Medical-surgical terms

87 terms

ABCDE approach: A systematic assessment of an acutely ill or injured person: Airway, Breathing, Circulation, Disability (level of consciousness by AVPU or the Glasgow Coma Scale, pupils, blood glucose) and Exposure (examine the whole body while preventing heat loss). Treat each problem as it is found before moving on, and reassess after every intervention. In trauma, catastrophic external bleeding is controlled first.
Abdominal aortic aneurysm: A permanent widening of the abdominal aorta to a diameter of 3 cm or more, linked to atherosclerosis, smoking, hypertension, male sex and older age. Most are silent and are found on imaging or as a pulsating abdominal mass; the risk of rupture rises with size and growth rate. Sudden, severe abdominal or back pain with hypotension suggests rupture and needs emergency surgery. Keep blood pressure in the ordered range and teach smoking cessation.
Activities of daily living: The tasks a person does to live independently. Basic activities of daily living (ADLs) are self-care tasks such as bathing, dressing, toileting, transferring, continence and feeding (Katz index). Instrumental activities (IADLs) are more complex tasks such as shopping, cooking, housework, using the telephone, transport, and managing medicines and money (Lawton scale). Report a sudden loss of function as a possible sign of acute illness.
Acute coronary syndrome: An umbrella term for a sudden drop in blood flow to the heart muscle, usually from a ruptured coronary plaque with a clot on it: unstable angina (no myocardial necrosis), non-ST-elevation MI (NSTEMI) and ST-elevation MI (STEMI). The ECG and serial troponin levels tell them apart, and STEMI needs emergency reperfusion, preferably by percutaneous coronary intervention. Treat chest pain as ACS until proved otherwise: obtain a 12-lead ECG within minutes, start cardiac monitoring, draw troponin, and give oxygen as ordered if saturation is below 92% or as agency protocol directs.
Acute kidney injury: A fall in kidney function over hours to days. By KDIGO criteria it is a creatinine rise of ≥0.3 mg/dL within 48 hours or to 1.5 times baseline within 7 days, or urine output below 0.5 mL/kg/h for 6 hours. Causes are prerenal (hypovolemia), intrarenal (nephrotoxic drugs, ischemia) and postrenal (obstruction). Monitor urine output, fluid balance, potassium and nephrotoxic drugs.
Acute pancreatitis: Acute inflammation in which activated digestive enzymes injure the pancreas and surrounding tissue; gallstones and alcohol are the leading causes. Severe, constant epigastric pain radiating to the back, with nausea and vomiting, is typical, and a high serum lipase supports the diagnosis. Severe cases bring hypovolemia, hypocalcemia, hyperglycemia, ARDS, kidney injury and shock. Give IV fluids and analgesics as ordered; monitor vital signs, intake and output, glucose and calcium; and help the client sit up and lean forward with knees bent for comfort.
Acute respiratory distress syndrome: Acute, diffuse inflammatory lung injury in which leaky alveolar capillaries flood the alveoli with fluid (noncardiogenic pulmonary edema), leaving stiff lungs and hypoxemia that responds poorly to oxygen. Sepsis, pneumonia, aspiration, major trauma and pancreatitis are common triggers. It begins within 1 week of the trigger, with bilateral infiltrates and a PaO2/FiO2 ratio of 300 mmHg or less. Care centers on lung-protective mechanical ventilation with PEEP and, when severe, prone positioning; monitor oxygenation and prevent ventilator-associated pneumonia.
Acute respiratory failure: Failure of the lungs to oxygenate the blood, to remove carbon dioxide, or both. A PaO2 below 60 mmHg is a critical value, and rising carbon dioxide makes the blood more acidic (pH falls). Causes include pneumonia, COPD exacerbation, asthma, pulmonary edema, opioid overdose and neuromuscular weakness. Restlessness, anxiety and confusion come early, with tachypnea, tachycardia and accessory muscle use; drowsiness and cyanosis are late. Position the client upright, give oxygen as ordered, monitor arterial blood gases, and prepare for noninvasive ventilation or intubation.
Adrenal insufficiency: Too little cortisol, plus too little aldosterone in primary disease (Addison's disease). Autoimmune destruction is the main primary cause; abruptly stopping long-term corticosteroids commonly causes secondary insufficiency. Fatigue, weight loss, hypotension, hyponatremia and hypoglycemia are typical; primary disease adds hyperkalemia and darkening of the skin. Adrenal crisis, triggered by infection, surgery or missed steroid doses, causes shock and needs IV hydrocortisone and fluids at once. Teach the client never to stop steroids abruptly, to follow sick-day rules and to wear medical ID.
Anaphylaxis: A life-threatening systemic allergic reaction that develops within minutes of exposure to an allergen such as a food, drug, insect sting or latex. Hives, swelling of the lips and tongue, stridor, wheezing, hypotension and vomiting may occur. Intramuscular epinephrine is the first-line treatment and must not be delayed. Stop the allergen, call for help, protect the airway, position the client, and keep monitoring for a late (biphasic) reaction.
