Nursing terminology

332 terms used across the NCLEX, TEAS, and HESI, in plain English. These same definitions appear when you tap a term inside a question.

Showing 332 of 332

ACE inhibitor

A blood pressure drug ending in -pril. A dry cough and a rising potassium are the classic effects.

See also angiotensin receptor blocker

acetaminophenUS / Canada

A common analgesic and antipyretic. The NCLEX uses the generic name.

Elsewhere: Known as paracetamol in the UK, Ireland, India, Nigeria, Kenya, the Philippines, and most of the world. Same drug, and the name change is the single most common source of confusion for internationally educated nurses.

acidosis

The blood is more acidic than normal, with a pH below 7.35.

See also alkalosis, arterial blood gas

activities of daily living

Everyday self-care tasks: bathing, dressing, toileting, eating, and moving around.

acute kidney injury

A sudden drop in kidney function over hours or days. Urine output falls and creatinine rises.

See also creatinine, oliguria

acute respiratory distress syndrome

Severe, widespread lung inflammation. Oxygen levels stay low even on high concentrations of oxygen.

adrenal insufficiency

Too little cortisol. Tiredness, weight loss, low blood pressure, low sodium, and high potassium.

See also cushing syndrome, corticosteroid

advance directiveUS / Canada

A written document saying what treatment a patient wants if they later cannot speak for themselves.

Elsewhere: Called an advance decision in the UK and an advance care directive in Australia. US hospitals are legally required to ask every patient about one at admission.

See also living will, durable power of attorney, dnr

against medical adviceUS / Canada

Leaving the hospital against the provider's recommendation, after being told the risks and signing a form.

Elsewhere: You cannot hold a competent adult anywhere. US practice is to notify the provider, document exactly which risks were explained, and still offer prescriptions and follow-up.

See also right to refuse treatment

airborne precautions

A fitted respirator and a negative pressure room, for tuberculosis, measles, and chickenpox.

See also standard precautions, tuberculosis

akathisia

An inner restlessness from antipsychotics that leaves the patient unable to sit still.

See also extrapyramidal symptoms

albuterolUS / Canada

The US generic name for the rescue inhaler drug that opens narrowed airways.

Elsewhere: Called salbutamol nearly everywhere else, including the UK, Ireland, Australia, India, and the Philippines. Sold under the brand Ventolin in both places, which is why the brand feels familiar but the generic does not.

See also generic name

alkalosis

The blood is more alkaline than normal, with a pH above 7.45.

See also acidosis

anemia

Too few red cells or too little hemoglobin, so less oxygen reaches the tissues. Pale, tired, breathless.

See also hemoglobin

angina

Chest pain because the heart muscle is not getting enough oxygen. Stable angina comes with effort and eases with rest.

See also myocardial infarction

angiotensin receptor blocker

A blood pressure drug ending in -sartan, often used when an ACE inhibitor causes a cough.

See also ace inhibitor

anticoagulant

A drug that makes blood slower to clot, such as warfarin or heparin. Bleeding is the main risk.

See also warfarin, heparin, antiplatelet

antiemetic

A drug that prevents or treats nausea and vomiting.

antiplatelet

A drug that stops platelets sticking together, such as aspirin or clopidogrel.

See also anticoagulant

antipsychotic

A drug for psychosis. Movement side effects and metabolic changes are the usual concerns.

See also extrapyramidal symptoms, tardive dyskinesia

anuria

Almost no urine at all, under about 100 mL in a day.

See also oliguria

Apgar score

A 0 to 10 newborn score at 1 and 5 minutes for heart rate, breathing, tone, reflexes, and color.

aphasia

Loss of language. Expressive aphasia is trouble producing words; receptive aphasia is trouble understanding them.

See also stroke

apical pulse

The heart rate counted with a stethoscope over the apex of the heart, for a full minute.

apnea

Breathing stops. It may be brief, as in sleep apnea, or complete, as in respiratory arrest.

arterial blood gas

Blood taken from an artery to show oxygen, carbon dioxide, and the acid-base balance.

See also acidosis, alkalosis

ascites

Fluid collecting in the abdomen, most often from liver disease. The belly swells and breathing gets harder.

See also cirrhosis

aspiration

Food, fluid, or stomach contents going into the airway instead of the stomach.

See also dysphagia

aspirinUS / Canada

An antiplatelet and pain drug. In the US, aspirin is the ordinary generic name.

Elsewhere: In Canada, Germany, and several other countries Aspirin is still a registered trade mark, and the generic name is acetylsalicylic acid, written ASA on charts. If you trained there, aspirin will look like a brand name to you.

assisted livingUS / Canada

Housing with meals and help with daily tasks, for people who do not need full nursing care.

Elsewhere: Sheltered or supported housing is the nearest equivalent elsewhere. It is not a nursing facility, and staffing rules differ from state to state.

See also long term care

asthma

Narrowing of the airways that comes and goes, with wheeze, cough, and chest tightness, set off by triggers.

ataxia

Unsteady, poorly coordinated movement and walking.

atelectasis

Collapse of air sacs in part of the lung. Common after surgery, when patients breathe shallowly.

See also incentive spirometer

atrial fibrillation

An irregular, disorganized rhythm in the atria. Blood pools there, so clots and stroke are the main risk.

See also stroke, anticoagulant

attending physicianUS / Canada

The senior physician who carries final responsibility for the patient's care.

Elsewhere: Called a consultant in the UK and Ireland. Residents and interns work under them and their orders can be questioned up the chain of command.

See also resident physician, chain of command

auscultation

Listening to the body with a stethoscope: heart sounds, lung sounds, or bowel sounds.

benzodiazepine

A sedative such as lorazepam. It slows breathing, especially alongside opioids or alcohol.

beta blocker

A drug ending in -olol that slows the heart and lowers blood pressure. Hold it if the pulse is too slow.

blood urea nitrogenUS / Canada

A US kidney test measuring the nitrogen part of urea in the blood. Normal is roughly 7 to 20 mg/dL.

Elsewhere: Most other countries report whole serum urea in millimoles per liter instead, so the numbers do not line up. Urea in mmol/L is roughly the BUN in mg/dL divided by 2.8.

See also milligrams per deciliter

board of nursingUS / Canada

The state agency that issues a nursing license, disciplines nurses, and can take a license away.

Elsewhere: Licensing is state by state, not national. There is no single US register, so you apply to one state's board and a qualification from abroad must be evaluated first.

See also nurse practice act, nclex

bolus

A dose given all at once rather than spread out over time.

Braden scale

A score predicting pressure injury risk from sensation, moisture, activity, mobility, nutrition, and friction.

See also pressure injury

bradycardia

A resting heart rate under 60 beats per minute in an adult. Whether it matters depends on the patient: it can be normal in a trained athlete and dangerous in someone on a rate-controlling drug.

See also tachycardia

bradypnea

Breathing slower than normal, under about 12 breaths a minute in an adult.

bronchodilator

An inhaled drug that opens up narrowed airways.

