Terms P-R

Pacing: Setting of the heart’s rhythm by the sinus node, by another site in the heart, or by an artificial electrical stimulator.

Package insert: A leaflet that, by order of the Food and Drug Administration (FDA), must be placed inside the package of every prescription drug.

Paget’s disease: A common nonmetabolic disease of bone of unknown cause, usually affecting middle-aged and elderly people, and characterized by excessive bone destruction and unorganized bone repair.

Pain and Suffering: In law, an element in a claim for damages that allows recovery for the mental and physical pain, suffering, distress, and trauma that an individual has endured as a result of an injury.

Pain assessment: An evaluation of the reported pain and the factors that alleviate or exacerbate it, as well as the response to treatment of pain. All long term care facilities should assess their resident’s level of pain and make recommendations for pain medications.

Palliative treatment: Therapy designed to relieve or reduce intensity of uncomfortable symptoms but not to produce a cure.

Pallor: An unnatural paleness or absence of color in the skin.

Palpation: To touch gently, as part of an examination.

Pancreas: An elongated grayish pink gland and secrets various substances, such as digestive enzymes, insulin, and glucagon.

Pancreatic Cancer: Malignant neoplastic disease of the pancreas, characterized by anorexia, flatulence, weakness, dramatic weight loss, epigastric or back pain. Diagnostic studies include barium radiographic studies of the stomach and duodenum, transhepatic cholangiography, or laboratory evaluation of liver function.

Pancreatic Diabetes: Diabetes mellitus caused by a deficiency of insulin production by the islet of the pancreas.

Pancreatitis: An inflammatory condition of the pancreas that may be acute or chronic.

Acute pancreatitis: Is generally the result of damage to the biliary tract, as by alcohol, trauma, infectious disease, or certain drugs.

Paracentesis: A procedure in which fluid is withdrawn from a body cavity.

Paradigm: A pattern that may serve as a model or example.

Paralysis: The loss of muscle function, loss of sensation, or both. It may be caused by a variety of problems, such as trauma, disease, and poisoning.

Paralytic ileus: A decrease in or absence of intestinal peristalsis. It may occur after abdominal surgery or peritoneal injury or be associated with severe pyelonephritis, ureteral stone, fractured ribs and myocardial infarction.

Parenchymal Cell: Any cell that is a functional element of an organ such as a hepatocyte.

Paresis: Motor weakness or partial paralysis related in some cases to local neuritis.

Parietal Bone: One of a pair of bones forming the sides of the cranium.

Parkinsonian: A mild resting tremor with slow, regular oscillations of three to six per Tremor: second, exacerbated by fatigue, cold, or emotion.

Parkinsonism: A neurologic disorder characterized by tremor, muscle rigidity, hypokinesia, a slow shuffling gait, and difficulty in chewing, swallowing, and speaking, caused by various lesions in the extrapyramidal motor system.

Patella: A flat, large bone at the front of the knee joint, having a pointed apex that attaches to the ligamentum patellae.

Patent: Open and unblocked, such as a patent airway or a patent anus.

Pathogen: Any microorganism capable of producing disease.

Pathogenic: Capable of causing or producing a disease. Also called pathogenetic.

Pathologist: A physician specializing in the study of disease. A pathologist usually specializes in autopsy or in clinical or surgical pathology.

Peer Review: An appraisal by professional coworkers of equal status of the way an individual health professional conducts practice, education, or research. In some states the peer review process may form the basis for an objection from producing certain documents created by a peer review committee.

Penrose Drain: A thin rubber tube used as a surgical drain device.

Peptic Ulcer: A sharply circumscribed loss of the mucous membrane of the stomach, duodenum, or any other part of the GI system exposed to gastric juices containing acid and pepsin. Also called gastric ulcer.

Percutaneous: Performed through the skin, such as a biopsy, aspiration of fluid from a space below the skin using a needle, catheter, and syringe.

Perfusion: The passage of a fluid through specific organ or an area of the body.

Pericardiac: Pertaining to the area around the heart. Also pericardial.

Pericarditis: Inflammation of the pericardium associated with trauma, malignant neoplastic disease, infection, uremia, myocardial infarction, collagen disease, or unknown causes.

Pericardium: A fibroserous sac that surrounds the heart and roots of the great vessels. It consists of the serous pericardium and the fibrous pericardium.