Anemia: A hemoglobin level or red cell count below normal for age and sex; by WHO thresholds, hemoglobin below 13 g/dL in adult men and below 12 g/dL in nonpregnant women. Fatigue, pallor, tachycardia and exertional dyspnea are common. Iron deficiency is the most common cause; bleeding, B12 or folate deficiency and chronic disease are others. Assess activity tolerance and fall risk, and give nutrition teaching.
Angina pectoris: Chest pain or pressure from temporary myocardial ischemia, when narrowed coronary arteries cannot meet the heart's oxygen demand. Stable angina comes on predictably with exertion or emotional stress, lasts a few minutes, and is relieved by rest or nitroglycerin. Pain that is new, occurs at rest or is getting worse is unstable angina, an acute coronary syndrome. During an episode, have the client stop and rest, assess the pain and vital signs, obtain a 12-lead ECG, and give nitroglycerin as ordered.
Atelectasis: Collapse of alveoli or of a lung segment or lobe, so that part of the lung is not ventilated. It is common after surgery, when pain, sedation and immobility lead to shallow breathing and retained secretions, and it also occurs with airway obstruction. Reduced breath sounds, crackles over the area, tachypnea and falling oxygen saturation are typical; large areas cause hypoxemia. Prevention is a core postoperative nursing task: coach deep breathing, coughing and incentive spirometry, give adequate pain relief, turn the client and get them out of bed early.
Atrial fibrillation: One of the most common arrhythmias: chaotic, rapid electrical activity in the atria replaces effective atrial contraction. The pulse is irregularly irregular, and palpitations, fatigue and dyspnea may occur. Blood pooling in the atria can clot and cause a stroke, so many clients need anticoagulation. Count the apical pulse for a full minute, monitor the rhythm, and watch for bleeding and signs of stroke.
Atrioventricular block: Delayed or interrupted conduction of sinus impulses from the atria to the ventricles. In first-degree block the PR interval exceeds 0.20 s and every P wave is conducted; in second-degree block some P waves are not followed by a QRS (type I: the PR lengthens progressively; type II: the PR is constant and beats drop suddenly); in third-degree (complete) block the atria and ventricles beat independently. Type II and complete block can cause bradycardia, hypotension and syncope: monitor rhythm and perfusion, review drugs such as beta blockers and digoxin, and prepare for pacing as ordered.
Brain death: The irreversible loss of all brain function, including the brainstem; legally, it is death. In Türkiye, Law 2238 requires two physicians outside the transplant team, a neurologist or neurosurgeon and an anesthesiology-reanimation or intensive care specialist, to decide unanimously. Since 2025, a donation wish declared in life prevails over relatives; without one, the family is asked. Notify the organ donation coordinator early, help maintain oxygenation, blood pressure, temperature and fluid balance, and support the family.
Carbon monoxide poisoning: Poisoning from breathing carbon monoxide, an odorless, colorless gas often produced by faulty stoves, water heaters and boilers, a common winter emergency in Türkiye. It binds hemoglobin far more tightly than oxygen, and standard pulse oximeters read carboxyhemoglobin as oxyhemoglobin, so SpO2 can look falsely normal. Headache, dizziness, nausea and confusion may affect several people in one home. Remove the person from the source, give high-flow oxygen and measure carboxyhemoglobin.
Cardiac tamponade: Compression of the heart by fluid, blood or clot in the pericardial sac, so the ventricles cannot fill and cardiac output falls sharply. It can follow chest trauma, cardiac surgery, pericarditis, cancer or kidney failure. Classic signs are Beck's triad (hypotension, jugular venous distension, muffled heart sounds), tachycardia and pulsus paradoxus, a fall in systolic pressure of more than 10 mmHg on inspiration. It is an emergency: report it at once, monitor vital signs closely, and prepare the client for emergency pericardiocentesis or surgical drainage.
Cardiopulmonary resuscitation: Chest compressions and rescue breaths that maintain circulation and breathing in cardiac arrest. Under the ERC 2025 adult basic life support guideline, compress the center of the chest 5–6 cm deep at 100–120 per minute, allow full recoil and keep pauses to a minimum; without an advanced airway, give 30 compressions to 2 breaths, and use a defibrillator as soon as possible. In hospital, call the code blue team.
Central venous pressure: The blood pressure in the vena cava near the right atrium, measured through a central venous catheter; it reflects right-heart filling pressure. Read it with other findings to judge fluid status and right ventricular function: a low value suggests hypovolemia, and a high value suggests fluid overload, right-sided heart failure, pulmonary hypertension or cardiac tamponade; trends matter more than one reading.
Chemotherapy: Cancer treatment with drugs that target rapidly dividing cells. Because it also affects normal cells of the bone marrow, the lining of the mouth and gut, and hair follicles, it causes low blood counts, mucositis, nausea and vomiting, and hair loss; the point when blood counts are lowest is the nadir. As hazardous drugs, they are prepared by trained staff; nurses wear chemotherapy-tested gloves and gowns and watch for extravasation of vesicants.