See also asthma

calcium channel blocker

A drug that relaxes blood vessels and can slow the heart. Used for blood pressure and for angina.

capillary refill

Press a nail bed until it goes white, then let go. Color should come back within about two to three seconds.

cardiac output

The blood the heart pumps in one minute. Heart rate multiplied by stroke volume.

See also stroke volume

case managerUS / Canada

The nurse or social worker who coordinates services, insurance approval, and the discharge plan.

Elsewhere: Largely a US role created by the insurance system. Elsewhere discharge coordination usually sits with the ward team or a community nurse.

See also discharge planning, prior authorization

catheter-associated urinary tract infection

A urinary infection caused by an indwelling catheter. The best prevention is taking the catheter out early.

See also indwelling catheter

cellulitis

A spreading bacterial infection of the skin and the tissue below it. Red, hot, swollen, and tender.

CelsiusUS / Canada

The temperature scale used almost everywhere except the US. Normal body temperature is about 37.

Elsewhere: US charting uses Fahrenheit. Canadian charting uses Celsius, so this differs between the two countries you may be testing for.

See also fahrenheit

central line

A catheter whose tip sits in a large vein near the heart, for strong drugs, fluids, and pressure readings.

See also picc line, sterile technique

central venous pressure

The pressure in the large vein entering the right atrium, measured through a central line. It reflects fluid volume.

See also central line

cephalosporinUS / Canada

A large antibiotic family that includes cefazolin, ceftriaxone, and cephalexin.

Elsewhere: International generic names spell the family with cef-, so US cephalexin is cefalexin elsewhere. The drugs are identical; only the spelling moved.

certified nursing assistantUS / Canada

An unlicensed worker who helps with bathing, feeding, toileting, moving patients, and vital signs.

Elsewhere: Called a health care assistant in the UK or a nursing aide elsewhere. In US exam answers they may never assess, teach, or evaluate, however experienced they are.

See also unlicensed assistive personnel, delegation

cesarean sectionUS / Canada

Delivering a baby through a surgical cut in the abdomen and the uterus.

Elsewhere: Spelled caesarean in the UK, Ireland, and Australia, and often shortened to LSCS on charts there. US sources drop the first a.

See also estrogen

chain of commandUS / Canada

The order you escalate a concern through: charge nurse, then nurse manager, then supervisor, and upward.

Elsewhere: US answers expect you to keep escalating until the patient is safe. Stopping because a physician dismissed your concern is never the correct answer, however senior they are.

See also charge nurse, nurse manager

charge nurseUS / Canada

The nurse coordinating a single shift on a unit. They make patient assignments, manage admissions and discharges, and are the first person you escalate to. The role is per-shift, not a permanent rank.

Elsewhere: The closest equivalent elsewhere is often the ward sister, nurse-in-charge, or senior nurse on duty. Unlike a ward manager, a charge nurse usually carries a patient load too.

See also scope of practice

chronic kidney disease

A lasting loss of kidney function over months or years, graded by how much the kidneys still filter.

See also glomerular filtration rate, dialysis

chronic obstructive pulmonary disease

Long-term airway damage that makes it hard to breathe all the way out, covering emphysema and chronic bronchitis. It is mostly caused by smoking. Give oxygen when the patient needs it, but titrate to the target saturation rather than turning it up freely.

cirrhosis

Permanent scarring of the liver. It leads to fluid in the abdomen, bleeding, and confusion.

See also ascites, hepatic encephalopathy

clientUS / Canada

The word US nursing exams use for the patient, to stress that the person directs their own care.

Elsewhere: Most countries say patient throughout. US questions use client and patient interchangeably and nothing about the question changes, so do not read anything into which word appears.

code blueUS / Canada

The hospital call for a cardiac or respiratory arrest, which brings the resuscitation team.

Elsewhere: Called a crash call or cardiac arrest call elsewhere. US hospitals name their emergencies by color, so you will meet other codes for fire, security, and infant abduction.

See also rapid response team, dnr

complete blood count

A blood test reporting red cells, white cells, hemoglobin, hematocrit, and platelets together.

contact precautions

Gown and gloves for organisms spread by touch, such as MRSA and C. difficile.

See also standard precautions

copayUS / Canada

A fixed amount the patient pays at each visit or for each prescription, on top of their insurance.

Elsewhere: Many countries charge nothing at the point of care. In the US a copay can stop a patient collecting a medication, so ask about cost before you teach them to take it as prescribed.

See also deductible

corticosteroid

A drug like prednisone or hydrocortisone that damps down inflammation and the immune response. It raises blood glucose, hides the signs of infection, thins the skin and bone, and must be tapered rather than stopped suddenly.

See also prednisone, cushing syndrome

CoumadinUS / Canada

A common US brand name for warfarin, the oral anticoagulant.

Elsewhere: Warfarin is sold under different brand names in other countries, such as Marevan. US exams always use the generic name warfarin, so learn the generic and treat the brand as background noise.

See also generic name

crackles

Fine popping sounds heard when breathing in, made by fluid or collapsed air sacs. Heard at the bases first.

creatinine

A waste product from muscle that the kidneys clear. A rising level means the kidneys are filtering less.

Cushing syndrome

Too much cortisol, often from long-term steroid treatment. Round face, central weight gain, thin skin, high glucose.

See also corticosteroid, adrenal insufficiency

cyanosis

A bluish color of the skin, lips, or nail beds because the blood is poorly oxygenated.

See also hypoxemia

deductibleUS / Canada

The amount a patient must pay themselves each year before their insurance starts paying anything.

Elsewhere: No equivalent in tax-funded systems. It explains why a US patient may put off care early in the year and then come in sicker.

See also copay

deep vein thrombosis

A clot in a deep vein, usually in the leg. Warm, swollen, painful calf. It can break loose and reach the lungs.

See also pulmonary embolism, anticoagulant

dehiscence

A surgical wound splitting open along the line of the stitches.

See also evisceration

dehydration

Not enough fluid in the body. Dry mouth, poor skin turgor, little urine, and a rising heart rate.

See also hypovolemia, skin turgor

delegationUS / Canada

Handing a task to another worker while keeping accountability for the outcome. US questions test the five rights of delegation: right task, right circumstance, right person, right direction and communication, and right supervision. Assessment, teaching, evaluation, and any unstable patient stay with the RN.

Elsewhere: Delegation exists everywhere, but the US grades staff finely and tests the boundaries hard. A task you performed yourself abroad may belong to a different grade here, and the reverse is also true.

See also scope of practice, unlicensed assistive personnel

delirium

Confusion that comes on over hours and comes and goes, caused by something physical. It can be reversed.

See also dementia

dementia

A gradual, lasting decline in memory and thinking. Unlike delirium, it does not appear overnight.

See also delirium

dextroseUS / Canada

The sugar in IV fluids. D5W is the US label for 5 percent dextrose in water.

Elsewhere: The same bag is labeled glucose outside the US, so 5% glucose and D5W are one and the same fluid.

diabetes mellitus

Blood glucose stays high because the body makes too little insulin or cannot use the insulin it makes.

See also insulin, hemoglobin a1c

diabetic ketoacidosis

With no insulin, cells cannot use glucose, so the body burns fat and acid ketones build up. Glucose is high, the patient is very dehydrated, and breathing is deep and fast to blow off acid. Treatment is fluids, insulin by infusion, and careful potassium replacement.

