Terms D-F

Damages: In law this refers to money recovered in the courts for a civil injury or loss caused by either negligence or an intentional tort.

Damage Caps: In law this refers to caps or limits on recovery, typically seen in medical malpractice caps. Presently, New York State does not have a damages cap.

Darvocet: Trademark name for a drug containing an analgesic (amphetamine and opiate analgesic).

Data Analysis: The part of a study that includes classifying, coding and tabulating information needed to perform a qualitative or quantitative analysis.

Death With Dignity: The philosophy that a terminally ill patient should be allowed to die naturally and comfortably, rather than experience a comatose vegetative life controlled by mechanical support systems.

Debride: The removal of dirt, foreign objects, damaged tissue or cellular debris from a wound or injury to prevent infection and promote healing. Large pressure sores are frequently debrided to facilitate healing and reduce the risk of infection. Debridement may be done surgically, mechanically, or chemically.

Decalcification: The loss of calcium salts from the teeth and bones caused by various conditions including malnutrition, mal-absorption or other factors including immobility. Mal-absorption can be caused by a lack of Vitamin D necessary for the absorption of calcium from the intestine. Individuals who have bones that are decalcified may be at higher risk for fracture injuries.

Decedent: A deceased person.

Declarative Memory: The mental registration, retention and recall of passed experiences, sensations, ideas, knowledge and thoughts.

Decompensation: The failure of a system as in cardiac decompensation and heart failure.

Deductible: The monetary amount that person covered under a health insurance plan or insurance policy must pay personally, in addition to whatever the insurance company may pay.

Deep Vein Thrombosis: Presence of a blood clot in a deep vein. Prolonged sitting and immobility can cause such a clot, which can be life threatening. Deep vein clots usually occur in the legs, regardless of the cause. The hallmark symptoms are rapid leg swelling and calf pain. Physical exam may reveal pitting edema and mild increase in skin temperature.

Dehydration: A medical condition resulting where a person has either lost or not retained sufficient fluids to maintain body function. Significant dehydration can be a sign of potential neglect in the long-term care setting. Dehydration is accompanied by the disturbance in the balance of essential electrolytes, particularly sodium, potassium and chloride. It may also follow prolonged fever, diarrhea, vomiting, acidosis or any condition where there is rapid depletion of body fluids. Signs of dehydration may include poor skin turgor, flush or dry skin, coated tongue, dry mucus membranes, irritability and confusion.

Decubitus Ulcer: Generally referring to skin breakdown typically caused by pressure. This term is synonymous with pressure ulcer or bedsore.

Defendant: In a civil lawsuit, the party defending the lawsuit against whom Plaintiff seeks to recover damages.

Deficiency: Nursing homes that receive federal monies are generally inspected by federal agencies. These agencies, usually operating through local state government’s Department of Health, will issue deficiencies where the facility has failed to meet proper regulatory standards of care. The regulations governing deficiencies can be found at 42 C.F.R. 483.10 et seq.

Dementia: A general term referring to the deterioration or decline of mental faculties, sometimes accompanied with aggressive or inappropriate behavior. There are many different types of dementia. One common form of dementia is Alzheimer’s disease. Dementia resulting from a stroke or acute brain damage is referred to as multi-infarct dementia.

Deep Vein Thrombosis: A disorder involving a thrombosis or blood clot in one of the deep veins of the body most commonly the iliac or femoral vein. It can be potentially life-threatening, especially if the clot breaks off and enters the lung, resulting in a pulmonary embolism.

Default Judgment: In law this refers to a judgment entered against the Defendant as a result of a Defendant’s failure to either appear in court or answer a Plaintiff’s claim within the proper time period.

Deficit: Any deficiency or difference from what is normal such as an oxygen deficit or memory deficit.

Degenerative Disease: Any disease in which the deterioration of structures or functions of tissue occurs. Kinds of typical types of degenerative diseases can include arthrosclerosis and osteoarthritis.

Deinstitutionalization: A philosophy relating to the change in location of treatment from an institution to a community setting.

Delirium: Referring to a state of frenzied excitement or wild enthusiasm. It can also refer to an acute organic mental disorder characterized by confusion, disorientation or incoherence.