Chest tube drainage: A tube in the pleural space, joined to a closed system with a one-way water seal, drains air, fluid or blood so the lung can re-expand. Keep the unit upright, below chest level, with no kinked tubing. Water rising and falling with breathing in the water seal is normal; constant bubbling means an air leak. Record drainage amount and color; report cloudy drainage or drainage averaging more than 200 mL an hour for 4 hours. If the tube disconnects, put its end in sterile water; if it comes out, cover the site with a sterile occlusive dressing taped on three sides and notify the provider at once.
Chronic kidney disease: Kidney damage or loss of function lasting more than 3 months, defined by a GFR below 60 mL/min/1.73 m² or markers of damage such as albumin in the urine. Diabetes and hypertension are the leading causes. As it progresses, wastes, fluid, potassium and phosphate build up, and anemia, metabolic acidosis, hypertension and bone disease follow; stage 5 (kidney failure) needs dialysis or a transplant. Monitor weight, blood pressure, intake and output and electrolytes, avoid nephrotoxic drugs, and protect the arm veins for future dialysis access.
Chronic obstructive pulmonary disease: A chronic lung disease with persistent, often progressive airflow obstruction from airway and/or alveolar abnormalities, caused mainly by tobacco smoke but also by biomass smoke and occupational exposures. Dyspnea, chronic cough and sputum are typical. In clients who retain carbon dioxide, titrate oxygen to a target saturation (usually 88–92%). Teach pursed-lip breathing, effective coughing, smoking cessation and vaccination.
Chronic venous insufficiency: Impaired return of blood from the legs because damaged vein valves (e.g., after deep vein thrombosis) or chronically distended veins let blood pool and venous pressure rise. Aching, heavy legs, edema worse on standing, varicose veins, brown skin discoloration, stasis dermatitis and ulcers with irregular edges, usually on the medial lower leg, are typical; pulses are usually present. Elevate the legs above heart level, encourage walking, check arterial flow (e.g., ankle-brachial index) before prescribed compression, which is unsafe in severe arterial disease, and protect the fragile skin.
Cirrhosis: Late-stage liver damage in which fibrous tissue and nodules replace normal tissue, most often from alcohol, chronic hepatitis B or C, or fatty liver disease. Portal hypertension and failing liver function lead to ascites, esophageal varices that can bleed massively, jaundice, a bleeding tendency and, as ammonia builds up, hepatic encephalopathy (confusion, asterixis). Weigh the client daily, measure abdominal girth, watch for bleeding and changes in mental status, give lactulose as ordered, avoid sedatives broken down by the liver, and support alcohol abstinence.
Comprehensive geriatric assessment: A multidisciplinary assessment of an older adult's physical health, functional ability (activities of daily living), cognition and mood, nutrition, continence, fall risk and mobility, medicines, sensory function and social situation, including carers and home safety. Brief tools such as the Mini-Cog, the Geriatric Depression Scale and the Mini Nutritional Assessment are used. It leads to a coordinated care plan that aims to keep the person independent.
Deep vein thrombosis: A clot in a deep vein, usually in the leg; Virchow's triad (stasis, vessel wall injury, hypercoagulability) sums up the risk factors. Unilateral leg swelling, pain, warmth and redness may occur, but it can be silent. Its most serious complication is pulmonary embolism. Prevention includes early mobilization, intermittent pneumatic compression and ordered anticoagulant prophylaxis.
Defibrillation: Delivering an electric shock to the heart to stop a chaotic rhythm so that a normal rhythm can return. It is used only for shockable rhythms, ventricular fibrillation and pulseless ventricular tachycardia, not for asystole or pulseless electrical activity. An automated external defibrillator (AED) analyzes the rhythm itself. Make sure no one is touching the patient just before the shock, and resume chest compressions at once afterwards.
Dehydration: A fluid deficit that develops when the body loses more fluid than it takes in. Thirst, dry mucous membranes, poor skin turgor, scant dark urine, tachycardia and orthostatic hypotension are typical; confusion in older adults and a sunken fontanelle in infants are important signs. Monitor intake and output, daily weight and electrolytes, and give oral or IV fluid replacement as ordered.
Diabetes mellitus: Chronic hyperglycemia caused by defective insulin secretion, insulin action or both. Type 1 involves autoimmune destruction of beta cells and requires insulin; type 2 involves insulin resistance with a progressive loss of beta-cell insulin secretion. Diagnostic criteria include fasting plasma glucose ≥126 mg/dL and HbA1c ≥6.5%. Nursing care centers on glucose monitoring, foot care, hypoglycemia teaching and self-management support.
Diabetic ketoacidosis: Life-threatening metabolic acidosis from ketone build-up when severe insulin deficiency drives fat breakdown; usually in type 1 diabetes after an infection or missed insulin. 2024 consensus criteria: glucose ≥200 mg/dL or known diabetes, ketonemia, and pH <7.3 and/or bicarbonate <18 mmol/L. Glucose can be near normal (euglycemic DKA), e.g., with SGLT2 inhibitors. Kussmaul respirations, fruity breath and dehydration are typical. Treatment centers on IV fluids, an insulin infusion and close potassium monitoring.
