiration; composed of two types: eccrine and apocrine glands.

Symptom Subjective finding.

Syncope Fainting; transient loss of consciousness due to decreased oxygen or glucose supply to the brain.

Syndactyly Fusion between two or more digits on the hand or foot.

Synovial Effusion Excessive synovial joint fluid.

Systemic Circulation The circulation of the blood through the arteries, capillaries, and veins of the general circulatory system.

Systemic Vascular Resistance See Peripheral Vascular Resistance .

Systole Phase in the cardiac cycle during which the myo­cardial fibers contract and tighten to eject blood from the ventricles; ­correlates with the first Korotkoff sound.

T

Tachycardia Pulse rate greater than 100 beats per minute in an adult.

Tachypnea Respiratory rate greater than 20 breaths per minute in an adult.

Tactile (or Vocal) Fremitus Palpable vibration of the chest wall that is produced by the spoken word.

Tail of Spence Upper outer quadrant of the breast that extends into the axilla.

Talipes equinovarus (clubfoot) Medially adducted and inverted toes and forefoot.

Tangential Lighting Light that is shone at an angle on the patient to accentuate shadows and highlight subtle findings.

Tarsal Plates Connective tissue that gives shape to the upper eyelid.

Taxonomy Classification system.

Telangiectatic Nevi Marks appearing on the back of the neck, lower occiput, upper eyelids, and upper lip of the ­newborn that are flat, deep, irregular, and pink in light-skinned ­children and deep-red in dark-skinned children; also known as “stork bites.”

Temperature Vital sign collected to assess core body heat.

Tendons Epimysium ends that attach a muscle to a bone.

Teratoma A neoplasm composed of multiple tissues, including tissues not normally found in the organ in which it arises.

Terminal Hair Coarse body hair in the axillary and pubic areas as well as the eyebrows, eyelashes, scalp, and, in men, the chest and face.

Termination Stage Last segment of the interview process, during which information is summarized and validated.

Testes Pair of ovoid glands located in the scrotum.

Tetralogy of Fallot The most common form of cyanotic congenital heart disease; the tetralogy consists of high pulmonic stenosis, ventricular septal defect, dextroposition of the aorta, and right ventricular hypertrophy.

Thenar Eminence Rounded prominence at the base of the thumb.

Thoracic Expansion The extent and symmetry of chest wall expansion.

Thrill Vibrations related to turbulent blood flow that feel similar to what one feels when a hand is placed on a purring cat.

Thrombolytic Therapy Treatment directed to dissolving blood clots.

Thrombophlebitis Venous inflammation with thrombus formation.

Thrombosis The formation or presence of a thrombus; clotting within a blood vessel.

Tilts Set of blood pressures taken in supine, sitting, and standing positions.

Tonsillectomy Removal of the tonsil.

Torticollis Lateral deviation of the neck; intermittent or sustained dystonic contraction of the muscles on one side of the neck.

Total Iron-Binding Capacity (TIBC) Amount of iron with which transferrin can bind.

Transferrin Protein that regulates iron absorption.

Transmission-Based Precautions Infection control practices involving contact, droplet, and airborne transmission of microorganisms that are known to exist in a patient or are suspected in a patient. They are practiced in conjunction with Standard Precautions.

Triceps Skinfold Anthropometric measurement used to determine body fat stores and nutritional status.

Triglyceride Substance that accounts for most of the fat stored in the body's tissues.

True Ribs See Vertebrosternal Ribs .

Tubular Breath Sound See Bronchial Breath Sound .

Turbinate (or Concha) Projection from the lateral wall of the nose and covered with mucous membranes that greatly increase the surface area within the nose.

Turgor Elasticity of the skin; it reflects the skin's state of hydration.

Tumescence Swelling.

Tussive Fremitus Palpable vibration produced by coughing.

Tympany Descriptor for a percussable sound that is loud in intensity, long in duration, of high pitch, drumlike, and normally located over a gastric air bubble.