Perineal Care: A cleansing procedure prescribed for cleansing the perineum after various obstetric and gynecologic procedures. Perineal care is given at prescribed intervals and after urination or defecation.

Peripheral: Pertaiing to the outside, surface, or surrounding area of an organ, other structure, or field of vision.

Peripheral Nervous: The motor and sensory nerves and ganglia outside the brain and spinal system: cord.

Peripheral Neuropathy: Any functional or organic disorder of the peripheral nervous system.

Peripheral Vascular Disease (PVD): Any abnormal condition that affects the blood vessels and lymphatic vessels, except those that supply the heart. Different kinds and degrees of PVD are characterized by a variety of signs and symptoms, such as numbness, pain, pallor, elevated blood pressure, and impaired arterial pulsations. Causative factors include obesity, cigarette smoking, stress, sedentary occupations, and numerous metabolic disorders. Treatment of severe cases may require amputation of gangrenous body parts. Some kinds of peripheral vascular disease are atherosclerosis and arteriosclerosis.

Peripheral Arterial Disease: A common age related disorder which parallels atherosclerosis. Risk factors include smoking, diabetes mellitus, hyperlipidemia, hypertension, family history and advanced age. Many patients with this condition, including the elderly, have no initial symptoms. Almost 70% of a vessel’s flow must be obstructed before the disease can be clinically recognized.

Peristalsis: The coordinated, rhythmic serial contraction of smooth muscle that forces food through the digestive tract, bile through the bile duct, and urine through the ureters.

Peritoneum: An extensive serous membrane that lines the entire abdominal wall of the body and is reflected over the contained viscera.

Peritonitis: An inflammation of the peritoneum. It is produced by bacteria or irritating substances introduced into the abdominal cavity by a penetrating wound or perforation of an organ in the GI tract or the reproductive tract. Peritonitis is caused most commonly by rupture of the appendix but also occurs after perforations of intestinal diverticula, peptic ulcers, gangrenous gallbladders, gangrenous obstructions of the small bowel, or incarcerated hernias, as well as ruptures of the spleen, liver, ovarian cyst, or fallopian tube, especially in ectopic pregnancy. Characteristic signs and symptoms include abdominal distension, rigidity and pain, rebound tenderness, decreased or absent bowel sounds, nausea, vomiting, and tachycardia.

Phagocyte: A cell that is able to surround, engulf, and digest microorganisms and cellular debris.

Phalanx: Any of the 14 tapering bones composing the fingers of each hand and toes of each foot. The fingers each have three phalanges (proximal, middle, and distal); the thumb has two.

Pharmacist: A person prepared to formulate, dispense, and provide clinical information on drugs or medications to health professionals and patients, through completion of a university program in pharmacy.

Pharmacokinetics: The study of the action of drugs within the body, including the mechanisms of absorption, distribution, metabolism, and excretion; onset of action; duration of effect, biotransformation, and effects and routes of excretion of the metabolites of the drug.

Phenobarbital: A barbiturate anticonvulsant and sedative-hypnotic.

Phlebotomist: A person with special training in the practice of drawing blood.

Phobia: An obsessive, irrational, and intense fear of a specific object, such as an animal or dirt, of an activity, such as meeting strangers or leaving the familiar setting of the home.

Photoaging: In the elderly, this refers to changes in the skins appearance that are the result of chronic exposure to UV radiation from sunlight. Elderly persons who are not exposed to the sun through lifestyle or occupation choices often look younger than their chronologic age.

Physical Abuse: One or more episodes of aggressive behavior, usually resulting in physical injury with possible damage to internal organs, sense organs, the central nervous system, or the musculoskeletal system of another person.

Physical Restraint: A nursing intervention from the Nursing Interventions Classification (NIC) defined as application, monitoring, and removal of mechanical restraining devices or manual restraints which are use to limit physical mobility of patient.

Physical Therapist: A person who is licensed in the examination, evaluation, and treatment of physical impairments through the use of special exercise, applications of heat or cold, and other physical modalities.

Physical Therapy Assistant: A person who, under the supervision of a physical therapist, assists in carrying out patient treatment programs.

Physician’s Desk Reference (PDR): A compendium compiled annually, containing information about drugs, primarily prescription drugs and products used in diagnostic procedures in the United States, supplied by their manufacturers.