See also metabolic acidosis, hyperglycemia

dialysis

Filtering waste and extra fluid out of the blood by machine or through the abdomen when the kidneys cannot.

diaphoresis

Heavy sweating. It often goes with pain, low blood sugar, or a heart attack.

digoxin

A drug that slows and strengthens the heartbeat, used in heart failure and atrial fibrillation. Count the apical pulse for a full minute before giving it and hold it if the rate is under 60. Low potassium makes toxicity more likely; toxicity shows as nausea, confusion, and yellow or halo vision.

See also apical pulse, hypokalemia

discharge planningUS / Canada

Arranging equipment, medications, follow-up, and support before the patient leaves. It starts at admission.

Elsewhere: Everywhere it asks what the patient needs. In the US it also has to answer who pays, because coverage decides whether the patient goes to rehabilitation, to home health, or straight home.

See also case manager, skilled nursing facility

diuretic

A drug that makes the kidneys pass more urine, used to clear extra fluid and lower blood pressure.

See also loop diuretic, potassium sparing diuretic

DNRUS / Canada

An order not to start CPR if the heart or breathing stops. Every other treatment carries on.

Elsewhere: Called DNACPR in the UK and 'not for resuscitation' in parts of Asia and Africa. In the US it needs a written provider order in the chart, and it never means withdrawing other care.

See also advance directive, code blue

droplet precautions

A surgical mask within about six feet, for organisms carried in large droplets such as influenza.

See also standard precautions

durable power of attorneyUS / Canada

A person the patient names in advance to make medical decisions for them if they cannot.

Elsewhere: Called a lasting power of attorney in the UK or a substitute decision maker in Canada. In the US the named person outranks other family members, even a spouse.

See also advance directive

dysphagia

Difficulty swallowing. It raises the risk of choking and of food going into the lungs.

See also aspiration

dyspnea

Difficulty breathing, or the feeling of not getting enough air.

ecchymosis

A bruise: bleeding under the skin spread over an area, rather than in pinpoint spots.

See also petechiae

eclampsia

Preeclampsia that has gone on to cause seizures. A life-threatening emergency for mother and baby.

See also preeclampsia, seizure

edema

Swelling from extra fluid in the tissues. Press the skin: if a dent stays behind, the swelling is pitting.

See also fluid overload

electrocardiogram

A tracing of the heart's electrical activity taken from electrodes on the skin. Written ECG or EKG.

electronic health recordUS / Canada

The digital chart. In the US it also drives billing, order entry, and safety alerts.

Elsewhere: US systems are chosen hospital by hospital, not nationally, so a nurse may use a different record in every job. Charting rules stay the same: factual, timely, and never altered after the fact.

emergency departmentUS / Canada

The hospital unit that takes unscheduled and emergency arrivals.

Elsewhere: Called A&E in the UK and Ireland and casualty in parts of Africa and South Asia. US federal law requires it to screen and stabilize anyone who arrives, whatever their insurance.

See also emtala

EMTALAUS / Canada

The US law making hospitals screen and stabilize anyone with an emergency, whatever their ability to pay.

Elsewhere: Systems with universal coverage need no such law. It is the reason a US emergency department may not turn a patient away or transfer them before they are stable.

See also emergency department

enteral nutrition

Feeding through a tube into the stomach or small bowel, so the gut is still doing the work.

See also total parenteral nutrition

epinephrineUS / Canada

The US generic name for the drug given in anaphylaxis and in cardiac arrest.

Elsewhere: Called adrenaline in the UK, Ireland, Australia, India, and most of the world. Same drug, same doses. US exams only ever use epinephrine.

See also norepinephrine, generic name

erythema

Redness of the skin from extra blood flow, seen in inflammation and infection.

estrogenUS / Canada

A female sex hormone, also given as medication. US sources spell it without the o.

Elsewhere: Spelled oestrogen outside the US. The same rule runs through the whole vocabulary: US edema is oedema, anemia is anaemia, diarrhea is diarrhoea, and fetal is foetal. Read the US spelling as the same word.

evisceration

Abdominal organs pushing out through an open surgical wound. Cover with sterile saline gauze and get help now.

See also dehiscence

extrapyramidal symptoms

Movement side effects of antipsychotics: stiffness, tremor, restlessness, and muscle spasms.

See also antipsychotic, tardive dyskinesia, akathisia

extravasation

Leakage of a tissue-damaging drug out of the vein into the surrounding tissue. Stop the infusion at once.

See also infiltration

exudate

Fluid that leaks out of a wound or inflamed tissue. Its color and amount tell you how the wound is doing.

FahrenheitUS / Canada

The temperature scale used in US clinical charting. Normal body temperature is about 98.6 degrees Fahrenheit and a fever is generally over 100.4.

Elsewhere: Most nursing programmes outside the US teach Celsius, where the same values are 37 and 38. To convert, multiply Celsius by 1.8 and add 32.

See also celsius

fluid overload

Too much fluid in the body. Weight gain, crackles in the lungs, bulging neck veins, and swelling.

See also edema, hypovolemia

fundus

The top of the uterus. After birth it should feel firm and midline; a soft, boggy fundus means bleeding.

See also postpartum hemorrhage

furosemideUS / Canada

A loop diuretic that clears fluid quickly. Sold in the US under the brand name Lasix.

Elsewhere: Older British, Australian, and Indian sources call it frusemide. The name was standardized to furosemide, but frusemide still appears in notes and older textbooks.

gastroesophageal reflux disease

Stomach acid washing back up into the esophagus, causing heartburn and a sour taste.

See also proton pump inhibitor

generic nameUS / Canada

The drug's official non-brand name, such as acetaminophen. US exams test the generic name only.

Elsewhere: Brand names are country-specific, and the same brand can even cover different drugs in different countries. If you learned a drug by its brand where you trained, find its US generic name before you revise it.

gestational age

How many weeks pregnant, counted from the first day of the last menstrual period.

Glasgow Coma Scale

A 3 to 15 score of eye opening, speech, and movement. Lower is worse; 8 or under means the airway is at risk.

See also level of consciousness

glomerular filtration rate

How much blood the kidneys filter each minute. It is the main measure of kidney function.

glyburideUS / Canada

A US tablet for type 2 diabetes that pushes the pancreas to release more insulin.

Elsewhere: Called glibenclamide outside the US and Canada. It is the same sulfonylurea.

Good Samaritan lawUS / Canada

A state law protecting someone who gives free emergency help outside work from being sued for an honest mistake.

Elsewhere: Some countries instead place a legal duty on you to stop and help. US law generally protects the volunteer but does not require you to act in the first place.

hand hygiene

Soap and water or alcohol rub. Soap and water is required for C. difficile and for visibly dirty hands.

handoffUS / Canada

The structured transfer of responsibility for a patient from one nurse to the next.

Elsewhere: Called handover in the UK, Ireland, Australia, and much of Asia. US practice increasingly does it at the bedside, with the patient listening and taking part.

