Nursing Fundamentals: End-of-Life Care, Infection Control, Elimination, Sensory Perception, and Stress & Coping

Comprehensive vocabulary flashcards covering End-of-Life Care, Infection Control and Asepsis, Urinary and Gastrointestinal Elimination, Sensory Perception Disorders, and Stress, Coping, and Defense Mechanisms from ATI Engage Fundamentals.

Hospice Care

The administration of medical care to support a client with a terminal illness so they can live the last days of their life as best and as long as they can; provided when curative treatments are discontinued and life expectancy is certified by a health care provider to be fewer than $6\text{ months}$.

Palliative Care

Holistic care provided across the lifespan for clients experiencing severe medical illness and approaching end of life; unlike hospice, it is initiated earlier in life-threatening health events and can be provided concurrently with curative treatments.

Cheyne-Stokes Respirations

An irregular respiratory breathing pattern characterized by fluctuating cycles of several rapid, deep breaths followed by periods of apnea, commonly observed during the active dying phase.

Death Rattle

A wet, crackling sound produced by the retention and accumulation of secretions in the respiratory tract as a client nears death.

Mottling

A purple, blotchy discoloration of the skin occurring hours or days before death, resulting from decreased peripheral blood perfusion as the heart fails to pump blood effectively.

Good Death

An end-of-life experience facilitated by healthcare providers and family that encompasses effective pain management, advance planning, closure, clear decision-making, and the opportunity for the dying client to contribute to others.

Postmortem Care

Physical care performed after death to prepare the body for viewing, autopsy, or transfer to a funeral home; involves washing the body, removing invasive devices, logging possessions, and applying identification tags to at least two locations.

Organ Procurement Organization (OPO) Protocol

The regulated procedure governing organ/tissue donation requests; bedside nurses are strictly prohibited from initiating donation dialogues, which must only be performed by professionals certified through an OPO-endorsed course.

Chain of Infection

The essential six-link sequence required for an infection to develop and spread: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.

Infectious Agent

Any biological pathogen capable of causing infection, classified as a bacterium, virus, fungus, parasite, or prion.

Reservoir

The natural habitat, host, or environment where an infectious agent lives, thrives, and multiplies or replicates.

Portal of Exit

The anatomical pathway or bodily mechanism through which an infectious agent leaves its reservoir host.

Portal of Entry

Any body orifice (such as the mouth, nose, or ears) or break in the skin that allows an infectious agent or toxin to enter and establish infection in a host.

Susceptible Host

An individual lacking effective immunity who provides a biological environment for an infectious agent to take hold, multiply, and become a new reservoir.

Direct Contact Transmission

The physical movement and transfer of microorganisms directly from an infected individual to another person without an intervening intermediate object or person.

Indirect Contact Transmission

The transfer of microorganisms from an infected person to a susceptible host via an intermediate contaminated object (fomite) or intermediate individual.

Droplet Transmission

A mode of infection transmission occurring when respiratory droplets expelled from an infected client travel through the air and deposit onto the mucous membranes of a host.

Airborne Transmission

The dissemination of infection occurring when small, lightweight infectious particulates suspend in air currents and travel into the airspace of another individual.

Nonspecific Immunity

Innate body defense mechanism mediated by phagocytic white blood cells (neutrophils and macrophages) that engulf and destroy pathogens during the inflammatory response.

Specific Immunity

Adaptive immune response mediated by lymphocytes and antibodies (immunoglobulins) that selectively bind to targeted antigens, recruiting complement and leukocytes for destruction.

Stages of Infection

The five clinical phases of an infection: incubation (replication without symptoms), prodromal (non-specific early symptoms), acute illness (manifestations peak and disease-specific symptoms appear), decline (pathogens decrease and manifestations subside), and convalescence (recovery to baseline health).

Medical Asepsis

Clean technique practices implemented to reduce the numbers, growth, and spread of disease-causing microorganisms.

Standard Precautions

Foundational infection prevention practices applied to the care of all clients regardless of their suspected or confirmed infection status.

Health Care-Associated Infections (HAIs)

Infections acquired during health care delivery, of which the four major categories are CLABSIs, CAUTIs, SSIs, and VAPs.

Kidneys

Two retroperitoneal, bean-shaped organs adjacent to the spine that filter $120\text{ to }150\text{ quarts}$ of blood daily to produce $1\text{ to }2\text{ quarts}$ of urine, while regulating electrolytes and blood pressure.

Stress Incontinence

Involuntary loss of urine triggered by increased intra-abdominal pressure from physical movements such as coughing, sneezing, laughing, or exercising.

Urge Incontinence

Involuntary leakage of urine occurring immediately following a sudden, intense sensation and need to urinate before reaching the toilet.

Reflex Incontinence

Involuntary loss of urine occurring at predictable intervals without prior warning or sensation, typically caused by neurological impairment or nerve damage.

Overflow Incontinence

Involuntary dribbling or leakage of urine resulting from incomplete bladder emptying and progressive overdistention.

Functional Incontinence

Urinary leakage caused by physical, cognitive, or environmental factors that prevent a client with normal bladder function from reaching the toilet in time.

Urinary Retention

The inability of the bladder to empty completely, leading to abdominal distention, pain, hesitancy, weak stream, and overflow leakage.

Pyelonephritis

A serious upper urinary tract and kidney infection that develops when an untreated lower urinary tract infection ascends from the bladder.

