Term
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Definition
| collection of health info to determine health status by observation, intervies and physical examination |
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Term
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Definition
| data ia analyzed, gaps recognized, clusters made, theories and patterns are developed and diagnosis is made |
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Term
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Definition
| develop of a plan of cae collabaritively with patient to achieve a common goal, prioritize diagnoses, select strategies, and develop a care plan, |
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Term
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Definition
| interventions are implemented in order to reach goal and documented. either done directly or indirectly. recoring response of patient. |
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Term
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Definition
| planned systematic comparison of persons health status with defined goals and expected outcomes, on going, delibertive activity involving the nurse, person, and other health care providers |
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Definition
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Term
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Definition
| diagnosis of a person response to health and illness |
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Term
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Definition
| human response to to a state or level of wellness in an individual, family, r community that has the desire to move toward higher state of being healthy. |
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Term
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Definition
| name of diagnosis and description |
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Term
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Definition
| identifies probable causes, gives direction to therapy and enables individualization |
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Term
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Definition
| places person at risk, or symptomns, etiology for potential problems |
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Term
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Definition
| causing or contributing to actual problem, etiology for actual problem, has signs and symptomns |
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Term
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Definition
| cluster of signs and symptomns that indicate the prescence of a diagnostic label, suggest outcomes |
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Term
| trust vs. mistrust and age |
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Definition
| birth-1 yr. infant is helpless depends on parent for food, warmth. if met it results in trust, if not it develops into mistrust and anxiety |
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Term
| autonomy vs. shame and doubt |
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Definition
| 1-3 yr. toddler wants to be autonomous and govern hisself. parent should properly allow this. otherwise shame and guilt develop |
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Term
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Definition
| 3-6 yr. childs task is to develop intiative. has energy surplus. parent needs to reasure chid otherwise guilt develops |
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Term
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Definition
| 6-12 yr. child masters social and cognitive skills allowing for competence and competition. inferiority develops if skils arent mastered. |
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Term
| role identity vs. role confusion |
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Definition
| 12-20 yr. self esteem and asthetics are major concern ans must match their view of themselves, if it does identity develops. |
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Term
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Definition
| 20-35. adult seeks love, commitment, and intimacy.and trust. if not found ina relationship, loneleiness develops. |
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Term
| generativity vs. stagnation |
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Definition
| 35-64 yrs. middle adult want to either procreate or contribute to the young generation. if not successfu they become bored and feel empty. |
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Term
| ego integrity vs. despair |
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Definition
| 64 + yrs. when many elder are pushed into retirement , they must find things to do, or they develop despair. |
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Term
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Definition
| birth-2yrs. time of intelligent activity, infants perceive info through the 5 senses and learn to modify behavior in response to those stimuli |
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Term
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Definition
| period of transition between childhood and adulthood |
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Term
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Definition
| neuromuscular growth starting at he head and moving toward the feet |
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Term
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Definition
| age for every yr since birth |
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Term
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Definition
| development of how the individual perceives and process info about the world |
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Term
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Definition
| cognitive develpmentstage where children begin to project themselves into other peoples situations and realize that their way of thinking isnt the only way |
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Term
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Definition
| periods of time when a person has an increased vulnerability to physical, chemical, psychological, or environmental influences |
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Term
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Definition
| progression of behavioral changes that involve the aquisition of appropriate, cognitive, linguistic, and social sklls |
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Term
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Definition
| age of development of a child, based on Ericksons developmental stages. |
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Term
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Definition
| task the child should perform during a developmental stage, before proceeding to the next, and by a certain age. |
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Term
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Definition
| ability to reason abstractly |
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Term
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Definition
| physiologic development of a living being and in the quantitie change seen in the body |
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Term
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Definition
| a child from age 1 to 12 months |
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Term
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Definition
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Term
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Definition
| development of motor skills(physical) |
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Term
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Definition
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Term
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Definition
| wide range of physical, mental, and psychosocial status. 65+ |
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Term
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Definition
| childrens work, where they learn to socialize, hot to play with others and aceptable behaviors |
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Term
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Definition
| age 2. use of symbols to represent bjects and experiences. this process is liberating. |
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Term
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Definition
| child between 3-5 yrs of age |
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Term
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Definition
| skill development starts at the midline of the body and moves outward |
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Term
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Definition
| stges of mental andsocial development. erickson and piaget |
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Term
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Definition
| dramatic physiological changes, self awareness peaks, physical ealth is good, makes bad descion such as sex and drugs. |
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Term
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Definition
