Definitions
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | XYZA
acidosis
when the blood is too acidic, often causing neurological symptoms.
access
1) to gain entry into a line, catheter, or vein. See also central venous access, vascular access, venous access.
2) the opportunity or right to receive healthcare.
access point
1) the disc through which an implanted port is accessed with a needle.
2) a major vessel in which a central line can be successfully placed.
adhesions
bands of scar-like tissue that cause the body's organs to stick together.
adhesive remover
a product that removes the glue and residue left behind by dressings, ostomy appliances, tape, etc.
administration set
a bag or tube that works with a pump to deliver nutrition, fluids or medications either by IV or feeding tube at a set rate.
aerobic bacteria
bacteria that need oxygen to survive, such as bacteria found on the skin.
allograft
tissue, such as bones, ligaments, heart valves, that is transplanted from a human donor to another person.
American with Disabilities Act
a U.S. law that prohibits discrimination based on disability.
amino acid
organic molecules that are the building blocks of proteins.
amino acid formula
a liquid food where the proteins have been broken down into their most basic building blocks, amino acids, to make them easier to digest. Examples are Elecare and Neocate.
anaerobic bacteria
bacteria that cannot live or grow when oxygen is present, such as the bacteria found in the intestine.
anaphylaxis
a severe and possibly life-threatening allergic reaction.
anastamose
to surgically connect two body tubes (such as intestine).
anastomosis
the surgical connection where two tubes (such as intestine) are joined together.
anastomotic ulcers
open sores at surgical connections in the intestine, sometimes causing severe bleeding.
antibiotic
a medicine that limits the growth of or destroys bacteria.
antibiotic-impregnated catheter
a catheter, such as a central line, that is coated with a substance such as chlorhexidine to prevent infection.
antibiotic lock
antibiotics that are put in a central line when not in use to prevent infection.
antibiotic sensitivity testing, antibiotic susceptibility testing
a test that subjects a sample from a culture to several different antibiotics to determine which will be most effective in treating an infection.
antimicrobial resistance, antibiotic resistance
when bacteria and fungi develop the ability to defeat medicines intended to kill them. See also ESBL bacteria and MRSA.
anticoagulant
1) a substance that prevents the formation of blood clots.
antimicrobial
any substance that slows or stops the growth of microorganisms such as bacteria or fungus.
antireflux valve
see back check valve.
antiseptic
1) designed to stop, slow down, or destroy microorganisms that cause infection.
2) a substance designed stop, slow down, or destroy microorganisms that cause infection; a disinfectant. See also antimicrobial
3) free of contamination. See also aseptic
anus
the opening at the end of the digestive tract where stool leaves the body.
apraglutide
a long-acting injectable GLP-2 drug currently in patient trials for the treatment of short bowel syndrome. It imitates a natural hormone found in the gut and designed to increase villi length, decrease inflammation, and increase absorption.
ascending colon
the first third of the colon, where food moves upward toward the liver.
aseptic
1) clean or free of contamination with harmful microorganisms such as bacteria and viruses.
2) (techniques, procedures, systems) designed to maintain sterility and prevent the spread of infection.
3) packaged in airtight containers to help sterile products be preserved for several months.
aspiration
1) to pull back on the stopper of a syringe to draw fluid or cells from the body into it. This may be done to check that a needle, line, catheter, or feeding tube is in the right position before use or is working. It is also done to collect a sample for lab testing.
2) when something enters the lungs or airway by accident during swallowing.
B
back check valve or backflow check valve
an IV device that, when connected to IV tubing, keeps fluid flowing in only one direction so that blood doesn't flow into the line. Also anti-reflux valve.
bacteremia
when bacteria is in the bloodstream.
bacterial colony
a group of bacteria that all started with the same mother cell.
bacterial overgrowth
when the bad bacteria in the gut outnumbers the good bacteria causing symptoms of stomach upset, gassiness, diarrhea, dilation, etc.
balloon g-tube
a feeding tube that is held in place by a water-filled balloon inside the body on one end.
barrier
1) an adhesive seal or dressing designed to protect the skin. See ostomy skin barrier.
2) an ointment, cream , paste, powder, or film applied to the skin designed to protect it. see barrier cream or barrier film.
barrier cream
a thick cream designed to protect skin from being exposed to irritatants like stool, stomach acid, and urine.
barrier film
a liquid that dries as a thin, flexible waterproof film on the skin keep it from being irritated by stool, stomach acid, and urine.
barrier paste
a thick paste designed to be used with ostomy appliances to fill uneven surfaces and prevent drainage from getting under an ostomy skin barrier.
barrier ring
see ostomy barrier ring.
barrier strip
see ostomy barrier strip.
bereavement
1) support and programs intended to support a person during a time of loss.
2) saddness, grief, and mourning following the loss of someone close to us.
Bianchi procedure
a bowel-lengthening surgery that divides the intestine down the middle, forming two tubes that are then connected end to end.
bile
a fluid produced by the liver, stored in the gall bladder, and used by the small intestine to digest food.
bile ducts
the tubes that move bile from the liver to the small intestine.
biliary
relating to bile, the bile ducts and the gallbladder.
biliary tract
the body's system of bile ducts.
bilirubin
a yellowish fluid made by the liver as it breaks down red blood cells. If the liver is damaged, bilirubin can leak from the liver into the blood, causing a yellow color in the skin and eyes. Bilirubin can be measured in blood tests to monitor liver health.
biofilm
a thin, slimy film of bacteria that builds up on a surface and is commonly found in medical devices such as central lines.
biohazard
any item that has come in contact with bodily fluids such as blood, stool, or urine.
biopatch
a sterile, circular chlorhexadine dressing placed under the sterile central line dressing around a line to help protect against exit-site infections.
Bishop-Koop ostomy
1) one type of ostomy in continuity surgery where the proximal segment end is attached to the side of the distal segment. The distal end is then brought to the surface as an ostomy.
2) an ostomy created with this surgical procedure.
blenderized diet
a liquid diet made of whole foods and liquid run through a blender.
blockage
1) something that stops something (such as food or blood) from passing through something else (like the intestine or a blood vessel); an obstruction.
2) the state of being blocked; obstructed.
blood count
a laboratory test that measures the number and types of cells in the blood to look at overall health and to help diagnose diseases.
blood plasma
the liquid in blood that carries platelets, red blood cells, and white blood cells around the body.
bolster
1) the portion of a g-tube above the skin that is wider and helps to hold the g-tube in place.
2) in the case of a non-balloon button, the wider part of the button that sits beneath the abdominal wall to hold the button in place on the inside.
3) any medical device that supports and cushions.
bolus
1) nutrition or hydration given quickly all at once. This may refer to fluids given by IV through a feeding tube.
2) the act of giving nutrition, hydration, or medicine in a single, large dose.
3) feeding tube equipment designed for bolus feeding.
bolus feeds, bolus feeding
tube feeds that are given quickly and all at once in a single feeding instead of as a slow drip over time. They can be given using a feeding pump, gravity bag, or feeding syringe.
bolus syringe
a large syringe designed for giving tube feeds.
bowel
intestine, gut.
bowel obstruction
a serious problem where something is blocking the intestine, making it so that food and stool cannot move freely. This may be a partial or complete obstruction. Symptoms include pain, nausea, vomiting, constipation, g-tube leakage, bloating, abdominal cramps, abdominal swelling or hardness. If not treated, pressure will build, and the intestine can rupture, which can result in death. This condition requires emergency treatment.
brachial vein
a large vein in the arm through with PICC lines are often placed.
brachiocephalic veins
two of the major vessels in the upper chest, where the subclavian and the internal jugular veins meet. These are also known as the innominate veins.
broad spectrum antibiotic
an antibiotic that is can treat infections from many different types of bacteria.
broviac line
Broviac is a brand of tunneled central venous catheter (CVC). It is a central line that is tunneled under the skin before being inserted into a central vein so that its tip sits just before the heart. It has a cuff just under the skin that helps to hold it in place and reduce tunnel infections. Although Broviac is a brand, the term broviac line is used interchangeably to refer to any tunneled CVC.
button
a small, low-profile style of g-tube. It does not have a long tube that is permanently attached. Instead, a tube called an extension can be connected to give feeds or medicine, and then disconnected. When not in use, the extension is removed, and only the button remains. The button is held in place in the stomach either by a small balloon that is inflated with water or by a slightly larger piece of material at the end called a capsule or bolster.
button buddy
a small circular cloth pad worn around a feeding tube to help prevent skin irritation.
C
C diff, clostridium difficile infection
a highly contagious bacteria that causes diarrhea and other intestinal problems.
caliber
1) the diameter, or width, of a tube.
2) diameter of the intestine.
candidemia
the presence of the Candida species of yeast in the blood.
cannula
a thin tube placed into the body, such as in the nose or vein, to administer needed medical care.
cannulation
the technique of placing a cannula
catheter
a flexible tube inserted into the body to deliver or withdraw fluids. This term can refer to IV's, central lines, shunts, feeding tubes, urinary catheters, etc.