Epilepsy: A brain disorder with a lasting tendency to unprovoked seizures: sudden bursts of abnormal electrical activity that change movement, sensation, awareness or behavior. A seizure lasting 5 minutes or more, or repeated seizures without recovery in between, is status epilepticus, an emergency. During a seizure, stay with the client, note the time and features, ease them to the floor or onto their side, protect the head, loosen tight clothing and never put anything in the mouth. Afterward, keep the airway clear, check orientation and injuries, and give antiseizure drugs on schedule.
Extravasation: Leakage of a vesicant (tissue-damaging) drug out of the vein into the surrounding tissue; it starts with pain, burning, swelling and redness and can cause tissue necrosis. Leakage of a non-vesicant fluid is called infiltration. Stop the infusion at once, notify the physician, follow the institution's protocol for that drug (aspiration, antidote, cold or warm compress), elevate the limb, and mark, document and monitor the area.
Frailty: Reduced physiological reserve in an older adult that leaves the person vulnerable to minor stressors such as an infection, surgery or a new medicine; it travels with geriatric syndromes such as falls, delirium, incontinence and pressure injuries. Signs include unintended weight loss, exhaustion, weakness, slow walking and low physical activity. Screen for frailty and support exercise, adequate protein intake and medication review.
Gastrointestinal bleeding: Bleeding anywhere in the digestive tract. Upper GI bleeding, from a peptic ulcer, esophageal varices or gastritis, shows as hematemesis (bright red or coffee-ground) or melena (black, tarry stool); lower GI bleeding, from diverticula, tumors, hemorrhoids or colitis, usually shows as red or maroon blood from the rectum. Brisk bleeding causes tachycardia, orthostatic hypotension, pallor, falling hemoglobin and shock. Monitor vital signs and stools, start two large-bore IV lines, send blood for type and crossmatch, and give fluids and blood as ordered.
Glasgow Coma Scale: A scale that scores level of consciousness by eye opening, verbal response and motor response; the three scores add up to a total from 3 (lowest) to 15 (best). Lower scores mean deeper impairment; 8 or below indicates severe brain injury and coma. Record each component as well as the total (e.g., E3V4M5) and report a drop of 2 or more points from the previous score at once.
Heart failure: The heart cannot pump enough blood to meet the body's needs. Left-sided failure causes pulmonary congestion (dyspnea, orthopnea, crackles); right-sided failure causes systemic congestion (peripheral edema, jugular venous distension, hepatomegaly). Weigh the client daily under the same conditions, report a gain of more than 1 kg in a day or 2 kg in a week, and teach sodium restriction, fluid restriction when prescribed, and medication adherence.
Hemodialysis: Removal of wastes and excess fluid by pumping blood through an external dialyzer, usually three times a week, through an arteriovenous fistula, graft or central dialysis catheter. Check a fistula or graft for a palpable thrill and an audible bruit, and never take blood pressure, start an IV or draw blood in that arm. Weigh the client before and after each session. Watch for hypotension, muscle cramps, and bleeding or other problems at the access site.
Hyperkalemia: Serum potassium above the lab's upper limit (typically 5.0–5.1 mmol/L), mainly from kidney failure, ACE inhibitors, potassium-sparing diuretics or tissue breakdown. It can cause muscle weakness, paresthesias and arrhythmias ranging from peaked T waves to cardiac arrest. Put the client on a cardiac monitor, remember that fist clenching during the blood draw can falsely raise the result, and review potassium sources.
Hypernatremia: Serum sodium above 145 mEq/L, nearly always a relative water deficit: water loss through fever, diarrhea or diabetes insipidus, or too little intake, especially in infants and in older or dependent people who cannot reach water or do not feel thirst. Water leaves the brain cells, causing thirst, restlessness, confusion, lethargy and seizures. Monitor neurological status, intake and output, daily weight and serum sodium, and offer water to clients who cannot get it themselves. Correct chronic hypernatremia slowly; rapid correction can cause cerebral edema.
Hyperosmolar hyperglycemic state: A life-threatening hyperglycemic crisis, mainly in older adults with type 2 diabetes, in which there is enough insulin to prevent ketoacidosis but not to control glucose. 2024 consensus criteria include glucose of 600 mg/dL or more and an effective serum osmolality above 300 mOsm/kg without significant ketonemia or acidosis. It develops over days, often after infection or poor fluid intake, and causes profound dehydration and confusion, seizures or coma. Treatment starts with IV fluids, then insulin; monitor neurological status, glucose, osmolality, potassium, and intake and output.
Hypertension: Persistently elevated blood pressure. US (ACC/AHA) guidelines define it as ≥130/80 mmHg, while the WHO uses ≥140/90 mmHg. It is usually silent but raises the risk of stroke, heart attack and kidney disease. Measure with correct technique, and teach salt restriction, exercise and medication adherence.
Hypertensive crisis: A severe rise in blood pressure, usually above 180/120 mmHg. It is a hypertensive emergency when there is acute target-organ damage, such as encephalopathy, stroke, acute coronary syndrome, pulmonary edema, aortic dissection or acute kidney injury, and a hypertensive urgency when there is not. An emergency needs IV drugs and continuous monitoring in intensive care; because the fall must be controlled, mean arterial pressure is usually lowered by about 20–25% at first (faster and further in aortic dissection). Monitor headache, vision, chest pain and neurological status.