See also sbar

HDL cholesterol

The cholesterol that carries fat away from the arteries. Higher is better.

See also ldl cholesterol

heart failure

The heart cannot pump enough blood for the body's needs. Left-sided failure backs fluid up into the lungs, giving crackles and breathlessness. Right-sided failure backs it up into the body, giving swollen legs and bulging neck veins.

See also fluid overload, jugular venous distension

hematocrit

The percentage of blood made up of red cells. It falls with bleeding and rises with dehydration.

See also hemoglobin

hemiparesis

Weakness down one side of the body.

See also hemiplegia, stroke

hemiplegia

Complete paralysis down one side of the body.

See also hemiparesis

hemoglobin

The protein inside red cells that carries oxygen. A low level means anemia.

See also anemia, hematocrit

hemoglobin A1C

A blood test showing average glucose over about three months. Most adults with diabetes aim under 7 percent.

See also diabetes mellitus

heparin

An injected anticoagulant that works within minutes. Protamine sulfate is the antidote.

See also partial thromboplastin time, anticoagulant

hepatic encephalopathy

Confusion and drowsiness because a failing liver lets ammonia build up and reach the brain.

See also cirrhosis

HIPAAUS / Canada

The US law governing patient privacy and who may see health information.

Elsewhere: In Canada, health records are governed provincially, such as PHIPA in Ontario. The UK uses UK GDPR plus the Data Protection Act 2018, and the Philippines has the Data Privacy Act. The principle is similar; the exam expects the US rules.

HMOUS / Canada

An insurance plan that pays only for care inside its own network and needs a referral for specialists.

Elsewhere: Tax-funded systems have no equivalent. In the US the plan a patient holds can decide which hospital, which specialist, and which discharge destination is possible.

See also ppo, prior authorization

home healthUS / Canada

Skilled nursing or therapy given in the patient's own house, usually after a hospital stay.

Elsewhere: Called district or community nursing elsewhere and often open-ended. US home health is authorized as a set number of visits, needs a provider's order, and expects the patient to be largely housebound.

See also discharge planning

hospiceUS / Canada

Care aimed at comfort rather than cure for someone expected to live about six months or less.

Elsewhere: In many countries hospice means a building you go to. In the US it is mostly a service delivered wherever the patient lives, and enrolling normally means giving up treatment aimed at curing the illness.

hospitalistUS / Canada

A physician who works only with hospitalized patients and keeps no outpatient practice.

Elsewhere: Mostly a US role. Elsewhere the admitting specialist team or a consultant usually keeps the patient throughout the stay.

hypercalcemia

Blood calcium above normal. Weakness, constipation, confusion, and kidney stones.

See also hypocalcemia

hypercapnia

Too much carbon dioxide in the blood, because the patient is not breathing deeply or often enough.

See also respiratory acidosis

hyperglycemia

Blood glucose above the normal range. Thirst, passing a lot of urine, and blurred vision.

See also hypoglycemia, diabetes mellitus

hyperkalemia

Blood potassium above the normal range, over about 5.0 mEq per liter. The danger is a fatal heart rhythm.

hypernatremia

Blood sodium above about 145 mEq per liter, usually from losing water. Thirst, dry mouth, and restlessness.

See also hyponatremia

hyperosmolar hyperglycemic state

Extremely high glucose with severe dehydration but little or no ketosis. Seen in type 2 diabetes.

See also diabetic ketoacidosis

hypertension

Blood pressure that stays high over time. US guidelines call 130/80 mm Hg or above hypertension in an adult. It usually causes no symptoms, so it is found on screening rather than reported by the patient.

See also hypotension

hyperthyroidism

An overactive thyroid. Weight loss, feeling hot, fast heart rate, tremor, and anxiety.

See also hypothyroidism

hypocalcemia

Blood calcium below normal. Muscle twitching, tingling around the mouth, and positive Chvostek and Trousseau signs.

See also hypercalcemia

hypoglycemia

Blood glucose below about 70 mg/dL. Shaky, sweaty, and confused. Treat quickly with fast-acting sugar.

See also hyperglycemia, insulin

hypokalemia

A blood potassium level below the normal range, typically under 3.5 mEq/L. Watch for muscle weakness, cramps, and cardiac rhythm changes. Note the spelling: US sources write hypokalemia, UK-trained nurses will have learned hypokalaemia.

hypomagnesemia

Blood magnesium below normal. It often goes with low potassium, which will not correct until magnesium is replaced.

hyponatremia

Blood sodium below about 135 mEq per liter. Headache, confusion, and seizures if it falls quickly.

See also hypernatremia

hypotension

Blood pressure that is too low for the patient, often under 90/60 mm Hg or a large drop from baseline.

See also hypertension, orthostatic hypotension

hypothyroidism

An underactive thyroid. Tiredness, weight gain, feeling cold, constipation, and a slow heart rate.

See also hyperthyroidism

hypovolemia

Too little fluid in the circulation. Low blood pressure, a fast weak pulse, and low urine output.

See also dehydration, fluid overload

hypoxemia

Not enough oxygen carried in the arterial blood. It is what a low oxygen saturation is showing you.

See also hypoxia, spo2

hypoxia

Not enough oxygen reaching the body's tissues.

See also hypoxemia

ibuprofen

A common NSAID for pain, fever, and inflammation. Take it with food to protect the stomach.

See also nsaid

ileus

The bowel stops moving. No bowel sounds, no gas passed, and a swollen abdomen. Common after abdominal surgery.

incentive spirometer

A handheld device the patient breathes in through to expand the lungs and prevent collapse after surgery.

See also atelectasis

inchUS / Canada

A US length unit. Charts give height in feet and inches; one inch is 2.54 centimeters.

Elsewhere: Most countries record height in centimeters. A patient charted as 5 feet 6 inches is 168 cm.

incident reportUS / Canada

An internal record of an error or unexpected event, written so the hospital can improve safety.

Elsewhere: Called a clinical incident form, or Datix, in the UK. In the US it is never filed in the patient's chart and the chart must not mention that one was written; you document the facts of what happened instead.

See also sentinel event

indwelling catheter

A tube left in the bladder to drain urine into a bag. Keep the bag below bladder level and remove it early.

See also cauti

infiltration

IV fluid leaking into the tissue around the vein. The site swells, feels cool, and the drip slows.

See also extravasation, phlebitis

informed consentUS / Canada

The patient's agreement to a procedure, given after the provider has explained what it involves, the risks, the benefits, and the alternatives. The provider is responsible for the explanation. The nurse witnesses the signature, confirms the patient understood, and stops the process if they did not.

Elsewhere: The principle is the same everywhere, but US questions test the split of roles hard: if the patient cannot explain the procedure back to you, the answer is to call the provider, not to explain it yourself.

See also provider

insulin

A hormone given by injection to move glucose out of the blood and into cells. Too much causes low sugar.

See also hypoglycemia, diabetes mellitus

international normalized ratio

A standardized clotting time used to dose warfarin. The usual target is 2.0 to 3.0.