Cathflo® Activase®
the brand name tPA that is used to break up blood clots in central lines.
cap
1) a common name for the clave used with an IV or line;
2) a sterile plastic cover that can be screwed onto the end of a line or clave to protect it from contamination.
capillary vessels
the smallest type of blood vessels, connecting the smallest arteries to the smallest veins.
care conference
a meeting of various members of a patient's healthcare team and family, including physicians from various specialties, nurses, social workers, etc., with the purpose of coordinating patient care and discussing treatment goals.
catheter tip syringe, cath tip syringe
a needleless syringe with a large funnel-shaped tip. These syringes fit foley catheters and legacy enteral feeding bolus connectors. They come in large sizes from 30 to 120 mL or larger. They are also often used for irrigation and are sometimes referred to as irrigation syringes.
catheter-related sheath
see fibrin sheath.
cecum
the short pouch-like section at the start of the large intestine where food from the ileum is moved into the rest of the large intestine.
central
1) the opposite of peripheral.
2) (line) with the tip positioned just inside the heart.
3) (veins) near the heart.
4) at or near the center. For example, an organ, a region in the body, or an anatomical structure.
central line
a long line, must longer than regular IV, that is inserted through a central vein with its tip ending just inside the heart. The positioning of a central line in the heart allows doctors to give fluids, bloods, and nutrients that would normally be too thick or irritating to give in a regular peripheral IV. A central line is also more durable, so it can be used for a longer period of time while allowing activity that would harm a regular IV. Central lines can be PICC lines, tunneled lines like broviac or hickman lines, or implanted ports.
central line-associated bloodstream infection (CLABSI)
an infection that entered the body through a central line, or that entered another way but has infected a patient's central line. Because of their placement in the heart and because TPN provides good food for bacteria, central lines increase the risk of bloodstream infections, especially in intestinal failure patients.
central vein
another name for the 8 major vessels large enough through which to place a central line.
central venous access
1) a procedure to place a central line.
2) the potential to place future central lines. There are only 8 major vessels in the body in which central lines are typically placed. With prolonged use, these veins can become damaged or scarred, making it more difficult or impossible to pass a central line through them.
central venous catheter (CVC)
a type of IV catheter that is made for use in a central vein. It is longer, wider, and more durable than a regular peripheral IV. PICC lines, tunneled central lines such as broviac and hickman lines, and implanted ports are all types of central venous catheters. See also central line.
chronic intestinal pseudo-obstruction
a rare, severe disorder where the digestive tract does not move as it should.
cholestasis
a condition where the bile from the liver is slowed or blocked.
chevron
a method of applying medical tape where two ends of a narrow piece of tape are wrapped under a line or catheter and then over it, criss-crossing each other to help secure it.
chlorhexidine
a disinfectant and antiseptic used to help clean and sterilize.
christmas tree adapter
Also known as a nut and nipple adapter, a connector that screws onto one end and has a pointed tip on the other end to fit into a tube. In tube feeding, this often refers to an ENFit to legacy bolus adapter. This is also the name of a common connection in oxygen tubing.
chyle
a milky white liquid made of lymph fluid and fat that is made in the small intestine during digestion.
chyme
the part liquid and part solid partially digested food as it leaves the stomach.
clamp
1) a device used to hold, join, or compress two objects tightly together.
2) a device used to close a catheter or tube by pinching. Clamps may be built into a cathether or may be an external device, such as hemostats.
3) a device used in surgery to grasp, join, compress, or support an organ, tissue or vessel.
4) the action of using a device as described above.
clave
a needleless IV connector used with IV catheters and tubing. It has a sterile internal fluid path protected by a stopper that is pressed in only when a leur lock syringe or IV tubing extension set is screwed onto it. When a syringe or tubing is connected in this way, fluid can pass through the clave. When not accessed, the clave seals the end of the tubing to which it is connected. In this way, it acts as both a cap and as a connector. Common names for the clave cap and sometimes the hub, though the latter may be technically incorrect.
clinical trial
a type of research that studies new treatments, medications, and tests to evaluate their effects on human health. Clinical trials are carefully designed, reviewed and completed. Participation is voluntary. However, patients are sometimes incentivized by access to new and otherwise unavailable treatment options.
cohesive paste
see barrier paste.
cohesive seal, cohesive ostomy seal, cohesive ring
see ostomy barrier ring.
cohesive tape (CoFlex/ Coban)
a non-adhesive elastic bandage wrap that is self-adhering, meaning it only sticks to itself. It is used to secure dressings and devices, and to provide compression after lab draws and on wounds.
collateral vessels
small "backup" blood vessels that the body creates to take over when an artery or vein is blocked or narrowed. It is common for patients with a central line to develop visible collateral vessels that may resemble the blue lines of a road map on the chest, shoulders, neck and arms.
collateralization
the growth of collateral blood vessels to that serve as a bridge for blood supply when another blood vessel becomes narrowed or blocked, such as by an occlusion of the vessel or because it has a line in it.
colon
also known as the large intestine, the organ where the body absorbs water and electrolytes and waste is formed into solid stool.
colonization, colonisation
1) the presence of bacteria or fungus in or on the body without symptoms of infection.
2) the normal growth of microorganisms within the body, such as on the skin surface or in the intestine. See also flora.
3) new growth of bacteria or fungus of a new environment, such as within a new part of the body or within a medical device. This word is often used negatively as the beginning of an infection.
4) an unusually high number of one specific bacteria or fungus found within the body or a medical device.
colonize
1) to introduce a microorganism such as bacteria or fungus to a new environment.
2) for a bacteria or fungus to be present in the body.
3) to grow a bacteria or fungus within a medical device such as a central line.
4) to spread infection to a new area or part of the body or a medical device.
5) for a bacteria or fungus to grow in quantities that overpower the other flora in the body.
colonized
1) having bacteria or fungus on or in the body.
2) being a non-symptomatic carrier of a specific species of bacteria or fungus, especially a pathogen such as MRSA.
3) growing a lab-detectable level of a bacteria or fungus in a specific place, with or without presence of symptoms, such as cultures growing from a blood sample taken from a central line.
colonoscopy
a test where a doctor uses a camera on a long, flexible tube to look inside the large intestine.
colony
see bacterial colony.
compassionate use
see expanded access.
compatibility
1) the ability of two things to exist together without problems.
2) the ability of two medications or ingredients to be given or administered together without a negative interaction.
complication
an unanticipated problem that results from a procedure, treatment or illness.
compound
1) the process of combining, mixing, or altering ingredients to create a medication tailored to the needs of a patient.
2) made up of two or more parts
3) a chemical that combines two or more elements
compound drug
1) a drug made of two or more ingredients
2) see compounded drug.
compounded drug
a tailored medication made by a compounding pharmacy.
compounding pharmacy
a pharmacy that specializes in making or mixing special medications, such as taking a medication that is usually a pill and preparing it as a liquid.
congenital
describing a condition or trait present at birth.
contaminant
a bacteria or other microorganism found to be growing in a sample or culture that is believed to have come an outside source, instead of from the sample itself, such as the sample being touched by a nurse during collection. Contaminants are one cause of false positive results.
continuous feeds
tube feeds that are given on a slow drip over several hours to maximize absorption.
contrast, contrast media
a substance that can be given in the body to help a radiologist to see inside the body in greater detail on medical imaging.
consensus
agreement.
controlled substance
a drug or other substance that is tightly controlled by the government because it may be abused or cause addiction.
convex ostomy skin barrier, convex ostomy pouch, convex ostomy wafer
an ostomy skin barrier that is slightly curved, instead of flat, to increase the depth of the barrier for stomas that may be otherwise difficult due to skin folds, creases, or a retracted stoma.
crypts
a pocket of cells found in between the villi of the intestine that contain stem cells the body uses to renew the tissue of the intestinal wall.
cuff
a small fabric ring toward the end of a tunneled central line that is placed just under the skin where the line exits the body. Tissue grows into this cuff as the body heals, creating a seal against infection and helping to keep the line in place.
culture
a test that looks for infection by observing the growth of bacteria or fungus in a sample taken from the body, such as from the blood or urine.
Curos™ cap
a plastic cap made by 3M™ that fits onto the end of an IV clave to cover and protect it. It has an alcohol-saturated swab inside of it to help disinfect the clave and prevent infection.
D
D-lactic acidosis
a rare, life-threatening condition where overgrowth of d-lactic acid producing bacteria in the gut leads to a buildup of acid in the bloodstream, causing neurological symptoms.
Dacron
a polyester fiber that is hypoallergenic, non-absorbent, and mildew-resistant.
Dacron cuff
a piece of fabric built into a tunneled central line in a position that sits just under the skin where the line exits the body. Tissue grows into this cuff as the body heals, creating a seal against infection and helping to keep the line in place.
debride
to remove damaged tissue from a wound.
deep vein thrombosis
a blood clot in a vein deep below the skin.
dehydration
1) when the body loses more fluid than it takes in and can't function as it should as a result.