Hyperthyroidism: Excess thyroid hormone that speeds up metabolism, most often from Graves' disease or toxic nodular goiter. Heat intolerance, sweating, weight loss despite a good appetite, palpitations, tachycardia or atrial fibrillation, tremor, anxiety and diarrhea are typical; Graves' disease can make the eyes bulge. Thyroid storm, triggered by infection, surgery or stress, brings high fever, severe tachycardia, agitation or delirium and can be fatal. Monitor heart rate and rhythm, weight and temperature; provide a cool, calm room and high-calorie diet; protect the eyes; give antithyroid drugs as ordered.
Hypervolemia: An excess of isotonic fluid in the extracellular space, from heart failure, kidney failure, cirrhosis, excess sodium intake, or IV fluids given faster than the body can handle. Rapid weight gain, edema, distended neck veins, a bounding pulse, hypertension, crackles and dyspnea are typical, and it can progress to pulmonary edema. Weigh the client daily at the same time on the same scale, monitor intake and output and lung sounds, apply the ordered sodium and fluid restriction and diuretic therapy, and raise the head of the bed for dyspnea.
Hypocalcemia: Total serum calcium below the lab's lower limit (about 8.6 mg/dL); ionized (unbound) calcium may also be measured. Causes include parathyroid injury after thyroid or parathyroid surgery, vitamin D deficiency, chronic kidney disease, acute pancreatitis and hypomagnesemia. Neuromuscular irritability is the hallmark: numbness around the mouth and in the fingers, muscle cramps, tetany, positive Chvostek's and Trousseau's signs, laryngospasm, seizures and a prolonged QT. Take seizure precautions, monitor the airway and rhythm, and give calcium as ordered.
Hypoglycemia: Blood glucose below 70 mg/dL; below 54 mg/dL is level 2 hypoglycemia, which needs immediate treatment. Sweating, shakiness, palpitations, hunger, confusion and loss of consciousness can occur; it is common with insulin and sulfonylureas. In a conscious client use the 15-15 rule: give 15 g of fast-acting carbohydrate, recheck after 15 minutes and repeat until glucose is at least 70 mg/dL, then give a snack or meal. Give nothing by mouth to an unconscious client: call for help and give glucagon or IV glucose as ordered.
Hypokalemia: Serum potassium below 3.5 mmol/L; vomiting, diarrhea and loop or thiazide diuretics are common causes. Muscle weakness, cramps, constipation, U waves on the ECG and arrhythmias occur, and it raises the risk of digoxin toxicity. Never give potassium as an IV push; give it diluted, by infusion pump. Oral potassium can irritate the stomach, so give it with food.
Hypomagnesemia: Serum magnesium below the normal range, common with alcohol use disorder, malnutrition, chronic diarrhea, diuretics and long-term proton pump inhibitor use. Like hypocalcemia, it raises neuromuscular and cardiac excitability: tremor, tetany, seizures and arrhythmias, including torsades de pointes. It often comes with hypokalemia and hypocalcemia. Monitor the cardiac rhythm, take seizure precautions, and during IV replacement check deep tendon reflexes, respirations and blood pressure.
Hyponatremia: Serum sodium below 135 mmol/L, usually reflecting a relative excess of body water (e.g., inappropriate ADH secretion, heart failure, diuretics). It can progress from headache to confusion, seizures and coma. Monitor neurological status, take seizure precautions and apply fluid restriction as ordered. Correcting chronic hyponatremia too fast can cause osmotic demyelination.
Hypothyroidism: Too little thyroid hormone, which slows metabolism; Hashimoto's thyroiditis is the most common cause where iodine intake is adequate, and treating hyperthyroidism is another. Fatigue, cold intolerance, weight gain, constipation, dry skin, hair loss, bradycardia, slowed thinking and depression develop gradually and are easily missed in older adults. Myxedema coma, often triggered by infection, cold or sedatives, brings hypothermia, hypoventilation and reduced consciousness. Teach that levothyroxine is lifelong and taken each morning on an empty stomach; give sedatives and opioids cautiously.
Increased intracranial pressure: Rising pressure inside the skull as the volume of brain tissue, blood or cerebrospinal fluid grows from trauma, bleeding, a tumor or edema. The earliest sign is a change in level of consciousness; Cushing's triad (hypertension, bradycardia and irregular respirations) is a late warning of brain herniation, and abnormal posturing signals severe brain damage. Raise the head of the bed to 30°, keep the head midline and perform frequent neurological checks.
Mechanical ventilation: Moving air into the lungs with a machine, usually through an endotracheal tube or tracheostomy, when a client's own breathing is not enough. Monitor the tube's position and depth at the lips, suction when needed, answer alarms by looking at the patient first, and apply the ventilator-associated pneumonia bundle (head of bed 30–45 degrees, oral care, daily sedation interruption). If a problem cannot be fixed at once, ventilate with a bag-valve device.