See also warfarin

intracranial pressure

The pressure inside the skull. Because the skull cannot expand, swelling or bleeding raises it quickly. A falling level of consciousness is the earliest sign. Late signs are rising blood pressure with a widening gap between the numbers, a slowing pulse, and irregular breathing.

See also level of consciousness

intradermal

Injected just under the top layer of skin at 5 to 15 degrees, raising a small bleb. Used for skin testing.

See also tuberculin skin test

intramuscular

Injected into muscle at 90 degrees. Absorbed faster than an injection under the skin.

See also z track

intravenous

Given straight into a vein. It acts fastest of all routes, and it cannot be taken back.

jaundice

Yellow skin and eyes caused by bilirubin building up, usually a liver or bile duct problem.

jugular venous distension

Bulging neck veins with the head raised about 45 degrees. A sign of fluid overload or right-sided heart failure.

See also heart failure, fluid overload

kilogramUS / Canada

The unit every weight-based drug dose is calculated in, including in the US.

Elsewhere: This is the one metric unit US practice never abandoned. The chart may say 154 pounds, but the heparin or pediatric dose is worked out on 70 kilograms.

See also pound, weight based dosing

late decelerations

A fall in fetal heart rate that starts after a contraction peaks. It means the placenta is not delivering enough oxygen.

See also variable decelerations

LDL cholesterol

The cholesterol that builds plaque in the arteries. Lower is better.

See also hdl cholesterol, statin

level of consciousness

How awake and aware the patient is. A change in it is often the first sign that something is going wrong.

levodopa

The main drug for Parkinson disease. A meal heavy in protein can slow down how much is absorbed.

licensed practical nurseUS / Canada

A nurse with shorter training who works under the direction of an RN. They may give many medications, do dressings, reinforce teaching, and collect data. They do not perform the initial assessment, create the care plan, or teach new content, and the exact boundary is set by each state.

Elsewhere: Called an LVN in Texas and California and an LPN in the rest of the US. The nearest role abroad is an enrolled nurse or nursing associate, and many countries have no equivalent grade at all.

See also scope of practice, delegation

lidocaineUS / Canada

A local anesthetic, also used for certain dangerous heart rhythms.

Elsewhere: Called lignocaine in older British, Australian, and Indian practice.

lithium

A mood stabilizer with a narrow safe range. Dehydration and low sodium push the level into toxicity.

See also therapeutic range, hyponatremia

living willUS / Canada

The part of an advance directive that lists which treatments the patient does and does not want.

Elsewhere: The closest UK equivalent is an advance decision to refuse treatment. In some countries such a document carries no legal force at all.

See also advance directive

lochia

The vaginal discharge after birth. It goes from red to pink to white over the first weeks.

long-term careUS / Canada

Ongoing residential care for people who can no longer manage safely at home.

Elsewhere: Called a care home or residential aged care elsewhere. In the US it is paid for privately or by Medicaid, not by Medicare, which surprises many families.

See also medicaid, assisted living

loop diuretic

A strong diuretic such as furosemide. It removes a lot of fluid quickly and wastes potassium.

See also diuretic, hypokalemia

malpracticeUS / Canada

Negligence by a licensed professional: care that fell below the accepted standard and caused harm.

Elsewhere: US nurses can be sued personally, and many carry their own liability insurance. In many other systems the employer or the state is the defendant instead.

See also negligence

mandatory reportingUS / Canada

A legal duty to report suspected abuse or neglect of a child or a vulnerable adult, on suspicion alone.

Elsewhere: US nurses are mandated reporters in every state. You report directly to the state agency, not only up the hospital chain, and you do not need proof or the family's permission.

MAOI

An older antidepressant. Eating aged cheese or cured meat with it can send blood pressure dangerously high.

Maslow's hierarchy of needs

A ranking used to set priorities: physical needs first, then safety, then emotional and social needs.

MedicaidUS / Canada

Joint federal and state US health coverage for people on low incomes.

Elsewhere: Distinct from Medicare, which is age-based. The similar names are a deliberate exam trap.

See also medicare

medical asepsis

Reducing the number of microorganisms rather than removing all of them. Handwashing and clean gloves.

See also sterile technique

MedicareUS / Canada

US federal health coverage, mainly for people 65 and older.

Elsewhere: Do not read it as a general public health service. US coverage is fragmented, and questions about discharge planning often turn on what a patient's specific plan pays for.

See also medicaid

medication administration recordUS / Canada

The record of every dose that is due and every dose given.

Elsewhere: Called a drug chart or medication chart elsewhere. In the US you sign it after the dose has been given, never before, and never for a dose someone else gave.

meningitis

Inflammation of the coverings of the brain and spinal cord. Fever, headache, stiff neck, and light hurting the eyes.

meperidineUS / Canada

A US opioid used for moderate to severe pain.

Elsewhere: Called pethidine in the UK, Ireland, Australia, and much of Asia. Nothing about the drug changes; only the name does.

metabolic acidosis

Acid builds up in the blood for a reason other than the lungs, such as ketones, lactic acid, or kidney failure.

See also acidosis

metabolic alkalosis

The blood turns alkaline for a reason other than the lungs, such as vomiting away stomach acid.

See also alkalosis

metformin

A first-line tablet for type 2 diabetes. It is held around scans using contrast dye because of kidney risk.

See also diabetes mellitus

microgram

One thousandth of a milligram. Written out as mcg on orders so it cannot be misread as mg.

milliequivalentUS / Canada

The unit US labs use for electrolytes such as potassium and sodium, written mEq per liter.

Elsewhere: Most other countries report these as millimoles per liter. For potassium and sodium the numbers are identical, so a potassium of 3.5 mEq/L is 3.5 mmol/L. For calcium and magnesium they are not, so check the reference range printed on the report.

milligrams per deciliterUS / Canada

The unit US labs use for blood glucose, creatinine, and cholesterol, written mg per dL.

Elsewhere: Most countries report these in millimoles per liter, and the numbers look nothing alike. For glucose, divide the US number by 18: 180 mg/dL is 10 mmol/L.

See also blood urea nitrogen

morphine

A strong opioid for severe pain. The danger to watch for is slowed, shallow breathing.

See also opioid, naloxone

MRSA

A staph bacterium resistant to many common antibiotics. Managed with contact precautions.

See also contact precautions

myocardial infarction

A heart attack. Blood flow to part of the heart muscle is blocked and that muscle begins to die.

See also angina

naloxone

The antidote that reverses opioid overdose in minutes. It can wear off before the opioid does.

See also opioid, morphine

NarcanUS / Canada

A US brand name for naloxone, the opioid overdose antidote.

Elsewhere: Naloxone carries different brand names by country. As with every drug question, the exam names the generic.

See also generic name

nasal cannula

Two short prongs sitting in the nostrils that deliver low-flow oxygen, usually 1 to 6 liters a minute.

nasogastric tube

A tube passed through the nose into the stomach to feed, to give medicine, or to drain stomach contents.

See also enteral nutrition

NCLEXUS / Canada

The licensing exam to practice as an RN in the US or most of Canada. NCLEX-PN, for practical nurses, is US-only.