Delirium Tremens (DT): An acute and sometimes fatal reaction caused by the stopping of excessive alcohol intake, which has occurred over a long period of time. Initial symptoms can include loss of appetite, insomnia and general restlessness which can be followed by agitation, disorientation and confusion. Sometimes vivid hallucinations and acute fear or anxiety can result.

Dependency: The physical and emotional requirements of an infant or other individual who may depend on others for love, support and protection. Many nursing home patients who have significant physical or mental ailments may be completely dependent on their caregivers to meet their daily needs.

Deposition: In the law this refers to a process by which an individual’s testimony is given orally and transcribed by a court reporter, usually before trial. A deposition can be used at trial and for impeachment and under some circumstances can be used as trial testimony.

Depression: An abnormal emotional state characterized by exaggerated feelings of sadness, melancholy, worthlessness and/or hopelessness. This is one of the most common psychiatric disorders in the elderly population. Depression can be caused by genetic, environmental or other factors including disease. The prevalence of clinically significant symptoms of depression ranges from 8% o 15% for elders in community settings and about 30% for the institutionalized elderly. Not surprisingly, the elderly in nursing homes are vulnerable to depression especially during the initial admission when they are undergoing a significant change from their prior environment. A nursing home should do a complete assessment of the resident’s mental status which should include consideration of potential depression and related issues.

Dermis: The layer of the skin just below the epidermis consisting of papillary and reticular layers and further containing blood and lymphatic vessels, nerves and nerve endings.

Diabetes: A clinical condition characterized by the imbalance of blood sugars. Diabetes can be caused by a deficiency of anti-diuretic hormone (ADH) as in diabetes insipidis or it may be the polyuria resulting from the hypoglycemia that occurs in diabetes mellitis. Diabetes mellitis is primarily a result of a deficiency or lack of insulin secretion by the pancreas and/or resistance to insulin. The disease is often familial but can be acquired, as in Cushing's syndrome. Early identification and treatment of diabetes is essential to the health of our elderly population. The goal of treatment is to maintain insulin glucose homeostasis. Type 1 diabetes generally refers to the need to treat the condition with insulin in combination with diet and exercise.

Diabetic Acidosis: A type of acidosis that may occur in diabetes mellitis as a result of excessive production of ketone bodies during oxidation of fatty acids.

Diabetic Neuropathy: A non-inflammatory disease process associated with diabetes mellitis and characterized by sensory and motor disturbances in the peripheral nervous system.

Diagnostic and Statistical Manual of Mental Disorders: A commonly used and widely accepted reference book used to diagnose various mental disorders.

Dialysis: A medical procedure for the removal of certain elements from the blood or lymph by virtue of their differences in rates of diffusion through a permeable membrane. Dialysis is typically used to remove poisons, drugs or to correct electrolyte or acid-based imbalances and remove urea, uric acid and creatinine in cases of chronic or stage renal disease.

Dialysis Dementia: A neurologic disorder that occurs in some patients undergoing dialysis. The precise cause is unknown.

Diastole: The period between contractions of the atria or the ventricles during which blood enters the relaxed chamber from the circulatory system and lungs.

Diastolic Blood Pressure: Measures the blood pressure at the instant of maximum cardiac relaxation.

Diastolic Murmur: A noise caused by turbulence of blood flow during a ventricular relaxation. With few exceptions, diastolic murmurs are caused by organic heart disease.

Diazepam: A benzodiazepine sedative and minor tranquilizer usually given for the treatment of anxiety, nervous tension or muscle spasms. Adverse reactions can be withdrawal symptoms, respiratory depression, drowsiness and fatigue.

Dietary Fiber: A generic term for non-digestible carbohydrate substances found in plant cell walls and surrounding cellular material. Dietary fiber can have a beneficial effect on GI function and colon transit time. The main dietary fiber components are cellulose lining, pectin and plant gums. Foods high in dietary fibers include fruits, green leafy vegetables, spinach, celery, cabbage, legumes, whole grain cereals, and breads.

Differential Diagnosis: The distinguishing between two or more possible diseases with similar symptoms by systematically comparing their different characteristics. Before a doctor reaches a final diagnosis he may undertake a differential diagnosis and list the various potential diagnoses that he will rule out.