2) the state of not having enough fluid.
denuded
missing upper layers of skin because of exposure to moisture, bodily fluids, or chemicals.
descending colon
the third part of the large intestine located on the left side of the abdomen.
device
in medicine, any tool used in healthcare, ranging from small items like tongue depressors and bandaids to large items like X-ray machines and medical lasers, and everything in between.
dextrose
sugar, particularly the form of sugar used in IV fluid.
diagnose
to recognize a medical condition by its signs and symptoms.
diagnosis
the identification of a disease or medical condition based on established criteria after evaluation by a licensed medical practitioner and confirmed by accepted testing and examination.
dilation
1) becoming wider, larger, or more open.
2) When talking about intestines, this refers to the intestine becoming ballooned or stretched to a larger size.
digestive tract, digestive system
see gastrointestinal tract.
discharge
1) the process of checking a patient out of a hospital or course of medical treatment.
2) the flow of fluid from a part of the body, such as the nose.
discharge planner
a hospital social worker who specializes in helping patients plan for discharge from the hospital, including arranging for home health care.
distal
1) further from the point of origin or a central point compared to proximal.
2) when speaking of the intestine, further from the stomach and closer to the anus.
distended
1) abnormally swollen outward because of pressure from inside.
2) Unusually enlarged, firm, and taut.
distension
1) an abnormal and measurable swelling beyond the normal size.
2) an expanding by pressure from inside;
3) becoming or the state of being distended.
diverting stoma
a surgical opening created to relieve pressure in the intestine by bringing up a short segment of intestine through the abdomen as a stoma that can drain into a wearable pouch.
don
to put on an article of clothing, such as gloves or a gown.
donor
1) a person who provides blood, tissue, or organ for transplantation.
2) a person who gives money to help others.
doppler ultrasound
a test that measures the flow of blood through the blood vessels using high-frequency sound waves. This test is used to look for clots and occlusions in blood vessels and to monitor potential central venous access.
double lumen
a catheter or line with two tubes combined side by side in one catheter, allowing for different medications or fluids to be given at the same time without concern about whether they may interact.
double-blind study
a study in which neither the researchers nor the participants know who is receiving a particular treatment, in order to help remove bias from research results.
drainage
1) the removal of fluid from the body.
2) gastric fluid that has been drained from a g-tube.
3) leakage of body fluids from a wound, surgical incision, catheter insertion site, stoma, etc.
draw
1) to use a syringe to remove the contents of a line, feeding tube, or catheter by pulling back on its plunger. Also "draw back."
2) to take a sample of blood or other fluid using a needled syringe, as in "drawing labs."
dressing
a sterile covering that protects an IV site or wound.
drug
the main ingredient in a medicine.
drug compound
see compound drug.
drug formulary
a list of medications covered or not covered by an insurance plan.
drug interaction
a change in the way that a drug works when mixed with other drugs, supplements, food, or drink, or when taken with certain medical conditions.
DualCap®
plastic caps designed to screw onto both male and female leur connections, such as IV tubing, claves and syringes, when not in use. They have a sponge soaked in sterile alcohol inside to help disinfect IV connections between uses.
duodenum
the first part of the small intestine. It connects the stomach to the rest of the intestine. In the duodenum, foods mix with bile from the gallbladder and enzymes from the pancreas and continue to be broken down. At the end of the duodenum, some nutrients are absorbed, including iron, calcium, and some minerals.
durable medical equipment provider
a company that provides health care equipment such as feeding tubes, ostomy supplies, respiratory equipment, etc.
E
EDTA
a molecule that binds to certain metal ions, such as calcium or lead. It is used in medicine to keep blood samples from clotting and to remove calcium and lead from the body. It is used as an ingredient in some cancer drugs, and is being researched as a treatment for other diseases. At low concentrations, it inhibits and removes biofilm. It is the main ingredient in EDTA lock therapy, such as Kitelocks, used to prevent central line infections. Also called edetic acid or ethelenediaminetetraacetic acid.
EDTA lock therapy
when EDTA is inserted into the central line when not in use to help prevent infection.
elastomeric pump
a small, disposable, portable IV infusion pump that delivers a single dose of an IV medication using an elastomeric ball pump. The pump portion resembles a balloon that is stretched when it is filled with the medication. As the balloon deflates, it pushes the medication through attached IV tubing that delivers the medication at a controlled dose. When the ball is empty, the dose is finished, and the pump can be disposed of.
Elecare®
a hypoallergenic, amino acid-based formula often prescribed to patients with short bowel syndrome, food allergies, and other digestive disorders.
electrolytes
essential minerals like sodium, potassium, magnesium, phosphate, and calcium that the body needs in order for its cells and organs to work. They are found in bodily fluids, so when fluids are lost, electrolytes are also lost. Chronic diarrhea associated with SBS makes electrolyte loss a major concern.
embolism
when a blood clot, air bubble, or other particle moves about in the veins or arteries. Depending on where they are located and if they block a vein or artery, embolisms can cause serious complications, including stroke or death.
emulsion
a mixture of two or more typically incompatible liquids. In TPN, this term is used to describe lipids prepared in liquid form for infusion.
endoscopy
a test that uses a long, flexible tube with a light and camera inside to look inside your digestive system. An upper endoscopy passes through the mouth to view the stomach and beginning of the intestine. A colonoscopy passes through the anus to look at the colon. Doctors use medication called general sedation to put a patient to sleep during this procedure. Doctors can also use an endoscope to look inside a stoma to check the health of an intestine, such as to check for rejection after transplant.
enema
an injection of fluid into the rectum, in many cases to stimulate the emptying of the bowel, but also sometimes to administer medication or contrast for imaging.
ENFit™
a type of universal connection for tube feeding devices like g-tubes, extension sets, and syringes that is designed not to fit any other type of devices to reduce connection errors.
ENFit™ adapter, ENFit transitional connector
a device used to help adapt ENFit connectors and syringes to fit oral syringes, catheter tip syringes, and other legacy enteral feeding products, so that incompatible products can be used together during the transition while the ENFit system is adopted.
enteral
1) related to feeding directly into someone's stomach or intestine, particularly tube feeding or tube feeds.Can describe a delivery route for food or medication and also supplies used for this method of delivery.
2) related to the intestine.
enteral feeding pump
a medical device that delivers food or liquid directly into the stomach or intestine at a controlled rate.
enteral feeding set
see feeding set
enteral nutrition (EN)
1) most often, tube feeding, meaning nutrition given via a feeding tube into the stomach or intestine, usually in a liquid form.
2) more rarely, this term refers to any form of liquid feeding to the stomach or gut.
enterocyte
cells which cover the surface of the villi of the intestine that secrete hormones and absorb nutrients that they catch in a brushlike border of microvilli.
enteroplasty
surgery to repair, reconstruct, enlarge, taper, or lengthen parts of the intestine.
enterostomy
1) a surgical procedure to create an opening (stoma) through the abdominal wall into the intestine.
2) any stoma in the intestine.
eosinophil
a special white blood cell that protects your body from outside germs and allergens.
eosinophilic disease
an immune system disease where the body produces too many of a cell called eosinophils. When these cells build up, they can cause inflammation and tissue damage. This can happen in response to exposure to allergens, infections, as well as other causes. Food sensitivity/allergy and bacterial/fungal overgrowth are triggers for eosinophilic disease in the GI tract of patients with SBS.
epidemiology
a branch of medicine that studies diseases, their causes, their spread, and how to possibly prevent or control them.
epidemiologist
a doctor who studies patterns and causes of diseases and injury, their causes, and possible prevention.
ESBL bacteria
a type of bacteria that produces an enzyme called Extended Spectrum Beta-Lactamase that makes it resistant to some antibiotics. ESBL bacteria can colonize a person without causing symptoms of infection, however, it is usually only detected when a patient is symptomatic. Bacteria can be spread via bodily fluids through direct contact or on surfaces.
ethanol locks
diluted, sterile ethanol (alcohol) that is put into a central venous catheter when not in use to kill bacteria and other microorganisms, thereby preventing central line-associated bloodstream infections.
excise
to remove tissue from the body surgically using a scalpel or other cutting tool.
exit-site infection
an infection of the skin and tissue where a central line exits the skin.
expanded access
known commonly as "compassionate use", a pathway created by the FDA that allows patients to receive access to an investigational medication outside of a clinical trial based on an immediate, serious, life-threatening medical condition for which there are no other comparable and satisfactory treatment options.
explant
to remove a transplant graft.
extension set
a tube, or catheter, that can be connected to another to make it longer. The tube attached to a feeding button, such as a MIC-KEY button, is called an extension set. IV tubing also has extension sets designed to make tubing longer, y-sites to split a single connection into two, etc.
extravasion
when IV fluid or medicine that is vesicant (irritating) is inadvertently given out of your veins and into surrounding tissues, because of a leak in the vein, a misplaced catheter, etc. Many nurses and doctors use the term "infiltration" for both extravation and infiltration.