Elsewhere: It replaces the registration exam you may already have taken at home. A license from another country does not exempt you from it. Canadian practical nurses write the CPNRE or REx-PN instead, and Quebec uses its own exam.

See also board of nursing

necrosis

Dead tissue. It looks black or brown and usually has to be removed before a wound can heal.

negligenceUS / Canada

Failing to do what a reasonable nurse would have done, and causing harm as a result.

Elsewhere: The idea exists in most legal systems. US questions test the four elements by name: duty, breach of that duty, causation, and damages.

See also malpractice

neuroleptic malignant syndrome

A rare, life-threatening reaction to antipsychotics: high fever, rigid muscles, confusion, unstable vital signs.

See also antipsychotic

neuropathy

Nerve damage causing numbness, burning, or weakness, most often in the feet and hands.

nitroglycerinUS / Canada

A drug that widens the coronary vessels, given under the tongue for chest pain.

Elsewhere: Called glyceryl trinitrate, or GTN, in the UK, Ireland, Australia, and India. If you learned GTN spray, this is the same drug.

norepinephrineUS / Canada

A vasopressor given by infusion to bring up a dangerously low blood pressure.

Elsewhere: Called noradrenaline outside the US. The naming follows epinephrine and adrenaline.

See also epinephrine

NPO

Nothing by mouth. The patient takes no food or fluids, usually before a procedure.

NSAID

A pain and inflammation drug such as ibuprofen. It irritates the stomach and can harm the kidneys.

See also ibuprofen, peptic ulcer

nurse managerUS / Canada

The nurse who runs a unit long term: hiring, budget, staffing, scheduling, and performance.

Elsewhere: Closest to a ward manager or matron elsewhere. Unlike the charge nurse, the nurse manager is not tied to one shift and does not usually carry patients.

See also charge nurse, chain of command

Nurse Practice ActUS / Canada

The state law that defines what a nurse may legally do in that particular state.

Elsewhere: Each state writes its own, so scope can change when you cross a state line. Most other countries have one national council setting a single standard.

See also scope of practice, board of nursing

nurse practitionerUS / Canada

A nurse with a graduate degree who diagnoses, prescribes, and manages patients directly.

Elsewhere: In many US states they practice without physician oversight. Most countries either restrict nurse prescribing sharply or have no equivalent role, so 'notify the provider' may mean calling a nurse.

See also provider

nursing judgmentUS / Canada

Working out what a finding means and acting within your own scope before you call anyone.

Elsewhere: In more hierarchical systems the nurse reports the finding and waits. US questions expect you to assess first and often to act first: reposition the patient, check the site, or stop an infusion that is causing harm, then call.

See also scope of practice, chain of command

nursing process

The five steps: assessment, diagnosis, planning, implementation, evaluation. Assessment always comes first.

objective data

What you can see, hear, or measure yourself, such as a blood pressure reading or a rash.

See also subjective data

occupational therapistUS / Canada

A specialist who helps patients regain daily tasks: dressing, cooking, and using adaptive equipment.

Elsewhere: The title is used worldwide. In US discharge planning they are the ones who assess the home and recommend the equipment, so questions route those tasks to them.

See also physical therapist, discharge planning

oliguria

Low urine output, under about 30 mL an hour in an adult. An early sign of kidney trouble or low volume.

See also anuria, acute kidney injury

opioid

A strong pain drug such as morphine. Watch breathing, sedation, and constipation.

See also morphine, naloxone

orthopnea

Breathlessness when lying flat that eases when the patient sits up. Common in heart failure.

See also heart failure

orthostatic hypotension

A drop in blood pressure when the patient moves from lying to sitting or standing, usually 20 mm Hg systolic or 10 mm Hg diastolic. Tell the patient to change position slowly and sit on the edge of the bed first.

See also hypotension

ounceUS / Canada

A US unit used for both weight and fluid volume. One fluid ounce is about 30 mL.

Elsewhere: Newborn weights and fluid intake are often recorded in ounces in the US. Elsewhere the same figures are recorded in grams and milliliters.

See also pound

outpatientUS / Canada

Care given without an overnight stay in a hospital bed.

Elsewhere: Called day case or ambulatory care elsewhere. Note that US charting also uses ambulatory on its own to mean simply that the patient can walk.

oxytocin

A drug that makes the uterus contract, used to start or strengthen labor and to control bleeding after birth.

See also postpartum hemorrhage

pallor

Unusual paleness of the skin, seen in anemia, blood loss, and poor perfusion.

palpation

Examining by touch, feeling for tenderness, lumps, pulses, or the edge of an organ.

paresthesia

Pins and needles, tingling, or numbness in a part of the body.

partial thromboplastin time

A clotting time used to monitor heparin given by infusion.

See also heparin

patient advocacyUS / Canada

Speaking and acting for what the patient actually wants, even when the team would prefer otherwise.

Elsewhere: In more hierarchical systems the nurse defers to the physician. On US exams the option that protects the patient's own stated choice is nearly always the right one.

See also right to refuse treatment, chain of command

patient-controlled analgesia

A pump the patient presses to give their own pain dose. Only the patient may ever press the button.

See also opioid

peptic ulcer

A sore in the lining of the stomach or the first part of the small bowel, usually from H. pylori or NSAIDs.

See also nsaid

percussion

Tapping the body surface and listening, to tell whether what is underneath is solid, hollow, or full of fluid.

perfusion

Blood actually reaching the tissues. Poor perfusion shows as cool, pale skin and slow capillary refill.

See also capillary refill

personal protective equipment

Gloves, gown, mask, and eye protection worn to stop infection passing between patient and staff.

petechiae

Tiny flat red spots from bleeding under the skin. They do not fade when you press them.

See also ecchymosis

phenytoin

An antiseizure drug with a narrow safe range. Overgrown gums are a well-known long-term effect.

See also seizure, therapeutic range

phlebitis

Inflammation of the vein at an IV site: red, warm, tender, with a firm cord you can feel.

See also infiltration

physical therapistUS / Canada

A licensed specialist in movement, strength, walking, and rehabilitation after illness or surgery.

Elsewhere: Called a physiotherapist almost everywhere else. US charts abbreviate this PT, which also means prothrombin time, so read the abbreviation from its context.

See also occupational therapist

physician assistantUS / Canada

A licensed clinician who diagnoses and prescribes, working with a supervising physician.

Elsewhere: Called a physician associate in the UK, where the role is newer and much narrower. In US questions their orders carry the same weight as a physician's.

See also provider

PICC line

A long IV line threaded from an arm vein to a large vein near the heart, for weeks of treatment.

See also central line

platelets

The blood cells that form clots. A low count means easy bruising and bleeding.

pneumonia

Infection of the lung tissue itself. Fever, cough, sputum, crackles, and falling oxygen.

pneumothorax

Air trapped around the lung, making it collapse. Sudden chest pain, breathlessness, and absent breath sounds.

postpartum hemorrhage

Heavy bleeding after birth. The first nursing action is to massage the uterus until it firms up.

See also fundus, oxytocin

potassium-sparing diuretic

A diuretic such as spironolactone that clears fluid without wasting potassium. Watch potassium rise.