Diffuse: In medical terms this may refer to a condition which is widely spread throughout a membrane or fluid.

Diphenoxylate Hydrochloride: An anti-diarrhea medication that contains atropine sulfate which is generally
prescribed in the treatment of non-infectious diarrhea and intestinal cramping. Adverse side effects can include
abdominal discomfort, nausea, skin rash, urinary retention or intestinal obstruction.

Diplomat: Generally referring to an individual who has earned a diploma or certificate. Professionally a physician who has been Board certified in his specialty.

Direct Costs: In managed care this refers to the cost of labor, supplies and equipment to provide direct patient care services.

Discharge Planning: Refers generally to the procedure used by a healthcare provider in determining when it would be appropriate to discharge or release a patient from ongoing care. A social worker or case manager will typically get involved in discharge planning. The discharge planning process should involve an assessment as to the patient’s needs and what facility or environment would be best suited to meet those patient needs.

Discovery: In the legal setting this refers to pretrial procedures that allow one party to obtain vital documents, testimony or other evidence that may be held by the adverse party. American courts favor an open discovery which reduces the chance of surprise at trial and also allows the parties to evaluate their respective cases prior to trial.

Diskectomy: Generally referring to the excision of an intervertebral disk.

Diuresis: Increased formation and secretion of urine. It occurs in conditions such as diabetes mellitis, diabetes insipidis, and acute renal failure. Water is considered to be the least expensive diuretic, as consuming large amounts of water will increase urine output.

Diverticulitis: Inflammation of one or more of the diverticula. Diverticula are sac-lined mucosal projections through the muscular layer of the GI tract which can cause symptoms by slowing or stopping the flow of feces, or by becoming infected, rupturing or bleeding. Penetration of fecal matter to the thin walled diverticula can cause inflammation and abscess formation in the surrounding tissue, with repeated inflammation, the lumen of the colon narrows and becomes obstructed. Aging typically leads to bowel problems and enemas are sometimes used to rule out carcinoma of the colon. Conservative treatment may include bed rest, IV fluids, antibiotics and abstaining from eating and drinking for a limited period of time.

Documentation: In the medical field this refers to the general recording of pertinent patient data in the clinical record. Standards of care generally require the documentation of patient’s assessment, care plan and treatments.

Dorsal: Relating to the back or posterior of a body or organ.

Dorsalis Pedis Pulse: The pulse of the dorsalis pedis artery palpable on the top of the foot. The lack of a pulse in the foot can be an indication of reduced blood flow which can increase a patient’s risk for skin breakdown in his legs or feet.

Drainage: The removal of fluids from a body cavity, wound or other source of discharge by one or more methods.

Drug Addiction: A condition characterized by an overwhelming desire to continue taking a drug to which one has become habitually used to consuming because it produces a particular effect, usually an alteration in mental status. Common addictive drugs are barbituates, alcohol, morphine and other opioids, especially heroine and oxycontin.

Drug Holiday: A period of withdrawal to reverse ineffectiveness of a drug resulting from receptor desensitization or adverse effects that result from chronic treatment. A drug holiday may be a good idea for an elderly person who has been on psychotropic or anti-psychotic medications for long periods of time.

Duodenum: The shortest and widest portion of the small intestine, it is the transitional organ between the stomach and small intestine.

Durable Power of Attorney: A document that designates an agent or proxy to make healthcare decisions for a patient who is no longer able to make them. This document typically directs the person to function as the attorney-in-fact and make decisions regarding all treatment including the final decision about the cessation of life support treatment. A durable power of attorney is a written document that must be executed before a patient loses the mental capacity to understand what he/or she is signing.

Duress: In law this refers to an action compelling another person to do what he or she would not have ordinarily or voluntarily done.

Duty: In law this refers to an obligation to conform to a particular standard or requirement, the failure of which may give rise to liability. In malpractice cases both community practice standards or regulatory standards may give rise to legal duties, the breach of which may give rise to legal liability.

Dysentery: An inflammation of the intestines especially of the colon that may be caused by chemical irritants, bacteria, protozoa or parasites. It can be characterized by frequent and bloody stool, and/or abdominal pain.

Dyskinesia: An impairment of the ability to execute voluntary movements. Tardive dyskinesia is caused by the adverse effect of prolonged use of psychotropic medications in elderly patients or those with brain injuries.