Multiple sclerosis: A chronic immune-mediated disease in which the central nervous system's myelin is damaged, slowing or blocking nerve conduction; it usually begins in young adults, more often women, and most often follows a relapsing-remitting course. Symptoms depend on the lesions: vision loss or double vision, numbness, weakness, spasticity, fatigue, balance problems, and bladder and bowel dysfunction. Heat, infection and stress can worsen symptoms. Help the client conserve energy, prevent falls, keep cool, manage bladder function and spasticity, and support adherence to treatment.
Myasthenia gravis: An autoimmune disease in which antibodies block acetylcholine receptors at the neuromuscular junction, so muscle weakness worsens with activity and improves with rest. Drooping eyelids and double vision are often the first signs; weakness of the chewing, swallowing, speech and breathing muscles follows. Infection, surgery, stress and some drugs can trigger myasthenic crisis, respiratory failure that needs ventilation. Give anticholinesterase drugs on time, ideally before meals, check swallowing before feeding, monitor respiratory effort, and report a weakening cough.
Myocardial infarction: Death of heart muscle from ischemia when a coronary artery is blocked. The classic symptom is chest pain or heaviness that does not ease with rest and spreads to the arm, jaw or back; women, older adults and people with diabetes often present atypically with dyspnea, nausea or fatigue. Diagnosis rests on the ECG and troponin. Obtain a 12-lead ECG within minutes of arrival and monitor pain and rhythm: time is muscle.
Neutropenia: An abnormally low neutrophil count, usually an absolute neutrophil count below 1500/mm³; below 500/mm³ is severe. Chemotherapy is the most common cause. With too few cells to make pus or inflammation, infection shows few signs and fever may be the only clue: a single temperature of 38.3 °C (101 °F) or higher, or 38.0 °C (100.4 °F) or higher for an hour, is febrile neutropenia, an emergency needing cultures and IV antibiotics within an hour. Practice meticulous hand hygiene, avoid rectal temperatures, keep sick visitors away, and teach the client to report fever at once.
Oliguria: Reduced urine output, in adults usually defined as less than 500 mL per day or, in hospitalized clients, less than 0.5 mL/kg/h. It can be an early sign of hypovolemia, shock, acute kidney injury or urinary obstruction. In a catheterized client first check the catheter for kinks or blockage, then monitor hourly output and report the decrease. Output below 50 mL per day is called anuria.
Oral mucositis: Painful inflammation and ulceration of the lining of the mouth caused by chemotherapy or head and neck radiotherapy; it makes eating and drinking hard and opens a route for infection. Assess the mouth daily, keep up oral hygiene with a soft toothbrush and bland rinses as the protocol directs, advise avoiding alcohol-based mouthwash, tobacco and spicy, acidic or rough foods, and control pain.
Palliative care: WHO describes palliative care as an approach that improves the quality of life of patients and families facing life-threatening illness, by early identification and relief of pain and other physical, psychosocial and spiritual problems. It can start at diagnosis, alongside curative treatment, not only at the end of life. In Türkiye, hospital palliative care centers and home health services provide it. Manage symptoms and support the client and family, including in grief.
Parkinson's disease: A progressive neurodegenerative disease in which dopamine-producing neurons of the substantia nigra are lost. Its cardinal signs are resting tremor (often pill-rolling), rigidity, bradykinesia and postural instability, with a shuffling gait, masked face, soft voice, constipation and orthostatic hypotension; depression and dementia may follow. Give levodopa and other antiparkinson drugs exactly on time, because a late dose can cause sudden immobility. Prevent falls, assess swallowing to prevent aspiration, and encourage physical activity and safe self-care.
Peptic ulcer disease: Erosion of the stomach or duodenal lining into deeper layers, caused mainly by Helicobacter pylori infection and NSAIDs; smoking and alcohol add risk. Burning or gnawing epigastric pain is typical: duodenal ulcer pain often eases with food and wakes the client at night, while gastric ulcer pain may worsen after meals. Bleeding (coffee-ground vomitus, black tarry stools) and perforation (sudden severe abdominal pain with a rigid abdomen) are emergencies. Teach the client to avoid NSAIDs and smoking and to finish H. pylori treatment, and report signs of bleeding.
Peripheral artery disease: Narrowing of the arteries to the limbs, usually the legs, by atherosclerosis; smoking and diabetes are major risk factors. The classic symptom is intermittent claudication: calf pain on walking that rest relieves. Advanced disease brings rest pain, weak or absent pulses, cool, pale, hairless skin and painful ulcers on the toes; an ankle-brachial index below 0.90 supports the diagnosis. Assess pulses and skin, keep the legs level or slightly dependent rather than elevated, and support walking exercise, foot care and smoking cessation.
Peritoneal dialysis: Dialysis that uses the client's own peritoneum as the filter: dialysate is instilled into the abdomen through a catheter, left to dwell, then drained with the wastes and excess fluid. It can be done at home, by hand or overnight by machine. Peritonitis is the main complication, so teach strict hand hygiene and aseptic connections, and have cloudy effluent, abdominal pain or fever reported at once. Warm the dialysate as instructed (never microwave an unwrapped bag); record inflow and outflow amounts and the effluent's appearance, and check the catheter exit site.