See also spironolactone, hyperkalemia

poundUS / Canada

The unit US charts use for body weight. One kilogram is about 2.2 pounds.

Elsewhere: Most of the world charts weight in kilograms. US drug doses are still calculated in kilograms, so a US chart often gives you pounds and the calculation wants kilograms. Divide pounds by 2.2.

See also kilogram, weight based dosing

PPOUS / Canada

An insurance plan that lets the patient see specialists without a referral but pays less outside its network.

Elsewhere: As with an HMO, there is no equivalent where care is tax-funded. The difference from an HMO is freedom of choice traded against cost.

See also hmo

preceptorUS / Canada

An experienced nurse assigned to guide and check a new nurse or a student on the unit.

Elsewhere: Similar to a mentor or clinical supervisor elsewhere, but the US preceptor stays accountable for supervising whatever they let the learner do.

prednisone

An oral corticosteroid. Take it with food, expect higher glucose, and never stop it suddenly.

See also corticosteroid

preeclampsia

New high blood pressure after 20 weeks of pregnancy, usually with protein in the urine. Headache and visual changes warn of worsening.

See also eclampsia

premature ventricular contraction

An early heartbeat that starts in the ventricles. Occasional ones are common; frequent ones need a closer look.

pressure injury

Skin and tissue damage over a bony point caused by unrelieved pressure. Prevented by turning and offloading.

See also braden scale

prior authorizationUS / Canada

Approval an insurer must give before it will pay for a test, a drug, or an admission.

Elsewhere: The nearest equivalent elsewhere is a funding or formulary approval. In the US it routinely delays treatment and discharge, and questions treat that delay as a real nursing problem.

See also case manager

PRN

A medication given as needed rather than on a fixed schedule.

proton pump inhibitor

A drug ending in -prazole that cuts down stomach acid production.

See also gerd

providerUS / Canada

The exam's word for whoever may legally prescribe: a physician, a nurse practitioner, or a physician assistant.

Elsewhere: Where you trained this was almost certainly the doctor. In the US any of the three can hold the role, which is why questions say 'notify the provider' rather than naming a doctor. The correct answer is the same whichever one it is.

See also nurse practitioner, physician assistant

pulmonary embolism

A clot lodged in a lung artery. Sudden breathlessness, chest pain, fast heart rate, and falling oxygen.

See also deep vein thrombosis

purulent

Containing pus. Thick yellow or green drainage that means the wound is infected.

range of motion

How far a joint can move. When a patient cannot move a joint themselves, the nurse moves it for them.

rapid response teamUS / Canada

A team you can call when a patient is deteriorating but has not yet arrested.

Elsewhere: Called a medical emergency team or critical care outreach elsewhere. In the US any nurse, and in many hospitals the family, can call it without asking the provider first.

See also code blue, chain of command

red blood cell count

The number of oxygen-carrying cells in the blood.

See also hemoglobin

registered nurseUS / Canada

The licensed nurse who assesses, plans care, and teaches. Those three steps are never delegated.

Elsewhere: US licensure is state by state, not national. A nursing qualification from another country has to be evaluated, and the NCLEX passed, before you can hold an RN license in any state.

See also board of nursing, nclex

resident physicianUS / Canada

A doctor still in training after medical school, working under an attending physician.

Elsewhere: Called a junior doctor, house officer, or registrar elsewhere. Be careful: in US long-term care the word resident on its own means a person living in the facility, so read it from context.

See also attending physician, long term care

respiratory acidosis

Carbon dioxide builds up because the patient is not breathing it off, so the blood turns acidic.

See also hypercapnia, acidosis

respiratory alkalosis

Too much carbon dioxide is blown off, usually from fast breathing, so the blood turns alkaline.

See also alkalosis

respiratory therapistUS / Canada

A licensed specialist who manages ventilators, oxygen delivery, nebulizers, and airway clearance.

Elsewhere: A distinct US and Canadian profession. In the UK, Ireland, India, and much of the world this work is shared by nurses and physiotherapists, so the role may be new to you.

restraint

A device or drug that limits movement. A last resort, needing a time-limited order and frequent checks.

right to refuse treatmentUS / Canada

A competent adult may refuse any treatment, including treatment that would save their life.

Elsewhere: The principle exists in most legal systems, but US questions apply it absolutely. You explain, you document, and you notify the provider. You never persuade, trick, or override.

See also informed consent, patient advocacy

rights of medication administrationUS / Canada

Right patient, right drug, right dose, right route, right time, checked before every dose.

Elsewhere: Taught worldwide. US sources add right documentation, right reason, right response, and the patient's right to refuse, so a question may count more than five.

See also two patient identifiers, right to refuse treatment

root cause analysisUS / Canada

A structured review after a serious event that looks for faults in the system rather than blaming a person.

Elsewhere: The method is used worldwide. In the US it is specifically required after a sentinel event, so exam answers point to the system fix rather than to disciplining the nurse.

See also sentinel event

SBARUS / Canada

A script for reporting a concern: situation, background, assessment, recommendation.

Elsewhere: Used internationally now, but the last letter is the US emphasis: you are expected to tell the provider what you think should happen, not simply to report the numbers.

See also handoff, nursing judgment

scope of practiceUS / Canada

The set of tasks a given licence legally permits. US exam questions lean heavily on what an RN may delegate to an LPN or a nursing assistant, and delegating outside scope is always the wrong answer.

Elsewhere: The boundaries differ sharply by country. Tasks that are routine for nurses in the Philippines, India, or Nigeria may sit outside a US assistant's scope, and the reverse is also true. Answer from the US boundaries, not the ones you trained under.

seizure

A burst of abnormal electrical activity in the brain. During one, stay with the patient, protect the head, turn them on their side, and time it. Do not put anything in the mouth and do not restrain the limbs.

See also status epilepticus

sentinel eventUS / Canada

A safety event that caused death or serious lasting harm. It triggers a full investigation.

Elsewhere: Called a never event or a serious incident elsewhere. The US term comes from The Joint Commission, which requires a root cause analysis afterwards.

See also root cause analysis, joint commission

sepsis

A dangerous whole-body response to infection that starts damaging organs. Fever, fast pulse, confusion.

See also septic shock

septic shock

Sepsis where blood pressure stays low despite fluids. Organs begin to fail and vasopressors are needed.

See also sepsis, vasopressor

serotonin syndrome

Too much serotonin from combined drugs: agitation, tremor, overactive reflexes, sweating, and fever.

See also ssri

skilled nursing facilityUS / Canada

A facility for patients who still need nursing or rehabilitation but no longer need a hospital bed.

Elsewhere: Closest to a rehabilitation or step-down ward elsewhere. In the US it is a separate business, and Medicare pays for only a limited stay after a qualifying hospital admission.

See also long term care, discharge planning

skin turgor

How elastic the skin is. Pinch it: if it stays tented instead of springing back, suspect dehydration.

See also dehydration

spironolactone

A potassium-sparing diuretic. Avoid potassium supplements and salt substitutes while taking it.

See also potassium sparing diuretic, hyperkalemia

SpO2

The percentage of hemoglobin carrying oxygen, read from a finger probe. Usually 95 or above in a healthy adult.