Dysphagia: Difficulty in swallowing commonly associated with obstructive or motor disorders of the esophagus. Additionally, patients with strokes may have difficulty swallowing because of their inability to control muscles of the esophagus. Diagnosis of the underlying condition can be made by barium studies or clinical observation.

Dysplasia: Any abnormal development of tissue or organs that causes an alteration in cell growth.

Dyspenea: A distressful sensation of uncomfortable breathing that may be caused by certain heart conditions, strenuous exercise or anxiety. Also called breathlessness.

Dystonia: Any impairment of muscle tone.

Ecchymosis: Bluish discoloration of an area of the skin or membrane caused by an extravasation of the blood into the subcutaneous tissue as a result of trauma to the underlying blood tissue or fragility of the vessel walls. Also known as a bruise or contusion.

ECG: Abbreviation for electrocardiogram.

Echo Cardiogram: A graphic outline of the movements of the heart structures produced by ultrasonography.

Echo Encephalograph: The use of ultrasound to study the intracranial structures of the brain. It is useful for showing ventricular dilation or major shifts of midline structures caused by an expanding lesion.

Echogram: A recording of ultrasound echo patterns of a body structure.

Ecology: The study of interaction between organisms and their environment.

Ectomorph: A person whose physique is characterized by slenderness, fragility and a predominance of structures derived from the ectoderm.

Ectopic: Situated in an unusual place away from its normal position. For example, an ectopic pregnancy occurs outside the uterus.

Edema: An abnormal accumulation of fluid in the interstitial spaces of tissue such as in the pericardial sack or joint capsules. Edema can be caused by increased capillary fluid pressure, venous obstruction, pressure from casts, tight bandages, congestive heart failure, renal failure, hepatic cirrhosis, inflammatory reactions and other conditions. Edema can also result from loss of serum protein in burns or other significant wounds. Treatment of edema focuses on correcting the underlying cause. Potassium diuretics may be administered to promote excretion of sodium and water.

Efferent Nerve: A nerve that transmits impulses away or outward from a nerve center such as the brain or spinal cord, usually causing a muscle contraction or a release of glandular secretions.

Efficacy: The ability of a drug or treatment to effectively produce a specific, intended result.

Ejection Fraction (EF): The fraction of the total ventricular filling volume that is ejected during each ventricular convulsion. The normal EF of the left ventricle is 65. This is one measure used to assess heart function in the elderly population.

Elder Abuse: In the legal sense this refers to a reportable offense of physical, psychological or financial abuse of an elder. Many times an abused person may deny that abusive acts occur and feels helpless to respond to the abuse.

Electroencephalogram (EEG): A graphic chart which is used to trace the electrical potential produced by brain cells as detected by electrodes.

Electrolyte: An element or compound that when dissolved in water or another solvent disassociates into ions and is able to conduct an electric current. Electrolytes are present in blood plasma and interstitial fluid. Proper balance of electrolytes is important to normal metabolic function. Diarrhea can cause a loss of many electrolytes leading to hypovolemia and shock.

Electromyogram (EMG): A test of the intrinsic electric activity in a skeletal muscle, which can aid in the diagnosis of neuromuscular problems. Readings are obtained by surface electrodes that measure electrical activity of the muscle.

Elopement: Describes the process in which a resident of a nursing home or other long-term care facility is able to successfully leave the premises without knowledge of the staff. Long term care facilities are required to evaluate residents for their potential risk of elopements and come up with a care plan to prevent such a problem. Many facilities use wander bracelets or other alarms to notify them when a resident has left a secure area. Every year elopements result in serious injuries, especially in situations where the elderly elope into a dangerous environment.

Emaciated: Characterized by extreme loss of subcutaneous fat that results in an abnormally lean body, i.e. as a condition associated with starvation.

Emancipated Minor: A person who may not be a legal adult under state law but because he or she is married, in the military or no longer dependent on parents, may not require parental permission for medical or surgical care.

Embolectomy: A surgical incision into an artery for the removal of an embolus or blood clot. Can be performed as an emergency treatment for an arterial embolism.