F
farrel bag
a bag that attaches to a feeding tube to vent air, bile, or stool.
fatty acid
building blocks of fat in our bodies and in the food we eat.
fecal transplant, fecal microbiota transplantation (FMT)
a procedure that restores healthy bacteria in a patient with overgrowth of bad bacteria in their gut by transferring stool from a healthy donor during a colonoscopy.
feeding set
an enteral feeding bag with built in extension tubing designed to be attached to a feeding tube to provide enteral nutrition or hydration. Feeding sets can be designed for use with a specific pump or by gravity.
feeding tube
any type of tube use for feeding without eating.
femoral vein
a large central vein deep in the thigh.
fibrin sheath
also known as catheter-related sheaths, a buildup of cells and tissue that accumulates on the end of a central venous catheter as the catheter irritates the vein wall. Fibrin sheaths are a common and usually asymptomatic, though they can cause line occlusions and make it withdraw from the line. They can also provide a breeding ground for infection, lead to further clotting and thrombosis, and dislodge, resulting in embolism.
fistula
an abnormal or surgically made passage or tunnel between an organ and the body's surface or between two organs.
flange
a plastic ring used to attach an ostomy pouch to an adhesive wafer.
flatulence
intestinal gas, commonly known as farting.
flora
the ecosystem of bacteria, yeast, and other organisms that live on and in the body, including in the intestine. Good flora benefit the body while unhealthy flora can cause impact health in negative ways. In the gut, good flora help digest food, play a role in the immune system, and produce vitamins and nutrients. On the other hand, unhealthy gut flora causes digestive upset and gassiness and have been associated with various health conditions. Also known as gut flora, intestinal flora, and microflora, and microbiome.
flow rate
the speed at which an infusion is run.
fluoroscopy
an imaging tool that takes a continuous image, much like an X-ray movie that shows how body parts move. Contrast dye may be used to help make these movements easier to see. Barium X-rays can show at the movement of the intestines. Fluoroscopy can also be used to place central lines, to check their position, and to look for breaks in the catheter.
flush
1) to push any reside of medication, fluid, etc. through a catheter. Flushes are used before use to make sure a catheter is working and after giving any medication or fluid to make sure that full dose is given and the catheter is clean.
2) a prefilled sterile syringe made for the purpose of flushing a catheter. These are usually saline flushes.
food-aversion
see oral aversion.
french size
a measurement of the diameter of a catheter. (Diameter in millimeters x 3 = the French size.)
fungemia
the presence of yeast in the blood, in other words, a fungal bloodstream infection.
G
g-tube, gastrostomy tube
a feeding tube placed surgically into the stomach.
g-button, gastrostomy button
see button.
gastric
having to do with the stomach.
gastrointestinal
of or related to the digestive system.
gastrointestinal tract, GI tract
the entire system from mouth to anus through which food travels, is digested, absorbed and converted into energy, leaving stool as waste.
Gattex®
the brand name for teduglutide, an daily injectable prescription medication for adults and children with short bowel syndrome that stimulates the growth of intestinal villi to increase nutrient absorption and decrease the need for parenteral nutrition (TPN).
gauge
the size of the hole of a needle. The higher the gauge, the smaller the hole.
general anesthesia, general sedation
medicine given through a mask or IV to make you sleep and keep you from feeling pain during surgery or other surgeries.
glepaglutide
an long-acting injectable GLP-2 drug currently in patient trials for treatment of short bowel syndrome. It works by simulating natural hormone found in the gut to increase villi length, decrease inflammation, and increase absorption.
GLP-1
a peptide secreted by the gut after a meal. It is believed to stimulate insulin secretion, regulate blood sugar, slow gastric emptying, and decrease appetite.
GLP-2
a naturally occurring hormone that stimulates growth of cells in the intestinal tract, decreases gastric secretions, and increases intestinal absorption.
GLP-2 analog, analogue
a medication that copies the traits of natural GLP-2's, thus stimulating the growth of intestinal villi, decreasing inflammation, and improving intestinal function.
glucagon
a peptide made by the pancreas to regulate blood sugar levels.
glucagon-like peptide
a hormone produced in the body in response to food.
glucagon-like peptide analog
a class of drugs that simulates the function of peptides naturally produced in the body.
glucose
the main type of sugar found in the blood and a source of energy for body cells.
graft
the organ taken from one person's body to another's in a transplant.
gram-negative bacteria
bacteria that do not change color during a gram staining test in the lab. Gram-negative bacteria are commonly found in the intestine and are more likely to be drug resistant.
gram-positive bacteria
bacteria that take on color during a gram staining test in the lab. Gram-positive bacteria are commonly found on the skin and in the nose.
granulation tissue
a growth of healing tissue that is essential in healing wounds. It is usually raised, pink or red in color and appears moist. It may bleed or drain slightly. In some cases, it may grow too rapidly, causing a lumpy protrusion. This is a common complication around catheters such as feeding tubes and central lines and may require treatment to ensure proper healing.
gravity bag
an IV or enteral feeding bag designed to deliver fluid by the force of gravity. The rate of flow is adjusted using a roller clamp.
gravity feeding
a type of tube feeding that uses a gravity bag rather than a feeding pump.
Grip-Lok®
a securement device that is attached to the skin with adhesive and uses hock and loop closures to help secure IV's, catheters, and feeding tubes.
Groshong™ catheter
a brand of central venous catheter with a three-way valve at its tip that creates negative pressure. It can be tunneled or non-tunneled.
Gus Gear vest
a wearable vest designed to help protect a tunneled central line, such as a broviac line, securing it to keep it from being pulled or broken.
gut permeability
see intestinal permeability.
H
hematocrit
a measurement of the percentage of red blood cells in the blood.
hemoglobin
an iron rich protein in red blood cells that carries oxygen.
hemostats
a device resembling a pair of scissors that, rather than being sharp for cutting, is blunt at the end so that, when closed, the two sides create a firm seal. There is an adjustable locking mechanism that locks the device closed, thus creating a firm hold with adjustable pressure. Hemostats were created for use in surgery and are commonly used there, but they are also generally used as medical clamps.
heparin
a medication that slows the formation of blood clots. It is produced naturally in the body and can also be made in the laboratory. It is often used as a lock therapy with central lines and IV's. It may also be added to TPN.
hereditary
describing a condition or trait that is passed from parent to child through genes.
Hickman line
1) A brand of tunneled central venous catheter (CVC). It a central line that is placed into a major vessel and then tunneled under the skin and where it exits several inches from the vein and is secured by a cuff to prevent the risk of infection or accidentally pulling out the line.
2) Although Hickman is a brand, the term "hickman line" is used interchangeably to refer to any tunneled CVC.
holistic medicine
1) a form of healing that considers the whole person.
2) a branch of medicine that pairs conventional treatments with holistic approaches such as acupuncture, acupressure, essential oils, meditation, naturopathy, supplementation, etc. Practitioners include integrative medicine doctors, osteopathic doctors, chiropractors, naturopaths, acupuncturists, and herbalists.
hospice
health care that focuses on providing physical comfort and emotional and spiritual support for terminally ill patients at the end of life. It may be provided in a treatment facility or in the home.
hub
1) the end of a tunneled central line, broviac, hickman, or PICC line that is accessed for treatment.
2) some people use this term to refer to the a clave.
Huber needle, huber-point needle
a special hollow needle used under sterile conditions to access an implanted port through the skin. It may have an attached leur-compatible tube that can be used to draw, flush, or infuse through the line.
hydrated
having enough fluid for the body to function as it should.
hydration
1) giving fluids to the body.
2) the quality of being hydrated, especially having adequate fluid.
3) designed to provide the body with fluid.
4) replacing the lost fluid in something.
hydrolyze
to break a chemical bond with water.
hyperalimentation, hyperal
the original name for total parenteral nutrition.
hypergranulation tissue
an excessive growth of granulation tissue.
hypersecretion
when the body secretes more bile and other digestive fluids (or other bodily fluids) than is normal.
hypertonic
1) having a higher osmolarity, or concentration, than is found in normal cells and blood. Hypertonic drinks like sugary drinks can cause dumping in short bowel syndrome patients. Hypertonic IV fluids like TPN and D10 can irritate peripheral veins and are usually given via central line.
2) with muscles, having a higher tension than normal.
hypotonic
1) having a lower osmolarity, or concentration, than is found in normal cells and blood. Hypotonic drinks like water, herbal tea, and some sport drinks pull fluids into the bowel and cause diarrhea and dehydration in patients with short bowel syndrome. Hypotonic IV fluids increase the fluid level in cells and are helpful in treating dehydration, hangovers, and migraines.
2) with muscles, having lower tension than normal.
I
implanted port, implantable port
see port.
incontinence
loss of control of bladder and/or bowel movements.
ileocecal valve (ICV)
a muscle between the small and large intestine that acts as a valve or gate between them, allowing digested food to pass into the large intestine while preventing waste and bacteria from washing back into the small intestine.
indwelling
placed or implanted in the body.
ileum
the last and longest portion of the small intestine and the section that absorbs most of the vitamins and nutrients from digested food. The ileum absorbs nutrients that no other part of the intestine can. For example, it is the only part of the intestine where vitamin B-12 can be absorbed.
ileus
when the movements that move food through the intestine are slowed or interrupted, often in response to illness, medication, or other stress in the body.
infection
when a bacteria, fungus, or virus enters a person's body and causes harm.
infectious disease
1) illness caused by germs such as viruses, bacteria, and fungi.