Nephrolithiasis

The formation of kidney stones (renal calculi or urolithiasis), which are hard crystalline deposits of minerals and acid salts that accumulate in the kidneys.

Constipation

A clinical bowel condition characterized by having fewer than $3\text{ bowel movements}$ in a week, producing dry, hard stools accompanied by difficult evacuation.

Diverticulosis and Diverticulitis

Diverticulosis is the formation of small outpocketings or pouches in the intestinal wall of the colon; diverticulitis occurs when these pouches trap fecal matter or food, becoming inflamed and infected.

Irritable Bowel Syndrome (IBS)

A functional gastrointestinal disorder marked by recurrent abdominal pain and altered bowel habits manifesting as diarrhea alone, constipation alone, or mixed patterns.

Ulcerative Colitis (UC)

A chronic inflammatory bowel disease characterized by progressive inflammation and ulcer formation limited to the mucosa and submucosa of the large intestine and colon.

Crohn's Disease

A chronic, transmural inflammatory bowel disease that most frequently affects the terminal ileum and small intestine, but has the potential to involve any segment of the gastrointestinal tract.

Sensory Deficit

A defect or objective impairment in the physiological functioning of one or more of the five primary senses (vision, hearing, smell, taste, touch).

Sensory Deprivation

A state in which an individual receives insufficient or inadequate quality or quantity of sensory environmental stimuli.

Sensory Overload

A state in which sensory input arrives at an intensity and rate that exceeds the client's cognitive and neurological capacity to process.

Myopia

A refractive visual disorder commonly referred to as nearsightedness, where close objects are seen clearly while distant objects appear blurred.

Hyperopia

A refractive visual disorder commonly referred to as farsightedness, where distant objects are viewed more distinctly than near objects.

Astigmatism

A refractive error caused by an irregular curvature of the cornea or lens that prevents light rays from focusing evenly onto a single retinal focal point, producing blurred and distorted vision.

Presbyopia

Age-related progressive loss of the eye's crystalline lens elasticity, resulting in difficulty accommodating and focusing on small print or close objects.

Cataracts

Progressive opacification and clouding of the eye lens caused by protein denaturation and clumping, manifesting as hazy vision, poor night vision, and yellowed color perception.

Diabetic Retinopathy

Microvascular damage to retinal blood vessels caused by chronic diabetes mellitus; it represents the leading cause of adult blindness and can progress to cause glaucoma.

Glaucoma

An ophthalmic condition defined by pathologically elevated intraocular pressure that progressively damages the optic nerve and visual fields.

Pachometer

An ophthalmic diagnostic instrument used during glaucoma evaluations to measure central corneal thickness when eye pressures are elevated or the optic nerve appears abnormal.

Stress

The mental, emotional, or physical response and adaptation of an individual to internal or external changes that disrupt normal bodily equilibrium.

Fight-or-Flight Response

Sympathetic nervous system response initiated by hypothalamic release of corticotropin-releasing factor (CRF) that prompts catecholamine release (epinephrine, norepinephrine, dopamine), increasing heart rate, blood pressure, airway diameter, and blood glucose levels.

Stress Response Hormonal Cascade

The neuroendocrine pathway where hypothalamic corticotropin-releasing hormone (CRH) signals the pituitary gland to secrete adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to release cortisol into the bloodstream.

General Adaptation Syndrome (GAS)

A universal three-stage physiological reaction to stressors comprising alarm reaction, stage of resistance, and stage of exhaustion, directed at maintaining or restoring homeostasis.

Eustress vs. Distress

Eustress refers to positive, motivating stress that triggers adaptive physiological responses, whereas distress describes negative, damaging stress that threatens equilibrium.

Transactional Theory of Stress and Coping

A cognitive framework conceptualizing stress as a dynamic interaction between a person and environment, determined by two stages of cognitive appraisal: primary (evaluating threat level) and secondary (assessing coping resources).

Acute Stress Disorder (ASD)

A severe, dysfunctional anxiety and behavioral reaction occurring shortly after exposure to a traumatic event that resolves in less than $1\text{ month}$.

Posttraumatic Stress Disorder (PTSD)

A persistent, debilitating psychiatric trauma response diagnosed when trauma-induced symptoms and acute stress manifestations persist for longer than $1\text{ month}$.

Crisis

An acute, threatening event precipitating severe behavioral, emotional, or psychiatric disorganization, classified along a severity gradient from Level 1 (least severe) to Level 4 (most severe).

Ego Defense Mechanisms

Unconscious mental operations that function to protect an individual from overwhelming anxiety, shield self-esteem, and maintain psychological integrity.

Denial

An ego defense mechanism marked by the active refusal to admit, acknowledge, or accept objective reality in order to avoid painful emotional impact.

Rationalization

An ego defense mechanism characterized by formulating plausible, logical, or socially acceptable excuses for unacceptable behaviors to avoid guilt and emotional discomfort.

Projection

An ego defense mechanism wherein an individual unconsciously attributes their own undesirable thoughts, unacceptable impulses, or feelings onto someone else.

Repression

An involuntary ego defense mechanism that excludes anxiety-provoking ideas, painful memories, or unacceptable impulses from conscious awareness.

Regression

An ego defense mechanism characterized by retreating to behaviors and coping patterns characteristic of an earlier, more comfortable developmental stage.

Compartmentalization

An ego defense mechanism where an individual segregates conflicting thoughts, feelings, or life experiences into separate mental compartments to avoid anxiety.