Embolus: A foreign object, quantity of air or gas, bit of tissue or piece of thrombus that circulates in the blood stream until it becomes lodged in a vessel.

Emergency Medical Technician (EMT): A person trained in and responsible for the administration of specialized emergency care usually associated with the transportation of victims of an acute illness or injury to a hospital.

Emergency Medicine: A branch of medicine concerned with the diagnosis and treatment of conditions generally associated with trauma or sudden illness, and presenting to an emergency room of a hospital or an acute care facility.

Emergency Nursing: Nursing care provided to prevent imminent severe damage or death or to avert serious injury. Activities typically involve basic nursing life support, cardiopulmonary resuscitation and control of hemorrhage.

Emesis: Vomit

Emetic: Pertaining to a substance that causes vomiting. An anti-emetic prevents nausea. Emetrol is a standard trademark drug used as an anti-nausea medication.

Emotional Abuse: The debasement of a person’s feelings or emotional state that causes himself to perceive that he is worthless or useless.

Emotional Deprivation: A lack of adequate warmth, affection and interest especially of a parent or significant nurturer. It is a relatively common problem among institutionalized persons or children from broken homes.

Emphysema: An abnormal condition of the pulmonary system characterized by over inflation and destructive changes in alveolar walls of the lungs. It results in a loss of lung elasticity and decreased gas exchange. Acute emphysema may be caused by a rupture of the alveoli during severe respiratory efforts. Emphysema may also occur after asthma or tuberculosis, conditions in which the lungs are overstretched until the elastic fibers of the alveolar walls are destroyed. In old age the alveolar membranes atrophy and may collapse producing large, air filled spaces and a decrease total surface area of the pulmonary membranes effectively reducing lung capacity.

Emphymea: An accumulation of pus in a body cavity especially in the pleural space, as a result of bacterial infection.

Encephalitis: Inflammation of the brain that can result from a variety of causes, including exposure to poison or other infections. Severe inflammation with destruction of nerve tissue can result in a seizure disorder or other permanent neurologic problems, or even death.

Encephalopathy: An abnormal condition of the structure or function of brain tissues especially chronic, destructive or degenerative conditions.

Endo: Prefix meaning inward or within.

Endocarditis: Inflammation of the endocardium and heart valve. This condition is characterized by lesions caused by a variety of diseases. All types of endocarditis can be lethal if not treated by various anti-bacterial or surgical means.

Endotrachaeal Tube: A large catheter tube inserted through the mouth or nose and into the trachea to the point above the bifurcation of the trachea. It is used for delivering oxygen under pressure when ventilation must be totally controlled.

End Stage Disease: A stage of the disease that is essentially terminal because of irreversible damage.

Enteral Tube Feeding: The introduction of nutrients directly into the GI tract by a feeding tube. Routes include both non-surgical and surgical placement.

Enteric Infection: A disease of the intestine caused by an infection among commonly involved enteric infections are Escherichia coli, vibrio cholera and several species of salmonella. These infections are typically characterized by diarrhea, nausea, abdominal pain and vomiting.

Enteritis: Inflammation of the mucosal lining of the small intestine, resulting from a variety of causes, such as bacterial, viral, functional or inflammatory.

Environmental Carcinogen: Any substance that can cause cancer or other disease processes. Such agents can be divided into chemical agents, physical agents, hormones, viruses and other pathogens. Some environmental carcinogens include arsenic, asbestos, uranium, vinyl chloride, radiation, xrays, and coal tar derivatives. Carcinogenic effects of chemicals can be delayed as long as thirty years.

Epidemiology: The study of the cause of diseases in the general population.

Epidermis: The superficial layers of the skin made up of the outer dead, conified part and a deeper living cellular part. The deepest layer of the skin is called the stratum basalae, which anchors the more superficial layers to the underlying tissue and provides new cells to replace those lost by abrasion from the outer layers.

Epilepsy: A group of neurologic disorders characterized by recurrent seizures, sensory disturbances, abnormal behavior and loss of consciousness. Common to all types of epilepsies are the uncontrolled electrical discharge from nerve cells of the cerebral cortex.

Epithelial Cancer: A carcinoma that develops from the epithelium or related tissue in the skin.

Equilibrium: The state of balance or rest from the equal action of opposing forces i.e., calcium and phosphorous in the body.