Pitting Edema: An edema characterized by a condition in which a finger pressed into the skin over an accumulation of fluid will result in a temporary depression in the skin, normal skin and subcutaneous tissue quickly rebound when the pressure is released.

Placebo: An inactive substance, such as saline solution, distilled water, or sugar, or a less than effective dose of a harmless substance, such as a water-soluble vitamin, prescribed as if it were an effective dose of a needed medication.

Plaintiff: A person who files a lawsuit initiating a legal action. The plaintiff complains or sues for remedial relief and is named a complainant in various civil actions.

Plasma: The watery straw-colored fluid part of the lymph and the blood in which the leukocytes, erythrocytes, and platelets are suspended. Plasma is made up of water, electrolytes, proteins, glucose, fats, bilirubin, and gases is essential for carrying the cellular elements of the blood through the circulation, transporting nutrients, maintaining the acid-base balance of the body, and transporting wastes from the tissues.

Plastic Surgery: The alteration, replacement, or restoration of visible parts of the body, performed to correct a structural or cosmetic defect.

Pleural Effusion: An abnormal accumulation of fluid in the intrapleural spaces of the lungs. It is characterized by fever, chest pain, dyspnea, and nonproductive cough. An exudate may result from pulmonary infarction, trauma, tumor, or infection, such as tuberculosis.

Plexus: A network of intersecting nerves and blood vessels or of lymphatic vessels. The body contains many plexuses, such as the brachial plexus, the cardiac plexus, the cervical plexus, and the solar plexus.

Pneumonia: An acute inflammation of the lungs, often caused by inhaled pneumococci of the species Streptococcus pneumonia. The alveoli and bronchioles of the lungs become plugged with a fibrous exudates. Pneumonia may be caused by other bacteria, as well as by viruses, rickettsiae, and fungi.

Pneumothorax: The presence of air or gas in the pleural space, causing a lung to collapse. Pneumothorax may be the result of an open chest wound that permits the entrance of air, the rupture of an emphysematous vesicle on the surface of the lung, or a severe bout of coughing.

Podiatrist: A health professional who diagnoses and treats disorders of the feet.

Popliteal Artery: A continuation of the femoral artery, extending from the opening of the abductor magnus, passing through the popliteal fossa at the knee, dividing into eight branches, and supplying various muscles of the thighs, leg, and foot.

Popliteal Pulse: The pulsation of the popliteal artery, behind the knee, best palpated with the patient lying prone with the knee flexed.

Post traumatic: Pertaining to any emotional, mental, or physiological consequences after a major illness or injury.

Posture: The position of the body with respect to the surrounding space.

Potassium (K): Potassium salts are necessary to the life of all plants and animals. Potassium in the body constitutes the predominant intracellular action, helping to regulate neuromuscular excitability and muscle contraction. Potassium is important in glycogen formation, protein synthesis, and correction of imbalances of acid-base metabolism. Potassium is most commonly depleted in the body by an increased rate of excretion by the kidneys or the GI tract. Increased renal excretion may be caused by diuretic therapy, large doses of anionic drugs, or renal disorders. Increased GI excretion of potassium may occur with the loss of GI fluid through vomiting, diarrhea, surgical drainage, or chronic use of laxatives.

Power of Attorney: A document authorizing one person to take legal actions on behalf of another, to act as an agent for the grantor.

Precedent: Previously adjudged decision that serves as an authority in a similar case.

Presbycardia: An abnormal cardiac condition that especially affects elderly individuals and may be associated with heart failure in the presence of other complications, such as heart disease, fever, anemia, mild hyperthyroidism, and excess fluid administration.

Pressure: A force, or stress, applied to a surface by a fluid or an object, usually measured in units or mass per unit of area.

Pressure Ulcer: A sore or open wound in the skin over a bony prominence that occurs most frequently on the sacrum elbows, heels, outer ankles, inner knees, hips, shoulder blades, and occipital bone on high risk-patients, especially those who are obese, elderly, or suffering from chronic diseases, infections, injuries, or poor nutritional state.

Preventive Care: A pattern of nursing and medical care that focuses on disease prevention and health maintenance.

Primary Care: The first contact in a given episode of illness that leads to a decision regarding a course of action to resolve the health problem.