Pleural effusion: An abnormal collection of fluid between the visceral and parietal pleura. It builds up when fluid enters the pleural space faster than it can be reabsorbed, as in heart, kidney or liver failure, or with pneumonia or cancer. Dyspnea, cough and sharp chest pain that worsens with deep breaths are typical. For thoracentesis, help the client into the ordered position, usually sitting on the edge of the bed; afterward, monitor breathing, vital signs and the puncture site, and report signs of pneumothorax.
Pneumonia: Infection of the lung parenchyma, most often by bacteria or viruses. Fever, cough, sputum, pleuritic chest pain, tachypnea and crackles are typical; in older adults confusion may be the first sign. Monitor oxygenation, collect cultures before the first antibiotic dose, and encourage deep breathing, coughing and early mobility. Aspiration precautions and vaccination help prevent it.
Pneumothorax: Air in the pleural space that partly or fully collapses the lung. It can be spontaneous (e.g., with lung disease such as COPD), traumatic, or caused by procedures such as central line insertion. Sudden pleuritic chest pain, dyspnea, tachypnea, and reduced or absent breath sounds on the affected side are typical. In tension pneumothorax, rising pressure in the chest pushes the trachea away from the affected side and cardiac output and blood pressure fall; this emergency needs immediate needle decompression. Sit the client upright, give oxygen as ordered and prepare for chest tube insertion.
Premature ventricular contraction: An early beat that starts in a ventricle instead of the sinus node: it has a wide, bizarre QRS and is usually followed by a pause. Occasional PVCs are common and often harmless; frequent, paired or differently shaped PVCs signal a more serious problem, such as heart failure or an electrolyte imbalance (e.g., low potassium or magnesium), or come from caffeine, energy drinks or alcohol; a PVC that falls on the T wave (R-on-T) can trigger ventricular tachycardia. Assess for low blood pressure and dizziness, review potassium and magnesium, and report rising PVC frequency.
Pulmonary embolism: Blockage of a pulmonary artery, most often by a clot that has broken off from a leg vein. Sudden dyspnea, pleuritic chest pain, tachycardia, tachypnea, anxiety and hypoxemia are typical; a large embolus can cause very low blood pressure and be life-threatening. Call for help, raise the head of the bed, give oxygen as ordered, monitor vital signs and prepare for anticoagulation.
Radiation therapy: Treatment that damages the DNA of cancer cells with high-energy radiation. With external beam radiotherapy the patient is not radioactive; with a temporary internal implant (brachytherapy) and some systemic radioactive treatments the patient emits radiation for a time, and time, distance and shielding apply. Side effects depend on the treated area; wash the skin gently with lukewarm water and mild soap, keep the markings and protect the area from sun.
Sepsis and septic shock: Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. In septic shock, vasopressors are needed to keep mean arterial pressure at 65 mmHg or above despite adequate fluids, and lactate is above 2 mmol/L. Fever or hypothermia, tachycardia, tachypnea, confusion and hypotension are warning signs. Early recognition saves lives: obtain cultures and start antibiotics and fluids without delay.
Shock: A life-threatening state in which inadequate blood flow and oxygen delivery cause cellular dysfunction. Types include hypovolemic, cardiogenic, septic, anaphylactic and neurogenic shock. Signs include tachycardia, hypotension, cool clammy skin (it may be warm in sepsis), falling urine output and altered mental status. Monitor vital signs, mean arterial pressure and urine output closely.
Sickle cell disease: An inherited (autosomal recessive) hemoglobin disorder in which hemoglobin S makes red cells rigid and sickle-shaped under stress, so they block small vessels and break down early. Vaso-occlusive pain crises, chronic hemolytic anemia, acute chest syndrome, stroke, spleen damage that invites serious infection, and organ injury result. Dehydration, hypoxia, cold, infection and stress trigger crises. Treat pain promptly, reassess it often, give fluids and oxygen as ordered, keep the client warm, and watch for fever, chest pain, new dyspnea (acute chest syndrome) and neurological changes.
Sinus bradycardia: A regular rhythm from the sinus node at a rate below 60 beats/min, with a normal P wave before every QRS. It can be normal in athletes, but beta blockers, digoxin, hypothermia, hypothyroidism, increased intracranial pressure and strong vagal stimulation also cause it. Many clients have no symptoms; dizziness, fatigue, hypotension, confusion or syncope mean perfusion is inadequate. Assess the client, not just the monitor: check blood pressure and mental status, review medications, and report symptomatic bradycardia at once.
Sinus tachycardia: A regular rhythm from the sinus node at a rate above 100 beats/min in an adult, with a normal P wave before every QRS. It is usually the heart's response to a trigger such as fever, pain, anxiety, hypovolemia, bleeding, hypoxemia, anemia or stimulants; a fast rate shortens the filling time between beats. Treat the cause, not the rate: assess pain, temperature, fluid status, oxygen saturation and signs of bleeding, and report a new, persistent tachycardia.