2) a medical specialty specializing in the treatment of contagious or communicable diseases.
inferior vena cava (IVC)
the largest vein in the human body, located at the bottom of the heart, through which the lower and middle body return blood to the right atrium of the heart.
infiltrate
a leak of IV medicine into surrounding tissue. See IV infiltration.
infiltration
1) when IV fluid medicine that is non-vesicant (non-irritating) is inadvertently given outside of the veins and into surrounding tissues because of a leak in the vein, a misplaced catheter, etc.
2) many nurses and doctors may also use the term infiltration to describe extravation.
infuse
to give fluids, nutrients, medicine, or blood directly into the blood through a vein.
infusion
1) the act of infusing fluids, nutrients, medicine or blood directly into the blood through a vein.
2) a single, measured dose of medication, fluid, etc. given intravenously.
infusion center
a clinic where a patient may come to receive infusion therapy as well as care for central lines needed for to these treatments.
infusion pharmacy
a pharmacy that specializes in preparing fluids, nutrition, and medications for intravenous delivery. This includes injectable medications, like antibiotics and chemotherapy drugs, as well as IV fluids and total parenteral nutrition. They also provide the needed medical devices and supplies related to central line care. These items include infusion pumps, IV tubing and connectors, syringes, dressing change kits, etc.
infusion pump
a motor driven device that controls delivery of fluids, nutrients, medicine or blood products into the bloodstream at a controlled rate. Infusion pumps are usually programmable with sensors that monitor for problems in delivery.
infusion rate
the speed at which an infusion is administered, usually stated in milliliters per hour.
infusion therapy
typically, medicines that are given intravenously, or in other words, into the blood through a vein. The term may also include other injected medications.
infusion time
the total time it takes to complete an infusion.
infusion set
thin sterile plastic tubing designed to be used with a medical device to administer a medical infusion. They may be as simple as a y-site or as complicated as pump-specific extension set.
ingest
to take into the body, as in eating or drinking.
injection
a shot, a dose of medicine given using a needle and syringe.
innominate veins
another name for the brachiocephalic veins, the two major vessels located where the subclavian veins and the internal jugular veins meet.
intake
1) the measure of fluids that enter the body, often measured in relationship to output.
2) the process of taking patient information when checking a patient into the hospital.
interaction
1) the reaction between two substances when mixed. See drug interaction.
2) the way that a health condition affects the effectiveness of a medication or treatment.
internal jugular veins
the major blood vessels that carry blood from the head to the heart via the superior vena cava. The internal jugular veins are two of eight major vessels commonly used for central lines.
interventional radiology (IR)
a branch of medicine that specializes in performing medical procedures guided by medical imaging like x-ray, ultrasound, CT, MRI, etc.
intestine
1) a long tube-shaped organ between the stomach and the anus that digests food and absorbs nutrients.
2) bowel, gut.
intestinal adaptation
the natural changes that happen in the intestine after bowel loss as the intestine works to absorb enough nutrition. These changes include lengthening of the villi, deepening of the spaces between them (crypts), and improved function of the intestinal cells tasked with absorption (enterocytes). Adaptation only happens in response to feeding.
intestinal failure (IF)
when the gut is unable to absorb enough nutrients, water, and electrolytes to meet the body's needs, resulting in the need for intravenous nutrition support.
intestinal obstruction
see bowel obstruction.
intestinal failure-associated liver disease (IFALD)
liver disease caused by the long-term effects of intestinal failure, including the effects of chronic gastrointestinal disease, long-term parenteral nutrition use, gut microbiome changes, bile acid circulation changes, and changes in intestinal permeability. Risk factors include soy-based lipid emulsion, TPN being fed at higher rates, and a lack of oral or enteral feeding.
intestinal flora
see flora.
intestinal insufficiency (II), intestinal deficiency
when the gut absorbs nutrients, water, and electrolytes poorly, but can still maintain health and growth without intravenous nutrition support, for example, by using nutritional supplements and enteral feeding.
intestinal permeability, gut permeability
a measure of how much material is able to pass from inside the intestinal tract, through the gut wall, and into the blood and the rest of the body. Increased permeability is a cause of bacterial translocation and is associated with food allergies and other chronic conditions.
intestinal rehabilitation
the process treating intestinal failure and SBS, helping the intestine to work better by using a combination of diet management, surgery, and medications, usually over the course of many years.
intestinal rehabilitation program (IRP)
a medical clinic with a multidisciplinary care team that specializes in treating intestinal disorders with a focus on intestinal rehabilitation, helping the patient's remaining bowel to work better through a combination of nutrition, medicine, or surgery. They seek to improve quality of life, reduce complications, decrease dependence on TPN, and avoid or delay the need for intestinal transplant. Because they specialize in rare intestinal disorders like short bowel syndrome, they have expertise in and access to treatment options not available elsewhere.
intestinal transplant
also known as small bowel transplant, a life-saving surgical procedure that replaces diseased, damaged or missing small intestine with a donor small intestine. Because of the risks involved in the procedure and its aftercare, intestinal rehabilitation is usually attempted before or alongside listing a patient for transplant.
intralipid
a sterile intravenous lipid emulsion made of soybean oil and water used in parenteral nutrition. Until recently, this was the only form of IV lipid available in the United States, and it is therefore the most widely adopted in this country.
intraluminal
within a catheter.
intravascular
within the blood vessels, whether veins or arteries.
intravenous
within the vein.
intravenous cannulation
the process or technique of placing a cannula into the body.
ischemic injury
an injury caused by a lack of blood.
ischemia, ischaemia
when part of the body isn't getting enough blood.
isolated intestinal transplant
transplantion of a small intestine.
isolated transplant
transplant of a single organ.
isotonic
1) having the same osmolarity, or concentration, as normal cells and blood. Isotonic drinks and formula are most easily absorbed by the gut. Oral rehydration solutions are isotonic. Isotonic IV fluids include lactated ringers, normal saline, and 5% dextrose, which are among the most commonly used IV fluids.
2) in muscles, contracted with equal tension.
IV
1) a tube or catheter placed in a vein to give fluid or medications. Most frequently, this term refers to a peripheral IV.
2) intravenous, within the vein
3) related or designed to be used with to intravenous catheters.
IV extravasation
see extravation.
IV infiltration
see infiltration.
IV3000 dressing
a clear occlusive dressing, similar to tegaderm, often used as a dressing on IV's and central lines and sometimes preferred by those with adhesive allergies.
J
J-tube, jejunostomy tube
a feeding tube placed into the upper part off the small intestine, specifically the jejunum, to give food and medicine and/or to drain bile.
jaundice
a condition where the eyes and skin become yellow because poor liver function causes a buildup of bilirubin in the body.
jejunum
the middle of three sections of the small intestine, where sugars, amino acids, and fatty acids are primarily absorbed, along with vitamins, minerals and proteins.
jugular line
typically, a central line placed in the interior jugular (IJ) vein. This may refer to a catheter placed directly into the vein for short-term use, or it may refer to a tunneled central line or port.
jugular veins
three pairs of veins that carry blood from the head to the heart, (exterior, interior, and anterior). When discussing central line placement, this term most often refers to an internal jugular (IJ) vein.
K
kidney stone
a hard pebble-like piece of material made of minerals and salts inside the kidneys. They cause pain and, in some cases, can get stuck, blocking urine from leaving the kidneys.
kite lock
an antimicrobial lock therapy containing 4% T-EDTA in a solution that can be put into a central line when not in use to kill bacteria and yeast and decrease biofilm, thus reducing central line-associated bloodstream infections. Kitelock is approved for use in some countries and is currently being studied for FDA approval in the United States.
L
large intestine, large bowel
also known as the colon, the organ where the body absorbs water and electrolytes and where waste is formed into solid stool.
legacy
technology that is outdated but is still in use.
legacy adapter, legacy enteral adapters
see ENFit adapter.
legacy connector, legacy enteral connector
a feeding tube connector that is compatible with oral and catheter tip syringes and connections that was replaced by the EN-Fit enteral feeding system for patient safety reasons.
legacy feeding tube
any non-ENFit feeding tube.
leur-compatible
devices with the right threading and size to fit leur lock connectors.
leur lock, leur-activated
a type of connector for medical syringes and tubing that allows the tip to be twisted and locked into place, opening a valve and creating a leakproof, sterile connection. Leur lock needles can be removed from syringes with a leur-compatible end that can then be connected directly to compatible tubing and connectors.
leur slip
or slip tip, a syringe with a tip that is leur-compatible, but does not have a threaded collar. The tip can be inserted directly into leur connections without being twisted on. Needles can also slip directly onto the end of the syringe without twisting.
leur slip eccentric
a leur-compatible syringe without a threaded collar where the syringe tip is slightly off center, making it easier to use the syringe parallel to the skin, such as for venous access.