ERISA: An abbreviation for the Employment Retirement Income Security Act.

Erythremia: An abnormal increase in the number of red blood cells.

Erythrocyte: Mature red blood cells that contain hemoglobin. This is one of the major cellular elements of the circulating blood and transports oxygen as its principal function. Blood loss, anemia, or chronic oxygen deprivation may cause erythrocyte production to increase. Erythrocytes originate in bone marrow of the long bones.

Esophageal Cancer: A rare malignant disease of the esophagus that peaks at about sixty years of age. It occurs three times more frequently in men than in women. Risk factors for the disease include heavy consumption of alcohol and tobacco.

Esophagus: The muscle membrane extending from the pharynx to the stomach.

Essential fatty acids (EFA): Poly unsaturated acid such as linoleic, alpha-linoleic, and anchidonic acids, essential in the diet for proper growth, maintenance and functioning of the body. EFAs play an important role in metabolism and the breaking up of cholesterol deposits on arterial walls. Best sources are natural vegetable oils such as soy and corn, wheat germ, edible seeds, fish oils and cod liver oil.

Etiology: The study of all factors involved in the causation of a disease including the susceptibility of the patient, the nature of the disease agent and the way in which the patient’s body is invaded by the agent.

Evoked Potential (EP): An electrical response in the brain stem or cerebral cortex that is elicited by a specific stimulus. Evoked Potential studies are used for patients with suspected sensory deficits who are unable to provide an accurate history of their symptoms. They are also used to evaluate areas of the cortex that receive incoming stimulus from the eyes, ears and extremities.

Expert Witness: A person who has specialized skill or knowledge about a subject which forms the basis for court testimony. Specialized knowledge can be acquired by education, experience, or observation. The admissibility of expert testimony varies from state to state.

Extended Care Facility: An institution devoted to providing medical, nursing or custodial care for an individual who over a prolonged period of time, usually in the course of a chronic disease or after rehabilitation for an acute injury or illness. Extended care facilities include intermediate care facilities and skilled nursing facilities (SNFs).

Extra Pyramidal Side Effects: Side effects that make voluntary movements or changes in muscle tone seen in tardive dyskinesia and Parkinson’s disease. These side effects can result from the use of drugs that block dopamine receptor sites. Psychotropic and antipsychotic drugs can cause such side effects when used for extended periods of time.

Exudate: Fluid cells or other substances that have been expelled or discharged from cells or blood vessels through small pores or breaks in cell membranes. Perspiration, pus and serum are sometimes referred to as exudates in medical records.

Faculty: Physiologic function or natural ability of a living or organism, such as the digestive faculty or the ability to perceive and distinguish sensory stimuli.

Failure to Thrive (FTT): The abnormal retardation of growth and development of an infant resulting from conditions that interfere with normal metabolism, appetite, and activity. Causative factors include chromosomal abnormalities, as in Turner’s syndrome and the various trisomies; major organ system defects that lead to deficiency or malfunction; systemic disease or acute illness; physical deprivation, primarily malnutrition; and various psychosocial factors, as in severe cases of maternal deprivation syndrome. This term can also be used to describe a significant decline of an elderly person.

Fall Prevention: A nursing intervention from the Nursing Interventions Classification (NIC) defined as the institution special precautions with patient at risk for injury from falling. Aggressive fall prevention should be part of any plan of care for an elderly person in a long term care setting, who is at risk for falling. The standard of care for long term care facilities requires that all patients get evaluated for fall risks and that evaluation forms the basis for a fall prevention plan.

False Positive: A test result that wrongly indicates the presence of a disease or other condition the test is designed to reveal.

Family Medicine: The branch of medicine that is concerned with the diagnosis and treatment of health problems in people of either sex and any age. Practitioners of family medicine are often called family practice physicians, family physicians, or, formerly, general practitioners. They often act as the primary health care providers, referring complex disorder to a specialist.

Fascia: The fibrous connective membrane of the body that may be separated from other specifically organized structures, such as the tendons, the aponeuroses, and the ligaments, and that covers, supports, and separates muscles.

Febrile: Combining form meaning fever.