Stroke: A sudden disruption of blood flow to the brain from a blocked vessel (ischemic stroke) or bleeding (hemorrhagic stroke). Warning signs include facial droop, arm weakness, speech difficulty, sudden vision loss and loss of balance (BE-FAST). Treatment windows are counted from when the client was last known well, so record when symptoms began or, if that is unknown, when the client was last known to be well. Give nothing by mouth until a swallow screen is done, and prevent aspiration and falls.
Supraventricular tachycardia: The general term for tachycardias that start above the ventricles; it usually means paroxysmal SVT: a narrow-QRS tachycardia, often faster than 160 beats/min, that starts and stops suddenly. Palpitations, dizziness, dyspnea and chest discomfort are common; a very fast rate can cause hypotension. In a stable client, try vagal maneuvers first, then adenosine as ordered as a rapid IV bolus as close to the client as possible, followed at once by a rapid saline flush, on a cardiac monitor; an unstable client needs synchronized cardioversion.
Thrombocytopenia: A platelet count below 150 × 10³/µL, from reduced production (chemotherapy, leukemia, bone marrow failure), increased destruction (immune thrombocytopenia, heparin-induced thrombocytopenia, DIC) or pooling in the spleen. Petechiae, easy bruising, bleeding gums, nosebleeds and blood in the urine or stool are warning signs; at very low counts, spontaneous bleeding can occur. Use bleeding precautions: a soft toothbrush and electric razor, no IM injections or rectal procedures when avoidable, no aspirin or NSAIDs, and fall prevention; report any new bleeding.
TNM staging: A system that describes how far a cancer has spread: T is the size and extent of the primary tumor, N whether regional lymph nodes are involved and M whether there is distant metastasis. These combine into stages 0 to IV. Tumor grade describes how abnormal the cells look under the microscope; higher-grade tumors tend to grow faster. The stage guides treatment and prognosis.
Tumor lysis syndrome: An oncologic emergency in which rapid breakdown of cancer cells, as treatment starts, releases potassium, phosphate and uric acid into the blood, causing hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia and acute kidney injury. Risk is highest with fast-growing, bulky cancers such as some leukemias and lymphomas. Give hydration and preventive drugs as ordered, monitor urine output, electrolytes and the ECG, and report signs of arrhythmia at once.
Urinary incontinence: Involuntary leakage of urine. The main types are stress (with coughing, sneezing or lifting), urge (with a sudden strong need to void), overflow (from a bladder that does not empty fully) and functional (cannot reach the toilet in time because of mobility or cognitive problems) incontinence. It is not a normal part of aging. Look for the cause, support timed voiding and pelvic floor exercises, and keep the skin clean and dry.
Urinary tract infection: Infection anywhere in the urinary tract, most often by Escherichia coli ascending from the urethra. Cystitis (bladder) causes dysuria, frequency, urgency and suprapubic pain; pyelonephritis (kidney) adds fever, chills, flank pain and costovertebral angle tenderness and can progress to sepsis. Older adults may show only new confusion. Collect a midstream or catheter urine specimen for culture before the first antibiotic dose, encourage fluids unless restricted, and teach the client to finish the course. Asymptomatic bacteriuria usually needs no treatment, except in pregnancy.
Urolithiasis: Stones in the urinary tract, most often containing calcium; dehydration, a diet high in salt and animal protein, gout and recurrent infection raise the risk. A stone moving down the ureter causes renal colic: sudden, severe, wave-like flank pain spreading to the groin, often with nausea, vomiting and hematuria. Give analgesics as ordered, strain all urine and save any stone for analysis, and record intake and output. Fever or chills with an obstructing stone suggest infection and need urgent treatment. Teach generous fluid intake to prevent recurrence.
Ventricular fibrillation: Chaotic electrical activity in the ventricles that produces no effective contraction, no cardiac output and no pulse; the ECG shows an irregular, wavy line with no recognizable QRS. It is a shockable cardiac arrest rhythm and is fatal within minutes without treatment. Because a loose lead can mimic VF, confirm that the client is unresponsive and pulseless before acting on the monitor. Call for help, start high-quality CPR at once and defibrillate as soon as a defibrillator arrives; the shock must be given as fast as possible.
Ventricular tachycardia: A wide-QRS tachycardia that starts in the ventricles, often at a rate above 120 beats/min. Coronary artery disease, earlier heart damage, heart failure, electrolyte imbalances such as low potassium or magnesium, and some drugs are causes, and it can degenerate into ventricular fibrillation. Assess the client first: with no pulse, start CPR and defibrillate at once; with a pulse but hypotension, altered mental status or chest pain, prepare for synchronized cardioversion; give a stable client antiarrhythmic drugs as ordered.
Wound dehiscence: Partial or complete separation of the edges of a surgical wound. Obesity, diabetes, infection, poor nutrition and anything that raises abdominal pressure, such as coughing, increase the risk. Evisceration (organs protruding through the wound) is an emergency: cover them with sterile saline-moistened dressings, place the client in low Fowler's position, keep the client NPO and notify the surgeon at once.