LILT procedure, longitudinal intestinal lengthening and tailoring
also known as the Bianchi procedure, this is a bowel-lengthening surgical procedure that treats intestinal dilation by dividing the intestine into two parallel tubes, cutting the intestine down the middle, and sewing or stapling down the center, essentially doubling the length of intestine while reducing its caliber, or diameter, by half.
limb
the portion of catheter that extends from the patient's body to the hub or clave.
line
any IV placed in a vein to give medicine or fluids in a vein. Typically used to refer to a central line, though it may also mean a peripheral IV.
line repair
1) the process of repairing a damaged central venous catheter, usually by using a sterile technique to cut off the damaged portion and then attached a piece of replacement catheter tubing that is held in place with a small metal fitting, a silicone oversleeve and sterile glue.
2) the section added on after a repair has been completed.
lipids
1) organic compounds including fats, oils, etc. that your body needs to function.
2) also known as intravenous lipid emulsion, a sterile preparation of fats and oils in water used in parenteral nutrition as a source of calories and essential fatty acids.
liver
an organ in the body that removes toxins from the body's blood supply, maintains healthy blood sugar levels, regulates blood clotting, and produces bile, and performs other important functions.
liver enzymes
proteins that assist in the function of the liver that can leak into the bloodstream during illness, infection, or when the liver is inflamed or injured. Liver enzyme levels can be measured in blood tests to monitor liver health and to help diagnose infection.
local anesthesia
numbing one part of the body using an anesthetic, usually by injection or cream, to temporarily prevent pain or feeling.
lock
1) the act of filling an IV catheter with a sterile fluid when not in use. Locking a line keeps blood out of it so it will not clot before it is next needed. A lock is often administered after an infusion or blood draw. The line is flushed, and then the lock is inserted into the line. A clamp is often applied while flushing gently to create negative pressure in the line.
2) The sterile fluid used to lock an IV catheter. Saline, heparin, ethanol, antibiotics, and sodium bicarbonate are examples of products used as locks.
3) an IV catheter that does not have fluid running through it and is locked as described above.
lock therapy
when a lock is used in an IV catheter for treatment purposes. For example, heparin lock therapy to reduce clotting, or ethanol lock therapy or antibiotic lock therapy to prevent central line infection.
lumen
1) a tube or channel in the body, such as a blood vessel or the intestine.
2) one tube in a central line. Multi-lumen central lines have two, three, or more separate tubes encased in one larger catheter that enters the body. These tubes branch off at the end, allowing different infusions to be given at the same time without mixing. Each individual tube is a lumen.
3) the inside part of any tubular path, such as the inside of a needle, the inside of a blood vessel, or the inside of a catheter.
M
maceration
softening or breaking down of the skin from prolonged exposure to moisture.
malabsorption
problems digesting and absorbing nutrients from food.
malnourished
not getting enough calories or the right amount of nutrients needed for health.
malnutrition
a lack of or imbalance of needed nutrients, vitamins, and minerals in the body.
major vessel
an artery or vein that connects directly to the heart.
MCT oil
a supplement made from a type of fat called medium-chain triglycerides that is usually derived from coconut or palm kernel oil.
mechanical catheter complication
a medical problem defined as damage to or physical failure of a catheter, such as a break or occlusion.
medical device
see device.
medical history
an account of a patient's health, including past and present illnesses, diseases, medical conditions, medications, and allergies.
medication, medicine
a substance used for medical treatment. See drug.
Medipore™ tape
a soft, white, breathable, hypoallergenic medical tape that is often used because of its comfort, stretchability, and gentleness on skin. Similar to mepore tape.
Mediport
1) a kind of central venous catheter (CVC) also known as a port, that has a small disc-shaped reservoir that is surgically placed under the skin through which medications, fluids, nutrients, etc. can be administered when the port is accessed via a special needle. See also port or port-a-cath.
2) the brand name of a specific style of port.
medium-chain triglycerides (MCT's)
a type of fats that are made in a lab from coconut and palm kernel oil and has molecules that are smaller than long-chain triglycerides and, therefore, easier to digest.
MCT oil
a dietary supplement often distilled from coconut or palm kernel oil, valued for being a source of medium-chain triglycerides which are easy to digest and rapidly absorbed.
Mepore™ tape
a soft, white, breathable, hypoallergenic medical tape that is often used because of its comfort, stretchability, and gentleness on skin. Similar to medipore tape.
mesentery
the tissue that holds the intestine in place.
microbiome
see flora.
microflora
see flora.
Microlipid ™
a medical food made of fatty acids and safflower oil, used in oral and tube-feeding formulas to supplement fats and calories.
microvilli
tiny hairlike structures that cover the villi of the intestine and increase the absorption of each individual cell, so each cell can absorb more nutrients.
midgut volvulus
a twisting of the intestine around the superior mesenteric artery causing a bowel obstruction and cuts of the blood supply to large parts of the intestine.
midline catheter
an IV that is usually placed deep in a peripheral vein in a leg or arm, or occasionally the scalp of an infant. It is about half the length of a PICC line, making it more durable than a traditional peripheral IV. A midline catheter, however, is still a peripheral venous catheter as it does not end in a central vein or in the heart.
migration
when a device, such as a central venous catheter, moves to a place in the body that is different than where it was originally placed.
motility
the speed and ease with which food, waste, and other contents move through the digestive system.
motility disorder
when the nerves or muscles of the digestive system don't work with their normal strength and/or coordination, causing food and waste to move through the digestive system in an abnormal way.
modified multivisceral transplant
a transplant that includes organs not usually included with a given multivisceral transplant. Which organs are standard and which make up a modified multivisceral transplant varies by center.
mucosal folds
the circular folds in the surface of the intestine that increase its surface area and help food flow through it.
multidisciplinary care team
a team of medical professionals made up of various specialists in different areas of care that may include physicians such as gatroenterologists and surgeons, nurses, dietitians, pharmacists, social workers, etc. who work together to provide a higher level of coordinated patient care for patients in their healthcare organization.
multivisceral transplant
a solid organ transplant involving two or more abdominal organs (such as intestine, liver, stomach, pancreas, duodenum, etc.).
N
needleless, needle-free
a device that does not use needles to infuse or withdraw medications or fluids. This term includes blunt cannula devices, three-way pressure-activated safety valves, and leur-activated devices. However, leur-activated devices are the most commonly used form of needless devices in IV therapy.
needleless connector
also known as claves or caps, these are medical devices that connect to the end of an IV catheter to allow connection of tubing or syringes without the use of a needle. Leur-lock connectors are the most common form of needleless connector.
Neocate®
a hypoallergenic, amino acid-based formula often prescribed to patients with short bowel syndrome, food allergies, and other digestive disorders.
NG tube, nasogastric tube
a soft tube that is inserted through the nose, down the throat and into the stomach usually to give food and drink or to decompress the stomach.
non-balloon g-tube, non-balloon button
a feeding tube that uses a bolster instead of an inflatable balloon to hold it it place. It requires a special tool for placement and removal.
nonocclusive dressing
a medical dressing that allows air to pass through to the skin, such as gauze.
nutrition support
a medical therapy for people who can't get enough nutrition from eating and drinking. Methods of feeding may include oral nutrition, enteral tube feeding, or parenteral nutrition (TPN)>.
O
obstruction
1) a blockage or clogging of a tube or vessel.
2) see bowel obstruction.
occlude
to close or block.
occlusion
a partial of complete blockage, such as or a blood vessel, catheter, or bile duct.
occlusive dressing
a medical dressing that is air and water-tight, such as tegaderm or IV3000.
octreotide
a medication used to slow intestinal motility and treat gastrointestinal hypersecretion, thus reducing stool losses.
off-label drug use
the practice of prescribing a drug for a purpose other than the one for which the FDA approved it, or using a dosage or form that was the one for which it was approved by the FDA.
OG tube, orogastric tube
a tube placed through the mouth into the stomach to give food and drink and/or to drain stomach contents.
omega-3 fatty acids
a family of short and long-chain fatty acids that are important to heart and skin health, brain and nervous system development, and overall growth and development. Omega-3 fatty acids are commonly found in fish oils and nuts. They help reduce inflammation in the body. They are the primary ingredient in Omegaven and are included in SMOF lipid emulsion.
omega-6 fatty acids
a family of short and long-chain fatty acids that are found in plant oils such as soy, sunflower, and safflower oils, nuts, and seeds. They are important for brain function, growth and development, & skin and bone health. Omega-6 fatty-acid-based lipid emulsions have been connected to liver inflammation. They are the main ingredient in Intralipid and are included in SMOF lipid emulsion.