Primary Physician: The physician who usually takes care of a patient; the physician who first sees a patient for the care of a given health problem.

Primaxin: Trademark for a broad-spectrum parenteral antibiotic.

Prognosis: Prediction of the probable outcome of a disease based on the condition of the person and the usual course of the disease as observed in similar situations.

Projectile Vomiting: Expulsive vomiting that is extremely forceful.

Pronation: Assumption of a prone position--face-down.

Prostate Cancer: Cancer of the prostate that affects about 2% of the primary population above age 50, and is one of the most common cancers in adult men. It is the second leading cause of cancer deaths in men after lung cancer. This cancer typically runs a protracted course, so most patients die with prostate cancer but not from it. Serum Prostate-specific antigen (PSA) screening is typically used to detect this form of cancer.

Protein: A large group of naturally occurring complex organic nitrogenous compounds. Each is composed of large combinations of amino acids (usually 50 or more) containing the elements carbon, hydrogen, nitrogen, oxygen, and occasionally sulfur, phosphorus, iron, iodine, or other essential constituents of living cells. Twenty- two amino acids have been identified as vital for proper growth. Adequate protein is considered essential for good nutrition and can be measured with an Albumin lab test.

Proteinemia: An excessive level of protein in the blood. Also called hyperproteinemia.

Prothrombin Time (PT): A one-stage test for detecting certain plasma coagulation defects caused by a deficiency of factors V, VII, or X. Thromboplastin and calcium are added to a sample of the patient’s plasma and simultaneously to a sample from a normal control.

Pseudomonas: A genus of gram-negative bacteria that includes several free-living species in soil and water and some opportunistic pathogens, such as Pseudomonas aeruginosa, isolated from wounds, burns, and infections of the urinary tract.

Psittacosis: An infectious illness caused by bacterium Chlamydia psittaci. It is characterized by respiratory pneumonia-like symptoms.

Psoriasis: A common chronic skin disorder characterized by circumscribed red patches covered by thick, dry silvery adherent scales that are the result of excessive development of epithelial cells.

Psychic Trauma: An emotional shock or injury or distressful situation that produces a lasting impression, especially on the subconscious mind.

Psychoanalysis: A branch of psychiatry founded by Sigmund Freud, devoted to the study of the psychology of human development and behavior. Using such techniques as free association, dream interpretation, and analysis of defense mechanisms, emotions and behavior are traced to the influence of repressed instinctual drives in the unconscious.

Psychology (psych): The study of behavior and of the functions and processes of the mind, especially as related to the social and physical environment.

Pruritis: An unpleasant sensation that instinctively causes one to scratch or rub. It is a common complaint among the elderly and is usually caused by dry skin (Xerosis).

Q: Symbol for blood volume. Symbol for quantity.

QRS: A series of waveforms that represent both normal and abnormal depolarization of ventricular muscle cells.

Quadriplegia: Paralysis of the arms, legs, and trunk of the body below the level of an associated injury to the spinal cord.

Quarantine: Isolation of people with communicable disease or those exposed to communicable disease during the contagious period in an attempt to prevent spread of the illness.

Rabies: An acute, usually fatal viral disease of the central nervous system of mammals.

Radial Artery: An artery in the forearm, starting at the bifurcation of the brachial artery and passing in 12 branches to the forearm, wrist, and hand.

Radial Nerve: The largest branch of the brachial plexus, arising on each side as a continuation of the posterior cord. It supplies the skin of the arm and forearm and their extensor muscles.

Radial Pulse: The pulse of the radial artery palpated at the wrist over the radius.

Radiation: The emission of energy, rays, or waves.

Radiation Burn: A burn resulting from exposure to radiant energy in the form of sunlight, x-rays, or nuclear emissions of explosion.

Radical: An atom or group of atoms that contains an unpaired electron.

Radicular: Pertaining to a root, such as a spinal nerve root or radical.

Radiculitis: An inflammation involving a spinal nerve root, resulting in pain and hyperesthesia.

Range of Motion: The extent of movement of a joint, measured in degrees of a circle.

Reaction: A response to a substance, treatment, or other stimulus, such as an antigen-antibody reaction, an allergic reaction, or an adverse pharmacological reaction.

Reasonably Prudent Person Doctrine: A concept that a person of ordinary sense will use ordinary care and skill in meeting the health care needs of a patient.