| 6-10 yrs. they take place in a peer group, adopt moral standards and build self-esteem |
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Term
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Definition
| development of the senses |
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Term
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Definition
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Term
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Definition
| 21-34. physical groth is complete |
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Term
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Definition
| children play with toys alone. infants |
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Term
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Definition
| toddlers play with their own toys but next to each other |
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Term
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Definition
| prescholers play the same game but without rules. no common goal |
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Term
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Definition
| preschoolers play the same game and follw the same rules. achieve the same goal. |
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Term
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Definition
| pretend play, play dress up , or pretend to be doctors |
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Term
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Definition
| pretend or imaginative play that enables preschool children to recreate experiences and try out roles. |
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Term
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Definition
| assess development of children by assessing the skills they can perform and comparing those to the norms. |
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Term
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Definition
| updated frequnetly and are accurate. infant/toddler. early preschool. preschool. kindergarten and 1st. they obtain strengths and weaknesses and obtain data. |
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Term
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Definition
| observing, listening, translating, reasoning, using intuition, validating. |
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Term
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Definition
| form of communication. using words to onvey messages by talking and writing |
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Term
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Definition
| form of communication. set of behaviors that convey messages ithout words or by supplementing verbal communication. |
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Term
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Definition
| form of nonverbal communication. it is the nonverbal componets of spoken language such as stress, acent, pitch, pause, intonation, rate, volume, and quality. |
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Term
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Definition
| response that echoes patients words. |
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Term
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Definition
| used when patients word choice is confusing or ambigious. used to summarize patients words, implifying and clarifying them. |
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Term
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Definition
you oberve a certain action, feeling or statement and focus the patients attention on it. give honest feedback. |
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Term
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Definition
| inform the patient . condenses the facts and presents survey of how you perceive their needs. type of validation. |
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Term
| health perception- helath maintenece |
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Definition
| clients personal view of health and associative behaviors with quest to be healthy. health ractices. use of alcohol and tobacco and other substances, home, schol, and occupational safety. clients description of illness. |
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Term
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Definition
| seem well-nourished and well developed, over/under weight for age and height. how does the skin look. cholesterol level. family hisotry of diabetes. dental. swallowing. endocrine or gastrointestinal problems. |
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Term
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Definition
| usual bowel and blader habits, frequency, color and odor, consistency of stool, difficulty urinating, incontinence, use of laxatives, any history of bowel or bladder problems |
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Term
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Definition
| daily activities. level of physical fitness. cardiac or respirtory problems. what activities give you the most pleasure, do you need help with home maintenece, what is your activity tolerane. pattern of crcise. sedentary. smoking., performing ADls. use of mobility devices. |
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Term
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Definition
| pattern of sleep. rituals. feel rested in the morning. use of sleep aids. sleep thorugh the night. trouble faling asleep. |
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Term
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Definition
| vision problems. hearing problems. name. address. what dy is it. why are you here at the hospital. how lng have you been here. any pain. heat/cold intolerance. |
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Term
| self- perception- sef- concept |
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Definition
| what can you tell me about yourself. how will hospitalization affect you rlife. support system. who relies on you. where do you get moral support. how do you take care of yourself. how do you fel about being ill. do you have anxiety. have you used psyche drug. alcohol. or street drugs. |
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Term
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Definition
| hollow sound, over normal lung tissue |
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Term
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Definition
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Term
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Definition
drum like ound, over gastric bubble |
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Term
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Definition
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Term
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Definition
| very dull, over muscles and bones |
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Term
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Definition
| lying flat on back, with knees bent |
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Term
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Definition
| flat, legs elevated in stirrups, used in operating rooms |
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Term
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Definition
| high fowler, sitting straight up. semi fowler, 45 angle in bed |
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Term
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Definition
| flat, lying on back, abdomen up |
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Term
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Definition
| position in which the patient lies on the side with the knee and thigh drawn upward toward chest. chest and abdomen are allowed to fll forward. |
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Term
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Definition
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Term
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Definition
| pulse on chest wall, 5th lics at MCL |
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Term
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Definition
| absecence of respirations |
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Term
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Definition
| time when no sound is heard between kortokoff sounds |
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Term
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Definition
| amount of energy use in a unit of time by fasting, resting subject to maintain vital functions. the rate, determined by the amount of oxygen used, expresed in calories consumed per hour per square meter of body surface or per kilogram of body weight |
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Term
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Definition
| heart rate les than 60 a min |
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Term
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Definition
| low rate of brething, less than 12 a min |
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Term
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Definition
| volume of lood expelled by the ventricles of the heart with each beat(stroke volume) multiplied by the heart rate |
