Chapter 50 Key Terms Page 1379

Adventitious breath sounds

abnormal breath sounds that occur when air passes through narrowed airways or airways filled with fluid or mucus, or when pleural linings are inflamed

Apneaa complete absence of respirations

Atelectasiscollapse of the air sacs

Biot's respirationsshallow breaths interrupted by apnea

Bradypneaabnormally slow respiratory rate, usually less than 10 respirations per minute

Cheyne-Stokes respirations

rhythmic waxing and waning of respirations from very deep breathing to very shallow breathing with periods of temporary apnea, often associated with cardiac failure, increased intracranial pressure, or brain damage

Closed suction system

a method for suctioning an endotracheal tube or tracheostomy in which the suction catheter, enclosed in a plastic sheath, attaches to the ventilator tubing, and the client does not need to be disconnected from the ventilator

Cyanosisa bluish tinge of skin color

Diffusionthe mixing of molecules or ions of two or more substances as a result of random motion

Dyspneadifficult or labored breathing

Emphysemaa chronic pulmonary condition in which the alveoli are dilated and distended

Erythrocytesred blood cells, or RBCs

Eupneanormal, quiet breathing

Expectoratespit out

Hematocritthe proportion of red blood cells (erythrocytes) to the total blood volume

Hemothoraxthe accumulation of blood in the pleural cavity

Humidifiera device that adds water vapor to inspired air

Hypercapniaa condition in which carbon dioxide accumulates in the blood

Hypercarbia (hypercapnia)

accumulation of carbon dioxide in the blood

Hyperinflation

giving the client breaths that are greater than the client's normal tidal volume set on the ventilator through the ventilator circuit or via a manual resuscitation bag

Hyperoxygenationincreasing the oxygen flow before suctioning and between suction attempts to avoid suction-related hypoxemia

Hyperventilationvery deep, rapid respirations

Hypoxemialow partial pressure of oxygen or low saturation of oxyhemoglobin in the arterial blood

Hypoxiainsufficient oxygen anywhere in the body

Incentive spirometer (sustained maximal inspiration device, SMI)

a device that measures the flow of air inhaled through a mouthpiece

Intrapleural pressure

pressure in the pleural cavity surrounding the lungs

Intrapulmonary pressure

pressure within the lungs

Kussmaul's breathing

hyperventilation that accompanies metabolic acidosis in which the body attempts to compensate (give off excess body acids) by blowing off carbon dioxide through deep and rapid breathing

Lung complianceexpansibility of the lung

Lung recoilthe tendency of lungs to collapse away from the chest wall

Orthopneaability to breathe only when in an upright position (sitting or standing)

Oxyhemoglobinthe compound of oxygen and hemoglobin

Partial pressurethe pressure exerted by each individual gas in a mixture according to its percentage concentration in the mixture

Pneumothoraxaccumulation of air in the pleural space

Postural drainagepositioning of a client to allow the drainage, by gravity, of secretions from the lungs

Respiratory membrane

where gas exchange occurs between the air on the alveolar side and the blood on the capillary side; the alveolar and capillary walls form the respiratory membrane

Sputumthe mucous secretion from the lungs, bronchi, and trachea

Stridora harsh, crowing sound made on inhalation caused by constriction of the upper airway

Suctioningthe aspiration of secretions through a catheter connected to a suction machine or wall suction outlet

Surfactant

a surface-active agent (e.g., soap or a synthetic detergent); in pulmonary physiology, a mixture of phospholipids secreted by alveolar cells into the alveoli and respiratory air passages that reduces the surface tension of pulmonary fluids and thus contributes to the elastic properties of pulmonary tissue

Tachypneaabnormally fast respirations; usually more than 24 respirations per minute

Tidal volumethe volume of air that is normally inhaled and exhaled, 500mL

Torrmillimeters of mercury

Vibrationa series of vigorous quiverings produced by hands that are placed flat against the chest wall to loosen thick secretions

Chapter 51 Key Terms Page 1427

Afterloadthe resistance against which the heart must pump to eject blood into the circulation

Atherosclerosisbuildup of fatty plaque within the arteries

Atriatwo upper hollow chambers of the heart

Atrioventricular (AV) node

conduction pathways that slightly delay transmission of the impulse

from the atria to the ventricles of the heart

Atrioventricular (AV) valves

between the atria and ventricles of the heart, the tricuspid valve on the right and the bicuspid or mitral valve on the left

Automaticityan electrical impulse and contraction independent of the nervous system and generated by the cardiac muscle

Blood pressure (BP)the force exerted on arterial walls by blood flowing within the vessel