Omegaven®
an intravenous lipid emulsion made of fish oil that was developed to treat liver disease associated with parenteral nutrition (or intestinal failure-associated liver disease). It is rich in omega-3 fatty acids, which can help to decrease inflammation in the liver.
oral aversion
a feeding disorder that is common in children on tube feedings and patients with digestive disorders. The person may refuse food or drink, gag or choke, and seem fearful of allowing food, drink, or objects near their mouth. Some individuals will compensate for food aversions by seeking strong smells or flavors or by chewing on non-food objects. Oral aversion is more than simple picky eating. Developmental, motor, psychological and sensory issues often contribute to the problem. Oral aversion is usually treated with therapy provided by occupational, speech, and behavioral therapists and/or psychologists. Tube feeding is often needed to help the person receive enough nutrition.
oral rehydration solution (ORS)
a drink made with sugars and electrolytes in a concentration that matches the osmolarity of normal cells and blood, so that it is easily absorbed to help prevent dehydration.
oregano oil
an oil made from the oregano plant that has antibiotic and antifungal properties. It is taken orally or given by g-tube to help manage bacterial overgrowth. Oregano oil is considered a "hot" oil and must be diluted in a carrier oil, usually olive oil, to be safe to ingest.
orphan disease
a rare condition that affects less than 200,000 people.
orphan drug
a drug developed to treat a rare disease classified as an orphan, disease. The Orphan Drug Act gives pharmaceutical companies certain financial benefits to encourage them to develop safe, effective orphan drugs.
osmolarity
a measure of the concentration of particles in a liquid. A dietitian may prescribe a certain osmolarity, or mixture, of formula to help improve how it is absorbed in the body.
ostomate
a person who has an ostomy.
ostomy
a surgically created opening from an organ inside the body to the outside. An ostomy can be used to drain waste, vent, or feed. The name of the ostomy tells you where the ostomy is located in the body. For example, a colostomy is in the colon, an ileostomy is in the ileum, a gastrostomy is in the stomach, a urostomy is in the urinary tract, etc.)
ostomy appliance
a term that refers to both an ostomy pouch and barrier/wafer, whether combined into one piece or separated into two.
ostomy bag
see ostomy pouch.
ostomy barrier sheet
an adhesive sheet that us applied under an ostomy skin barrier to protect sensitive skin.
ostomy barrier strip
a narrow, flexible adhesive strip designed to keep the edges of an ostomy skin barrier from lifting and rolling.
ostomy belt
a belt designed to help secure an ostomy pouch to prevent leaking.
ostomy-barrier-ring
a round, flat, moldable ring that is worn around a stoma to a seal to prevent leaking under the ostomy skin barrier. Also known as a cohesive seal or ring.
ostomy in continuity (OIC)
a surgery that connects two disconnected ends of intestine in a y-shape with the end of the Y coming out of the abdomen as an ostomy. This ostomy creates an escape valve through which pressure can be released, allowing the intestine to decompress while leaving the intestine connected to the colon for better absorption and feeding tolerance. Bishop-Koop and Santulli are two common ostomy-in-continuity procedures.
ostomy pouch
the bag portion of an ostomy appliance that collects urine or stool.
ostomy reversal
see stoma reversal.
ostomy skin barrier
The adhesive portion of an ostomy appliance that attaches to the skin, protecting it from stool and urine. The skin barrier can be part of a one-piece pouch system or applied separately from the bag in a two-piece system. Also known as an ostomy wafer.
ostomy takedown
see stoma reversal.
ostomy wafer
see ostomy skin barrier.
output
1) a measurement of waste that leaves the body.
2) stool passed through an ostomy.
3) bile drained from a g-tube.
overfeeding
1) providing more nutrition than the body needs.
2) in parenteral nutrition, providing more calories than the patient needs, a practice sometimes seen in critical care settings. Overfeeding has been associated with serious complications, such as liver disease and sepsis.
overfill
extra IV solution that is included in an IV bag above what is prescribed or the volume printed on the bag.
overgranuation
excessive growth of granulation tissue.
oxalate, oxalic acid
a natural substance found in many foods that is associated with kidney stones. Short bowel syndrome patients who have an intact colon may be told to eat a low-oxalate diet to reduce malabsorption of oxalates that could cause kidney stones.
P
pancreas
an organ in the digestive and endocrine systems that produces enzymes that are released into the small intestine to help with digestion. The pancreas also contains clusters of cells called islets that help control the level of glucose (sugar) in the blood.
paradoxical reaction
when a patient experiences side effects that are opposite of what the majority of patients experience, for example, when Benadryl makes a patient fidgety and restless instead of tired.
parenteral nutrition (PN)
1) nutrition that is given intravenously (through a vein) instead of through the digestive system and may include carbohydrates, proteins, fats, vitamins, minerals, and other nutrients. Parenteral nutrition may refer to both peripheral parenteral nutrition (PPN) and total parenteral nutrition (TPN).
2) Among nutritionist and within the nutirition support community, the term parenteral nutrition or PN, used broadly, often describes TPNor total parenteral nutrition.
3) Within the general hospital setting, there are some clinicians who use the term PN to specify peripheral PNas opposed to TPN or total parenteral nutrition.
parenteral nutrition-associated cholestasis (PNAC)
the onset of liver disease in the context of parenteral nutrition for patients with intestinal failure. It is usually defined as a direct bilirubin greater than 2 mg/dL.
parenteral nutrition-associated liver-disease (PNALD)
liver disease caused by the long-term use of parenteral nutrition and lack of oral or enteral feeding. Soy-based lipids, TPN overfeeding, and lack of oral or enteral feeding increase the risks of liver disease. See also intestinal failure-associated liver disease.
patent
open or unobstructed.
patency
1) the state of being open and unobstructed.
2) a description or measure of how open or unobstructed something is.
pathogen
a bacteria, virus, or fungus that causes illness and disease.
pediatric
relating to the medical care of babies, children, and teens.
pediatrician
a doctor, usually a primary care physician, who treats babies, children, and teens.
peer review
the evaluation of work by one or more subject experts in the same field prior to publication.
PEG tube, percutaneous endoscopic gastrostomy
a feeding tube placed through the skin of the abdomen into the stomach. The tube is flexible, usually several inches long, and has a circular bumper next to the skin, a clamp, and an adapter on the end that can be used to attach to a syringe or feeding set.
PEJ tube, percutaneous endoscopic jejunostomy
a feeding tube placed through the skin of the abdomen into the upper part of the intestine (jejunum). Like a PEG tube, this tube is flexible, several inches long with an adapter on the end.
peptide formula, peptide-based formula
a formula made with partially broken down (hydrolyzed) proteins that make them easier to digest and absorb.
perineal
the area of the body between the thighs, between the genitals and the anus.
peripheral
1) the opposite of central.
2) (line or IV) positioned in a small vein outside the heart
3) (veins) smaller veins distant from the heart, often veins in the hands, arms, legs, or feet.
4) far from the center. For example, the arms and legs..
peripheral IV
a thin, flexible tube inserted into a small vein, usually in the hand, arm, leg or foot, through which fluid and medications can be given.
peripheral line
see peripheral IV.
peristomal skin
the skin surrounding a stoma.
peripheral parenteral nutrition (PPN)
nutrition that is given through a peripheral vein instead of through the digestive tract, providing some of the needed hydration, electrolytes, vitamins, sugars, etc., However, peripheral parenteral nutrition needs to be less concentrated (a lower osmolarity) in order to reduce the strain on peripheral vessels and, therefore, does not provide complete nutrition.
peristalsis
the involuntary wave-like movement of the intestine that moves food and liquids through the digestive tract.
peristomal skin
the skin around a stoma.
peritonitis
inflammation of the tissue that lines the belly and abdominal organs, usually because of a bacterial infection.
permeability
the ease with which one substances pass through another. see intestinal permeability.
pharmacy
1) a store where medications are sold.
2) a place where medicines are compounded and dispensed.
3) the science and profession of preparing, preserving, compounding, and dispensing, reviewing, and monitoring medical drugs.
pharmaceutical
1) relating to medical drugs.
2) an ingredient used in the manufacture of a drug.
3) any kind of drug.
pharmaceutical company
a company that manufactures medical drugs.
pharmacist
a person licensed to prepare and dispence medical drugs.
pharmacy technician
a person who assists a pharmacist in preparing and distributing medications.
phlebitis
inflammation of the vein, sometimes as a result of irritation from a venous catheter
pica
a compulsive eating disorder where a person compulsively eats things that are not food.
PICC line, peripherally inserted central catheter
1) a central line that enters the body through a peripheral vein in the arm, leg, or neck goes all the way up to a specific location in a vein just inside the heart. Although there are specific catheters designed for use as PICC lines, any line in this placement, regardless of the type of catheter, is a PICC line.
2) a catheter designed for use as a PICC lines, usually made of polyurethane, with small wings that held in place using a small stitch or suture.
piggyback
a small bag of medication that needs to be diluted or given slowly, so it is attached to and given along with a continuously running compatible fluid, such as normal saline or other continuously running solution.
placebo
a treatment used in clinical trials that has no active properties. The purpose of a placebo is to provide a point of reference to help compare the effectiveness of the treatment being tested.
plasma
see blood plasma.
platelet
cells in blood that form clots to stop or prevent bleeding.
plunger
the moving part of a syringe, also called the piston.
pocket infection
an infection of the tissue pocket of skin at a port-site where the port is placed.
polyps
a growth on or in an organ of the body, usually benign or harmless, though some can be precancerous.
population
see colonization or bacterial colony.
port
1) a central venous catheter, also known as an implanted/implantable port, port-a-cath, mediport, or subcutaneous port, that is attached to a small disc shaped reservoir, also called a port, that is underneath the skin. The port and attached catheter are accessed through the skin using a huber needle.