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Term
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Definition
| temp of deep structures compred to peripheral structures |
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Term
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Definition
| minimum level of blood presure measured between heart contractions |
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Term
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Definition
| breathlessness, a distressful subjective senstion of uncomfortable breathing |
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Term
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Definition
| any disturbance or abnomality in a normal rhythimic pattern, specificaaly irregularity in the brain waves or cadence of speech |
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Term
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Definition
| normal breathing 12- 20 breaths a min |
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Term
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Definition
| extremely elevated temp that can occur in disease |
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Term
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Definition
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Term
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Definition
| low and inadequate blood pressure |
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Term
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Definition
| temp below 95, slow and shallow respiration, faint heart rate |
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Term
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Definition
| condition in which a person must sit or stand to breathe |
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Term
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Definition
| low BP occuring when a person sudenly stands |
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Term
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Definition
| palpating pulse while taking blood pressure |
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Term
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Definition
| condition in which peripheral pulse rate is less than ventricular pulse rate |
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Term
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Definition
systolic-diastolic pressure |
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Term
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Definition
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Term
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Definition
| heart rate higher than 100 a min |
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Term
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Definition
| rapid rate of breathing. more than 20 a min |
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Term
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Definition
| total abscence of pigment melanin |
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Term
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Definition
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Term
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Definition
| decrease in size or physiologic activity of a normally developed tissue or organ as a result of inactivity or disse |
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Term
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Definition
| transverse furrow or groove across a nail, extends down to nail bed |
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Term
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Definition
| assess risk:sensory perception, moisture, activity, mobility, nutrition, friction and shear. of geting a pressure ulcer |
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Term
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Definition
| larger than 1 cm diameer, single chambered, superifcial in epidermis, thin walled and ruptures. Ex:friction blister, burns, contact dermatitis |
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Term
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Definition
| increased pigmentaion in face and comon in pregnancy |
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Term
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Definition
| angle between finger and nail straightens to 180 and nail base feels spongy to palpation |
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Term
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Definition
| tickened, dried, exudate. left when vesiles or pustules burst or dry up. color is red-brown, honey or yellow. Ex: impetigo, weeping eczematous dermatitis, scab after abrasion |
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Term
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Definition
| bluish color signifying decreased profusion , occurs with hypoxemia, shock, heart failure, chronic bronchitis, and congenital heart disease |
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Term
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Definition
| encapsualted-fluid filled cavity in dermis or sub-cutaneous layer, tensely evaluating skin. Ex: sebaceous cyst, wen. |
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Term
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Definition
| hemorrhagic spot or blotch, larger than petechia, in skin or mucous memebrane, forming a nn-elevated, rounded or regular, blue or purplish patch. |
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Term
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Definition
| scooped out but shallow depression, superficial, epidermis lost, moist but no bleeding, heals without scar because it doesnt extend into dermis |
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Term
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Definition
| intense redness of skin from excss blood in dilated superficial capillaries. Expected with fever, inflammation, and blushing |
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Term
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Definition
| self-inflicted abrasions. SUperficial, sometimes crusted. scratches from intense itching. Ex: scabies, insect bites, varicella, dermatitis |
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Term
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Definition
| linear crack with abrupt edges, estends into dermis, dry or moist. Ex:cheilosis, athletes foot |
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Term
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Definition
| bruise you cn feel, elevates skin and swells, multiple petechia and purpura may occur on face when prolonged crying or couging raises venous pressure |
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Term
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Definition
| excess body hair. forms male pattern distribution on face and chest in females |
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Term
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Definition
| exhibited by yellow color, indicating rising amounts of bilirubin in the blood. ocurs with hepatitis, cirrhosis, sickle-cell, and transfuions and hemolytic disease of the newborn. |
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Term
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Definition
| hypertrophic scar resulting skin level is elevated by excess scar tissue, which is invasive beyond injury sight. |
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Term
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Definition
| prolonged intense scratching eventually thickens the skin and produces tightly packed sets of papules, resembles lichen. |
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Term
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Definition
| elevated ridges extend from proximal nail fold to distal nail plate, usually in those over 50 |
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Term
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Definition
| color change, flat and circumscribed of less than 1 cm. Ex: freckles, scarlet fever, measles, hypopigmentation, flat nevi |
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Term
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Definition
| cells that produce melanin , which gves brown pigment to hair and skin |
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Term
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Definition
| tiny white papules on the cheeks, forehead, and aross the nose and chin of newborns. Caused by sebum that occludes the opening of the follicles , dont squeeze lesions |
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Term
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Definition
| variation of hyperpigmentation in black, asian, american indian, and hispani newbons. blue-black to purple macular area. at sacrum, buttocks, (ab, thighs, shoulders, and arms) |
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Term
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Definition
| macular and occursin chilren and adolescents. mole. |
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Term
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Definition
| solid, elevated, hard, soft, larger than, 1cm. may extend deep into dermis. Ex: xanthoma fibroma, intradermal nevi |
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Term