Fecal Impaction: An accumulation of hardened  feces in the rectum or sigmoid colon that the individual is unable to move. Diarrhea may be a sign of fecal impaction, since only liquid material is able to pass the obstruction. Occasionally fecal impaction may cause urinary incontinence through pressure on the bladder. Treatment includes oil and cleansing enemas and manual breaking up and removal of the stool by a gloved finger. Persons who are dehydrated, nutritionally depleted, on long periods of bed rest, receiving constipating
medications (such as iron or opiates), or undergoing barium radiographic studies are at risk of developing fecal impaction. Prevention includes adequate ingestion of bulk food, fluids, exercise, regular bowel habits, privacy for defecation, and occasional stool softeners or laxatives.

Federal Tort Claims Act: A statute passed in 1946 that allows the U.S. federal government to be sued for the wrongful action or negligence of its employees. The act, for most purposes, eliminates the doctrine of governmental immunity, which formerly prohibited the bringing of a suit against the federal government.

Femoral Vein: A large vein in the thigh originating in the popliteal vein and accompanying the femoral artery in the proximal two thirds of the thigh.

Femur: The thigh bone, which extends from the pelvis to the knee. It is largely cylindric and is the longest and strongest bone in the body.

Fetal Distress: A compromised condition of the fetus, usually discovered during labor, characterized by a markedly abnormal rate or rhythm of myocardial contraction. Some patterns, such as late decelerations of the fetal heart rate seen on records of electronic fetal monitoring are indicative of fetal distress.

Fibromyalgia: A form of non-articular rheumatism characterized by musculoskeletal pain, spasms, stiffness, fatigue and severe sleep disturbance. Common sites of pain or stiffness include the lower back, neck, shoulder region, arms, hands, knees, hips, thighs, legs, and feet. These sites are known as trigger points. Physical therapy, nonsteroidal anti-inflammatory drugs, and muscle relaxants provide temporary relief. Also called fibrositis.

Fibula: One of the two bones of the lower leg, lateral to and smaller in diameter than the tibia. Also called the calf bone.

Flexion: A movement allowed by certain joints of the skeleton that decreases the angle between two adjoining bones, such as bending the elbow, which decreases the angel between the humerus and the ulna. Compare extension.

Float Nurse: A nurse who is available for assignment to duty on an ad hoc basis, usually to assist in times of unusually heavy workloads or to assume the duties of absent nursing personnel. A float nurse is recruited from a group of nurses called a float pool. Also called contingent nurse.

Fluid Volume Deficiency: A fluid volume deficit is the state in which an individual experiences decreased intravascular, interstitial, and/or intracellular fluid. This refers to dehydration, water loss alone without change in sodium.

Folic Acid: A yellow crystalline water-soluble vitamin essential for cell growth and reproduction. Deficiency results in poor growth, graying of hair, glossitis, stomatitis, GI lesions, and diarrhea, and it may lead to megaloblastic anemia.

Food and Drug Administration (FDA): A U.S. federal agency responsible for the enforcement of federal regulations on the manufacture and distribution of food, drugs, and cosmetics intended to prevent the sale of impure or dangerous substances.

Food Contaminants: Substances that make food unfit for human consumption. Examples include bacteria, toxic chemicals, carcinogens, teratogens, and radioactive materials.

Formulary: A listing of drugs intended to include a large enough range of medications and sufficient information about them to enable health practitioners to prescribe treatment that is medically appropriate. Hospitals maintain formularies that list all drugs commonly stocked in their pharmacy. Third-party organizations such as insurance companies usually maintain formularies that list drugs for which the company will cover under plan benefits.

Fraud: The act of intentionally misleading or deceiving another person by any means so as to cause him or her legal injury, usually the loss of something valuable or the surrender of a legal right.

Free Radical: An organic compound with at least one unpaired electron.

Free-radical Theory of Aging: A concept of aging based on the premise that the main causative factor is an imbalance between the production and elimination of free chemical radicals in the body tissues.

Frontal Lobe: The largest of five lobes constituting each of two cerebral hemispheres. It is responsible for voluntary control over most skeletal muscles. The frontal lobe significantly influences personality and is associated with the higher mental activities, such as planning, judgment, and conceptualization.

Fusion: The joining into a single entity, as in optic fusion. The act of uniting two or more bones of a joint.