Bundle of Histhe right and left bundle branches of the ventricular conduction pathways

Cardiac arrestthe cessation of heart function

Cardiac output (CO)the amount of blood ejected by the heart with each ventricular contraction

Cardinal signssee Vital signs

Contractilitythe inherent ability of cardiac muscle fibers to shorten or contract

Coronary arteriesa network of vessels known as the coronary circulation

Creatine kinase (CK)

enzyme that is released into the blood during a myocardial infarction (MI)

Diastolein measuring blood pressure, the period during which the ventricles relax

Endocardiuma layer of the heart wall lining the inside of the heart's chambers and great vessels

Epicardiumthe visceral pericardium adhering to the surface of the heart, forming the heart's outermost layer

Heart failure

a condition that develops if the heart cannot keep up with the body's need for oxygen and nutrients to the tissues; usually occurs because of myocardial infarction, but it may also result from chronic overwork of the heart

Ischemiadeficiency of blood supply caused by obstruction of circulation to the body part

Myocardial infarction (MI)

heart attack; cardiac tissue necrosis owing to obstruction of blood flow to the heart

Myocardiuma layer of the heart wall; cardiac muscle cells that form the bulk of the heart and contract with each beat

Pericardium double layer of fibroserous membrane of the heart; the parietal, or outermost, pericardium serves to protect the heart and anchor it to

surrounding structures

Peripheral vascular resistance (PVR)

impedance or opposition to blood flow to the tissues; determined by viscosity, or thickness, of the blood; blood vessel length; blood vessel diameter

Preloadthe degree to which muscle fibers in the ventricle are stretched at the end of diastole

Purkinje fibersfibers of the ventricular conduction pathways that terminate in ventricular muscle, stimulating contraction

Semilunar valvescrescent moon-shaped valves between the cardiac ventricles and the pulmonary artery (pulmonic valve) and the aorta (aortic valve)

Septuma dividing structure such as that between the cardiac chambers or between the two sides of the nose

Sinoatrial (SA or sinus) node

the primary pacemaker of the heart located where the superior vena cava enters the right atrium

Stroke volume (SV)the amount of blood ejected with each cardiac contraction

Systolethe period during which the ventricles contract

Troponinenzyme that is released into the blood during a myocardial infarction (MI)

Ventriclestwo lower chambers of the heart

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Chapter 52 Key Terms Page 1450

Acida substance that releases hydrogen ions (H+) in solution

Acidosisa condition that occurs with increases in blood carbonic acid or with decreases in blood bicarbonate; blood pH below 7.35

Active transportmovement of substances across cell membranes against the concentration gradient

Agglutininsspecific antibodies formed in the blood

Agglutinogensa substance that acts as an antigen and stimulates the production of agglutinins

Alkalosis a condition that occurs with increases in blood bicarbonate or

decreases in blood carbonic acid; blood pH above 7.45

Anionsions that carry a negative charge; includes chlorine (Cl-), bicarbonate (HCO3-), phosphate (HPO42-), and sulfate (SO4-)

Antibodies

immunoglobulins, part of the body's plasma proteins, defend primarily against the extracellular phases of bacterial and viral infections

Bases(alkalis) have low hydrogen ion concentration and can accept hydrogen ions in solution

Buffersprevent excessive changes in pH by removing or releasing hydrogen ions

Cationsions that carry a positive charge; includes sodium (Na+), potassium (K+), calcium (Ca2+), and magnesium (Mg2+)

Central venous catheter

catheter that is usually inserted into the subclavian or jugular vein, with the distal tip of the catheter resting in the superior vena cava just above the right atrium

Colloid osmotic pressure

a pulling force exerted by colloids that help maintain the water content of blood

Colloidssubstances such as large protein molecules that do not readily dissolve into true solutions

Compensationdefense mechanism in which a person substitutes an activity for one that he or she would prefer doing or cannot do

Crystalloidssalts that dissolve readily into true solutions

Dehydrationinsufficient fluid in the body

Diffusionthe mixing of molecules or ions of two or more substances as a result of random motion

Drop factorthe number of drops that equal 1 mL as specified on the package of IV tubing

Electrolyteschemical substances that develop an electric charge and are able to conduct an electric current when placed in water; ions

Extracellular fluid (ECF)

fluid found outside the body cells

Filtrationprocess whereby fluid and solutes move together across a membrane from one compartment to another

Filtration pressurethe pressure in a compartment that results in the movement of fluid and substances dissolved in fluid out of the compartment