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Definition
| when red pink tone in skin is lost, skin takes the color of connective tissue. common in anxiety and fear. |
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Term
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Definition
| something you can feel(solid,elevated, circumscribed, less than 1cm diameter). caused by superficial thickening in the epidermis. Ex: elevated nevus(mole), lichen planus, moluscum, verruca(wart). |
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Term
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Definition
| red,swollen,tender, inflammation of the nail folds. Usually a bacterial infection if acute, if chronic usually a fungal infection. from a break in the cuticle of those who do wet work. |
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Term
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Definition
| macules that are larger than 1 cm. Ex: mongolian spot, vitiligo, measles, rash, chloasma, cafe au lait spot |
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Term
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Definition
| tiny punctuate hemorhages 1-3mm round and discrete, dark red,purple,black,brown, color. caused by bleeding from superficial capillaries. |
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Term
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Definition
| papules coalesce to form surface elevation wider than 1 cm, a plateau like disk shaped lesion. Ex: psoriasis, lichen planus |
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Term
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Definition
| lesion aused by unreleived pressure that leads to damage of underlying tissues. typically over a bony prominence. |
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Term
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Definition
| confluent ad extensive patch of petechiae and ecchymoses. greater than 3mm flat, red- purple, macular hemorrhage. Seen in thrombocytopenia and scurvy |
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Term
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Definition
| turbid fluid in the cavity. circumscribed and elevated. Ex: impetigo and acne |
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Term
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Definition
| compact, descate flakes of skin, dry or greasy, silvery or white. Ex: psoriasis, seborrhea dermatitis, eczema, dry skin |
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Term
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Definition
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Term
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Definition
| fiery red, star shaped, marking with a solid circular center. capillary radiations extend from cental arterial body. on face, neck or chest, and associated with pregnancy, chronic liver disease, or estrogen therapy |
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Term
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Definition
| caused by vascular dilation, permanently enlarged, and dilated blood vessels that are visible on skin serbvice.Ex: spider/star angioma or venous lake |
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Term
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Definition
| larger than 1-3 cm in diameter, firm or soft, deep into dermis, benig or malignant Ex: lipoma, hemangioma |
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Term
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Definition
| deeper depression extending into dermis, irregular shape, may bled, leaves scar when heals. Ex:stasis, ulcer, pressure sre, chancre |
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Term
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Definition
| hves, wheals, coalesce to form exensive reaction intensely piuritic. |
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Term
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Definition
| elevated cavity containing free fluid, up to 1 cm, a blister. clear serum flows if ruptured. Ex:herpes simplex, varicells, shingles, contact dermatitis |
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Term
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Definition
| patchy depigmentation from destruction of melanocytes. appears milky white spots and usually symmetrical. |
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Term
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Definition
| superficial, raised, transient, and errythematous, slightly irregular in shape due to edema. Ex: mosquito bite, allergic reaction, dermographism. |
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Term
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Definition
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Term
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Definition
| free sluid in the peritoneal cavity. |
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Term
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Definition
| loud gurgling sounds, rumbling or tinkling sounds heard in ascultation. |
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Term
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Definition
| vasclar sounds, abnormal blowing or swishing sound or murmur heard while ascultationg, results from blood flowing in an occluded artery |
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Term
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Definition
| angle formed by intersection of 12th rib and vertebral column |
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Term
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Definition
| seperation of rects muscle with a visible bulge along the midline. common in infants and pregnant women |
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Term
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Definition
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Term
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Definition
| portion of abdomen in upper zone |
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Term
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Definition
| act of drawng up air from stomac with a characterisitc sound through mouth. belching. |
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Term
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Definition
| air or gas in the intestine hat is passed though the rectum |
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Term
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Definition
| test for ascites. patient pushes hands down on midline of abdomen and examiner taps one flank, while feeling for the tap on the other. fluid allows this. |
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Term
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Definition
| dry, grating sound heard with a stethoscope during asculatation. Normal over liver and spleen. |
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Term
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Definition
| rgid contraction of ab wall muscles, usually an involuntary reaction to visceral disease |
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Term
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Definition
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Term
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Definition
| inferior part of abdomen below epigastrium |
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Term
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Definition
| coordinated rhythmic serial contraction of smooth muscle that forces food through digestive tract |
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Term
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Definition
| area around the umbilicus |
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Term
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Definition
| heartburn, a burning sensation in asophagus and stomach from reflux of gastric seretions |
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Term
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Definition
| choose site away from painful area, hld hand perpendicular, to abdomen, push down slowly and deeply, then lift up quckly, this makes, stuctures rebound. this should not be painful. |
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Term
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Definition
| pain is felt at a site other than injured organ |
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Term
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Definition
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Term
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Definition
| silvery white linear jagged marks 1-6mm long. occurs when elastic fibers are broken as in obesity and pregnancy. recent ones are pinkish blue |
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Term
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Definition
| adaption of eye for near vision |
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Term
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Definition
| excesive secretion of growth hormone from the pituitary after puberty. creates enlarged skull, thick cranial bones, elongated head. |
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Term
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Definition
| having pupils of 2 different sizes |
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