See also hypoxemia

SSRI

An antidepressant such as sertraline or fluoxetine. It takes several weeks to reach full effect.

See also serotonin syndrome

standard precautions

Treat every patient's blood and body fluids as infectious. Hand hygiene and gloves for everyone, every time.

See also hand hygiene, personal protective equipment

statin

A cholesterol-lowering drug ending in -statin. Unexplained muscle pain must be reported.

See also ldl cholesterol

status epilepticus

A seizure lasting more than five minutes, or seizures repeating with no recovery between. An emergency.

See also seizure

sterile technique

Keeping an area completely free of microorganisms. Used for surgery, central lines, and catheter insertion.

See also medical asepsis

stridor

A harsh, high-pitched sound on breathing in. It means the upper airway is narrowing and is always urgent.

stroke

Blood flow to part of the brain stops, either because a vessel is blocked by a clot or because one has burst. Sudden one-sided weakness, facial droop, and slurred speech are the classic signs. Note that US charts abbreviate this CVA, which also stands for costovertebral angle in kidney assessment.

See also transient ischemic attack, hemiparesis, aphasia

stroke volume

The amount of blood the left ventricle pushes out with each single beat.

See also cardiac output

subcutaneous

Injected into the fatty layer just under the skin, at 45 to 90 degrees. Used for insulin and heparin.

subjective data

What the patient tells you, such as pain, nausea, or dizziness. You cannot measure it directly.

See also objective data

sublingual

Placed under the tongue to dissolve. It reaches the blood quickly and skips the stomach.

suctioning

Clearing secretions from the airway with a catheter and gentle negative pressure.

tablespoonUS / Canada

A household measure used in US patient teaching. One tablespoon is 15 mL, or three teaspoons.

Elsewhere: As with teaspoons, most other countries teach liquid doses in milliliters only.

See also teaspoon

tachycardia

A resting heart rate over 100 beats per minute in an adult.

See also bradycardia

tachypnea

Breathing faster than normal, over about 20 breaths a minute in an adult.

tardive dyskinesia

Repetitive movements of the face and tongue after long-term antipsychotic use. Often permanent.

See also antipsychotic

teaspoonUS / Canada

A household measure used in US patient teaching. One teaspoon is 5 mL.

Elsewhere: Many countries teach liquid doses only in milliliters and hand out an oral syringe. Kitchen spoons vary in size, so teach the dose in milliliters where you can.

See also tablespoon

telemetry

Continuous heart rhythm monitoring sent to a central screen so staff can watch the patient from the desk.

The Joint CommissionUS / Canada

The body that accredits most US hospitals and publishes the National Patient Safety Goals.

Elsewhere: The nearest equivalents are the CQC in England or a national accreditation body elsewhere. Its safety goals, such as using two patient identifiers, are directly examinable.

See also two patient identifiers, sentinel event

therapeutic communication

Talking in a way that invites the patient to say more: open questions, silence, and reflecting back.

therapeutic range

The blood drug level that works without being toxic. Below it the drug does nothing; above it, it does harm.

See also trough level

thyroid storm

A life-threatening surge of thyroid hormone with very high fever, a racing heart, and agitation.

See also hyperthyroidism

time-outUS / Canada

A pause before a procedure where the team says the right patient, right site, and right procedure out loud.

Elsewhere: The WHO surgical checklist covers the same ground worldwide. The US point is that anyone on the team, including the nurse, can stop the procedure.

See also two patient identifiers

titration

Adjusting a dose up or down in small steps until you get the effect you want.

topical

Applied to the skin or a mucous surface to work mainly in that one spot.

total parenteral nutrition

Full nutrition given straight into a vein when the gut cannot be used. It needs a central line and glucose checks.

See also central line, enteral nutrition

tracheostomy

A surgical opening in the front of the neck into the windpipe, held open by a tube, for long-term breathing support.

transdermal

Absorbed through the skin from a patch, giving a steady dose over hours or days.

transient ischemic attack

Stroke symptoms that clear up completely and leave no damage. It is a warning that a stroke may follow.

See also stroke

trough level

A drug level drawn just before the next dose, when the amount in the blood is at its lowest.

See also therapeutic range, vancomycin

tuberculin skin test

An intradermal test for tuberculosis exposure. Read the raised firm area, not the redness, at 48 to 72 hours.

See also tuberculosis, intradermal

tuberculosis

A bacterial lung infection spread through the air. Cough, night sweats, weight loss, and blood in the sputum.

See also airborne precautions, tuberculin skin test

two patient identifiersUS / Canada

Checking identity with two pieces of information, such as name and date of birth. Never the room number.

Elsewhere: Wristband checks are universal, but the US rule names two identifiers specifically and is tested constantly. The room or bed number never counts as one.

See also joint commission

unit secretaryUS / Canada

A non-clinical staff member who runs the desk: charts, phones, transcribing orders, and appointments.

Elsewhere: Called a ward clerk in the UK and Australia. They hold no clinical scope, so no patient care task may be delegated to them.

See also delegation

unlicensed assistive personnelUS / Canada

The exam's umbrella phrase for staff who hold no nursing license, mainly assistants and technicians.

Elsewhere: Nearly every delegation question is written around this phrase. Answer from the US boundary, not from the tasks unlicensed staff carried out where you trained.

See also delegation, certified nursing assistant

urinary tract infection

Infection in the urinary tract. Burning, urgency, and cloudy urine; in older adults it may show as confusion.

See also cauti

vancomycin

An antibiotic for resistant gram-positive infection. Infuse slowly and watch trough levels and kidneys.

See also trough level, mrsa

variable decelerations

Sudden drops in fetal heart rate of changing shape and timing, usually caused by cord compression.

See also late decelerations

vasopressor

A drug that tightens blood vessels to bring up a dangerously low blood pressure.

See also septic shock

venous thromboembolism

The umbrella term covering a clot in a deep vein and a clot that has traveled to the lungs.

See also deep vein thrombosis, pulmonary embolism

ventricular fibrillation

Chaotic quivering of the ventricles. There is no pulse and no output. Treat with CPR and defibrillation.

ventricular tachycardia

A fast rhythm starting in the ventricles. Always check for a pulse: pulseless ventricular tachycardia is defibrillated.

vital signs

Temperature, pulse, respiratory rate, blood pressure, and oxygen saturation.

warfarin

An oral anticoagulant monitored by INR. Vitamin K reverses it, and green vegetables change how it works.

See also inr, anticoagulant

weight-based dosingUS / Canada

A dose worked out per kilogram of body weight, standard in pediatrics and for drugs like heparin.

Elsewhere: The math is the same everywhere. The extra step in the US is converting the recorded weight from pounds first, and that conversion is where most calculation errors start.

See also pound, kilogram

wheezing

A high whistling sound from narrowed airways, loudest when breathing out. Typical of asthma.

See also asthma

white blood cell count

The number of infection-fighting cells. High suggests infection; very low means the patient cannot fight one.

Z-track

Pulling the skin sideways before an intramuscular injection so the drug cannot leak back up the needle track.

See also intramuscular