Fluid volume deficit(hypovolemia) loss of both water and electrolytes in similar proportions from the extracellular fluid

Fluid volume excess (FVE)

(hypervolemia) retention of both water and sodium in similar proportions to normal extracellular fluid (ECF)

Hematocritthe proportion of red blood cells (erythrocytes) to the total blood volume

Hemolytic transfusion reaction

destruction of red blood cells as a result of transfusion of incompatible blood

Homeostasis

the tendency of the body to maintain a state of balance or equilibrium while continually changing; a mechanism in which deviations from normal are sensed and counteracted

Hydrostatic pressure

the pressure a liquid exerts on the sides of the container that holds it; also called filtration force

Hypercalcemiaan excess of calcium in the blood plasma

Hyperchloremiaan excess of chloride in the blood plasma

Hyperkalemiaan excess of potassium in the blood plasma

Hypermagnesemiaan excess of magnesium in the blood plasma

Hypernatremiaan excess of sodium in the blood plasma

Hyperphosphatemiaan excess of phosphate in the blood plasma

Hypertonicsolutions that have a higher osmolality than body fluids

Hypervolemiaincreased blood volume

Hypocalcemiadeficiency of calcium in the blood plasma

Hypochloremiadeficiency of chloride in the blood plasma

Hypokalemiadeficiency of potassium in the blood plasma

Hypomagnesemiadeficiency of magnesium in the blood plasma

Hyponatremiadeficiency of sodium in the blood plasma

Hypophosphatemiadeficiency of phosphate in the blood plasma

Hypotonicsolutions that have a lower osmolality than body fluids

Hypovolemiaan abnormal reduction in blood volume

Infiltration occurs when the tip of the IV is outside the vein and the fluid is

entering the tissues instead; manifested by local swelling, coolness, pallor, and discomfort at the IV site

Insensible fluid lossfluid loss that is not perceptible to the individual

Interstitial fluidfluid that surrounds the cells, includes lymph

Intracellular fluid (ICF)

fluid found within the body cells, also called cellular fluid

Intravascular fluidplasma

Ionsatoms or group of atoms that carry a positive or negative electric charge; electrolytes

Isotonicsolutions that have the same osmolality as body fluids

Metabolic acidosis

a condition characterized by a deficiency of bicarbonate ions in the body in relation to the amount of carbonic acid in the body; the pH falls to less than 7.35

Metabolic alkalosis

a condition characterized by an excess of bicarbonate ions in the body in relation to the amount of carbonic acid in the body; the pH rises to greater than 7.45

Milliequivalentone-thousandth of an equivalent, which is the chemical combining power of a substance

Obligatory lossesessential fluid losses required to maintain body functioning

Oncotic pressuresee Colloid osmotic pressure

Osmolalitythe concentration of solutes in body fluids

Osmosis

passage of a solvent through a semipermeable membrane from an area of lesser solute concentration to one of greater solute concentration

Osmotic pressure

pressure exerted by the number of nondiffusible particles in a solution; the amount of pressure needed to stop the flow of water across a membrane

Overhydration

occurs when water is gained in excess of electrolytes, resulting in low serum osmolality and low serum sodium levels, also known as hypo-osmolar imbalance or water intoxication

Peripherally inserted central catheter (PICC)

a long venous catheter inserted in an arm vein and extending into the distal third of the superior vena cava

pHa measure of the relative alkalinity or acidity of a solution; a measure of the concentration of hydrogen ions

Pitting edema edema in which firm finger pressure on the skin produces an

indentation (pit) that remains for several seconds

Plasmathe fluid portion of the blood in which the blood cells are suspended

Renin-angiotensin-aldosterone system

system initiated by specialized receptors in the juxtaglomerular cells of the kidney nephrons that respond to changes in renal perfusion

Respiratory acidosis(hypercapnia) a state of excess carbon dioxide in the body

Respiratory alkalosis

a state of excessive loss of carbon dioxide from the body

Selectively permeable

cell membranes that allow substances to move across them with varying degrees of ease

Solutessubstances dissolved in a liquid

Solventthe liquid in which a solute is dissolved

Specific gravity

the weight or degree of concentration of a substance compared with that of an equal volume of another, such as distilled water, taken as a standard

Third space syndrome

fluid shifts from the vascular space into an area where it is not readily accessible as extracellular fluid

Transcellular fluid

compartment of extracellular fluids; includes cerebrospinal, pericardial, pancreatic, pleural, intraocular, biliary, peritoneal, and synovial fluids

Volume expanders used to increase the blood volume following severe loss of blood, or loss of plasma