Recannulate: To make a new opening through an organ or tissue, such as opening a passage through an occluded blood vessel.

Receptive Aphasia: A form of sensory aphasia marked by impaired comprehension of language.

Reciprocity: A mutual agreement to exchange, dependence, or relationships.

Record: A written form of communication that permanently documents information relevant to the care of a patient.

Rectum: The lower part of the large intestine, about 12 cm long.

Recumbent: Lying down or leaning backward.

Reduce: (in surgery) The restoration of a part to its original position after displacement, as in the reduction of a fractured bone.

Reflex Sympathetic Dystrophy (RSD): A diffuse, persistent pain involving central reorganization of sensory processing. It is characterized by vasomotor disorders, and limited joint mobility.

Registered Nurse: A nurse who has completed a course of study at a state approved school of nursing and passed the National Council Licensure Examination (NCLEX-RN). A registered nurse may use the initials RN after the signature.

Reimbursement: A method of payment, usually by a third-party payor, for medical treatment or hospital costs.

Reminiscence Therapy: A psychotherapeutic technique in which self-esteem and personal satisfaction are restored, particularly in older persons, by encouraging patients to review past experiences of a pleasant nature.

Renal Acidosis: an excessive increase in the H+ ions in body fluids because of impaired kidney function. The acidosis can result from excessive loss of bicarbonate or from the inability to excrete phosphoric and sulfuric acid.

Renal Diet: A diet prescribed in chronic renal failure and designed to control intake of protein, potassium, sodium, phosphorus, and fluids, depending on individual conditions.

Renal Failure: Inability of the kidneys to excrete wastes, concentrate urine, and conserve electrolytes.

Acute Renal Failure: Characterized by oliguria and by the rapid accumulation of nitrogenous wastes in the blood (azotemia).

Chronic Renal Failure: May result from many other diseases. The early signs include sluggishness, fatigue, and mental dullness. Later, anuria, convulsions, GI bleeding, malnutrition, and various neuropathies may occur. Urinalysis reveals greater than normal amounts of urea and creatinine.

Renal Insufficiency: Partial kidney function failure characterized by less than normal urine excretion.

Res Ipsa Loquitur: A legal concept that is important in some malpractice suits, describing a situation in which an injury occurred when the defendant was solely and exclusively in control and in a situation in which the injury would not have occurred had due care been exercised. Classic examples of res ipsa loquitur are a sponge left in the abdomen after abdominal surgery or the amputation of the wrong extremity.

Resonance: An echo or other sound produced by percussion of an organ or cavity of the body during a physical examination.

Respiration Rate: The rate of breathing. It is typically from 40 to 50 breaths per minute for newborns, 20 to 25 breaths per minute for older children, and 15 to 20 breaths per minute for teenagers and adults.

Respiratory Acidosis: An abnormal condition characterized by a low plasma pH resulting from reduced alveolar ventilation.

Respite Care: Provision of short-term care to provide relief for family caregiver.

Respondeat Superior: The concept that an employer may be held liable for torts committed by employees acting within the scope of their employment.

Restorative: Pertaining to the power or ability to restore or renew a person to a normal state of health or consciousness.

Restraint of Trade: An illegal act that interferes with free competition in a commercial or business transaction so as to restrict the production of a product or the provision of a service, affect the cost of a product or a service, or control the market in any way to the detriment of the consumers or purchasers of the service or product. The Clayton Act and the Sherman Antitrust Act are U.S. federal statutes that embody the basic concepts of the definition and the illegal nature of restraint of trade.

Retinal Detachment: A separation of the retina from the retinal pigment epithelium in the back of the eye.

Retinopathy: A group of noninflammatory eye disorders. Major contributing conditions include diabetes, hypertension, and atherosclerotic vascular disease.

Retrospective Study: A study in which a search is made for a relationship between one (usually current) phenomenon or condition and another that occurred in the past.

Rheumatology: The study of disorders characterized by inflammation, degeneration, or derangement of connective tissue and related structures of the body.

Ribosome: An organelle composed of RNA and protein that functions in the synthesis of protein.

Risk Factor: A factor that causes a person or a group of people to be particularly susceptible to an unwanted, unpleasant, or unhealthful event.

Rupture: A tear or break in the continuity or configuration of an organ or body. See also hernia.