U

Ulcerative Colitis A chronic, episodic, inflammatory disease of the large intestine and rectum.

Urethra Duct from the urinary bladder to the urethral meatus; carries urine and, in the male, semen.

Urticaria A pruritic skin eruption characterized by transient wheals of varying shapes and sizes and caused by capillary dilation.

Uterus Inverted pear-shaped, hollow, muscular organ in which the impregnated ovum develops into a fetus.

Uvula Fingerlike projection hanging down from the center of the soft palate.

V

Vagal Stimulation Maneuvers that result in increased electrical activity of the main nerve of the parasympathetic nervous system supplying the heart; may cause slowing of the heart.

Vagina Pink, hollow, muscular tube extending from the cervix to the vulva, located posterior to the bladder and anterior to the rectum.

Vaginal Introitus Entrance to the vagina, situated at the inferior aspect of the vulval vestibule.

Value Orientation Patterned principles (about time, human nature, activity, relations, and people-to-nature) that provide order and give direction to an individual's thoughts and behaviors related to the solution of commonly occurring human ­problems.

Varicocele Bluish mass resulting from abnormal dilatation of the veins of the pampiniform plexus of the spermatic cord.

Vasopressor An agent that promotes constriction of blood vessels.

Vellus Hair Fine, faint hair that covers most of the body.

Venous Hum Continuous, medium-pitched sound originating in the inferior vena cava and associated with obstructed portal circulation.

Venous Star Linear or irregularly shaped blue vascular pattern on the skin; does not blanch when pressure is applied.

Vernix Caseosa Protective integumentary mechanism of the newborn; consists of sebum and shed epithelial cells.

Vertebra Prominens The long spinous process of the ­seventh cervical vertebra.

Vertebrosternal (or True) Ribs Rib pairs 1–7; they articulate via the costal cartilage to the sternum.

Vertigo Dizziness or lightheadedness.

Vesicular Breath Sound Breath sound that is low in pitch and soft in intensity and is heard best over the peripheral lung; has a breezy, gentle rustling quality; heard longer on inspiration than expiration.

Vestibule Boat-shaped area between the labia minora and ­containing the urethral meatus, the openings of the Skene's glands, the hymen, the openings of the Bartholin's glands, and the vaginal introitus.

Vestibule (of the Ear) Part of the inner ear located between the cochlea and the semicircular canals.

Visceral Pericardium Pericardial layer that lies against the actual heart muscle.

Visceral Pleura Lining of the external surface of the lungs.

Visual Analog Scale Numerical scale used to rate pain from 0 to 10.

Vital Signs Measurements, including temperature, pulse, respirations, and blood pressure, that provide an index of the patient's physiological status.

Vitamin Organic substance needed to maintain the function of the body.

Vitiligo Patchy, symmetrical areas of white on the skin.

Vitreous Humor Gelatinous material that fills the center ­cavity of the eye and helps maintain the shape of the eye and the position of the internal structures.

Vocal Fremitus See Tactile Fremitus

Voice Sounds Techniques used to assess whether the lungs are filled with air, fluid, or a solid.

W

Water-Soluble Vitamin Vitamin soluble in water; is not stored in the body and is excreted in the urine.

Weber Test Tuning fork test to evaluate hearing loss and determine whether the loss is conductive or sensorineural.

Wellness Nursing Diagnosis “Describes human responses to levels of wellness in an individual, family, or community that have a readiness for enhancement.” (NANDA, 2005, p. 277)

Wharton's Ducts Openings from the submaxillary glands; located on either side of the frenulum.

Whispered Pectoriloquy Voice sound where the patient whispers the words “ninety-nine” or “one, two, three” to determine if the lungs are filled with air, fluid, or a solid.

Working Stage That segment of the interview process during which the majority of data are collected.

X

Xanthelasma Creamy, yellow plaque on the eyelid and secondary to hypercholesterolemia.

Xerosis Excessive dryness of the skin.

Xiphoid Process Cartilaginous process at the base of the sternum; it does not articulate with the ribs.