2) the disc shaped access site of an implantable port through which it can be accessed with a needle.
3) colloquially, a general term used to refer to the connection of any venous access device.
port-a-cath
1)Port-a-Cath™, a name brand implanted port-style central venous catheter.
2)a general term used to refer to all port-style central venous catheters.
port pocket infection
see pocket infection.
portal vein
a blood vessel that carries blood from the entire bowel and spleen to the liver.
polyurethane
a durable, flexible synthetic polymer used to make central venous catheters and other medical devices.
pouch
see ostomy pouch.
plication
using a surgical procedure to strengthens, shortens, or narrow a part of the body that is weak or dilated by pulling together folds of excess material and suturing them in place.
pneumatosis
the presence of gas in the wall of the intestine.
power-injectable port or catheter
an type of central venous catheter or port designed to allow rapid injection of contrast agent or dye during radiological exams.
PowerLine ™
a brand of power-injectable tunneled central venous catheter manufactured by BD. It is made of a durable polyurethane catheter that is resistant to breaking and therefore it is sometimes recommended due to its overall durability.
PowerPort ™
a brand of power-injectable port manufactured by BD. It is made of titanium and a durable polyurethane catheter that is resistant to breaking and, therefore, it is sometimes recommended due to its overall durability.
precipitate
1) the solid particles that result when incompatible IV drugs react and crystalize, causing complications including catheter occlusion, embolism, drug inactivation, and other patient harm.
2) a deposit of solid particles in a liquid solution, such as an injection or infusion, that appears cloudy or has visible crystals or particulates.
3) to cause a substance in a solution to separate out as a solid.
4) to cause an event or occurrence.
precipitation
1) the inadvertent creation of solid particles in an IV solution caused by mixing incompatible IV drugs or solutions.
2) the formation of a solid when liquids interact and crystalize.
3) the presence of IV precipitates.
Precision Flow Rate Tubing ™
IV tubing that uses its diameter to control the rate at which an IV infusion is delivered on a mechanical syringe pump, specifically the Freedom pump series manufactured by KORU Medical Systems.
prescription
an order or instruction written by a doctor or other medical practictioner to authorize medicine or treatment.
prescription drug
a medication that is only available when the written authorization of a physician.
primary anastomosis (PA)
when the intestine is reconnected at the time of initial surgery, rather than creating a temporary stoma and waiting for reconnection (secondary anastomosis) later.
prime
the process or removing air from the tubing of an IV administration set, line, feeding tube, or other tubing.
priming volume
the amount of fluid required to fill the entire IV administration set.
probiotics
live bacteria or yeasts that are believed to improve and maintain the good balance of flora in the body.
prolapsed stoma
when the intestine extends farther than intended through the ostomy.
prophylactic
used to prevent a disease.
proteins
molecules made up of amino acids that the body needs to grow and repair cells and work properly.
proximal
1) further from the point of origin or a central point, especially in reference to the distal.
2) in the intestine, closer to the stomach and further from the anus.
pseudo-obstruction
a rare condition which causes symptoms of intestinal obstruction without any physical blockage.
pulse oximeter
a device that measures blood oxygen levels and pulse by measuring a light worn as it passes through the finger, toe or elsewhere on the body.
pylorus, pyloric sphincter
the valve that connects the stomach to the duodenum and small intestine.
Q
quality of life
1) a patient or caregiver's view of their physical, emotional, social, psychological, and spiritual well-being.
2) the degree to which a person finds satisfaction and fulfillment in life.
R
rare disease
a disorder, disease or condition that affects fewer than 200,000 people in the United States at a given time.
reanastomosis
a procedure to surgically reconnect the intestine, such as with stoma reversal.
recipient
in medicine, the person who receives blood, tissue, cells, or an organ from another person.
rectum
the final section of the digestive tract, where leftover waste collects until it is emptied as stool through the anus.
red man syndrome
a hypersensitive reaction to vancomycin and other antibiotics such as Cipro, cefepime, and rifampin, which, although it is not an allergy, causes symptoms similar to allergy including red, flushed and itchy skin, fever, chills, headache, facial swelling, among other symptoms. Also known as vancomycin flushing syndrome.
rehydration
1) the process or restoring fluid to a body that is dehydrated.
2) designed to restore hydration.
rejection
see transplant rejection.
resect
to surgically remove part of the body's tissue or organs.
resection
surgically removing any part of an organ or tissue.
reservoir
the disc shaped access site of an implantable port that is located beneath the skin through which it can be accessed with a needle.see also septum
resistance
see antimicrobial resistance.
retracted stoma
a stoma where the intestine is sitting at or below the skin's surface.
right-angle connector
a feeding tube connector that is L-shaped where it inserts into a g-tube button.
rigors
severe chills with violent shaking or shivering that can occur with a high fever.
rupture
1) break or tear.
2) a severe injury where an internal part of the body tears or bursts open.
S
Santulli enterostomy
1) one type of ostomy-in-continuity procedure, where the distal (nearer to anus) segment is attached to the side of the proximal (nearer to stomach) segment. The proximal end is brought to the surface as an ostomy.
2) an ostomy created using the Santulli procedure.
secondary anastomosis
surgical reconnection of the intestine at the time of stoma reversal rather than at the time of initial surgery (primary anastomosis.)
securement device
a medical device designed to secure a catheter in place.
SecureAcath®
a securement device for PICC lines that uses an anchor implanted beneath the skin at the catheter insertion site to hold the line in place.
septic
1) suffering from sepsis.
2) related to sepsis.
septic shock
a severe drop in blood pressure caused by sepsis that can cause severe organ damage and death. Septic shock is a life-threatening medical emergency that requires immediate treatment.
septicemia
1) a severe bloodstream infection that, if left untreated, can progress to sepsis.
2) some providers use the terms sepsis and septicemia interchangeably.
sepsis
the body's extreme and life-threatening in response to infection. Because the overwhelming immune response causes inflammation that can rapidly lead to tissue damage, organ failure and death, urgent treatment is essential. Symptoms of sepsis may include fever or hypothermia, fast heart rate, low blood presure, shaking or chills, warm or clammy or sweaty skin, confusion or disorientation, shortness of breath, rash, and/or extreme pain and discomfort.
septum
1) port access site
2) the self-sealing silicone disc through which a port is accessed using a huber needle.
sensitivity
1) (drug sensitivity) intolerance or adverse immune reaction to a food or medication.
2) (antibiotic sensitivity) see susceptibility.
side effect
an unintended and sometimes undesirable effect of a drug or treatment.
skin barrier
see ostomy skin barrier.
skin protectant
a product designed to be applied to the skin to prevent breakdown from irritants such as bodily fluids. This may come in the the form of a barrier cream or ointment or as a barrier film.
slip tip
a syringe with a leur compatible tip that does not have a threaded collar. Unlike leur lock syringes, the tip can be inserted directly into the connections and needles slip directly onto the end of the syringe without being twisted on. All leur lock connections can be accessed with a slip tip syringe. However, not all slip tip connections can be accessed with a leur lock syringe. See also leur slip.
short bowel syndrome
a condition where the small intestine is shortened or damaged and is not able to absorb enough nutrients from eating as a result.
sigmoid colon
the s-shaped end of the colon where the large intestine curves and empties into the rectum.
SILT procedure, spiral intestinal lengthening and tailoring
a surgical procedure that lengths and narrows a portion of dilated bowel by making a spiral incision down the length of the intestinal wall. The intestine is then stretched,essentially lengthening out the curl created by the cut, so that the intestine becomes a tube that is longer and narrower. The intestine is then sutured to hold its new shape. This is a relatively new procedure with limited data regarding its success.
silver nitrate
a natural compound with anti-infective properties. It is used medically to cauterize, or burn, the skin around a wound or stoma, and sometimes used in the treatment of granulation tissue.
silver-plated catheter dressing
a sterile, circular dressings coated in silver that is placed around a central line, under the sterile dressing, to help prevent infection.
Site Scrub ™
a plastic cap with a 70% alcohol infused foam sponge inside designed to scrub clean and sterilize claves and connections using friction.
single lumen
having a single fluid path, tube, or channel into the body.
small bowel transplant
also known as intestinal transplant, a surgical procedure that replaces a failing small intestine with part or all of a small intestine from a donor. The vast majority of small intestine transplants are from deceased donors.
small intestine, small bowel
the long, tube-like organ between the stomach and large intestine where nutrients are broken down and absorbed. It is made of three parts: duodenum, jejunum, and ileum.
SMOF, SMOFlipid®
known by the brand name SMOFlipid ™ is a composite lipid used in parenteral nutrition that is made of a blend of soybean oil, medium chain triglycerides, olive oil, and fish oil. This blend of fats more closely resembles a typical diet, including both omega-3 and omega-6 fatty acids, and is believed to be better for both liver health and brain development.
sodium bicarbonate, sodium bicarb
a medication and general chemical known commonly as baking soda. Because it is a base, sodium bicarbonate is often use to help balance pH when acidity is too high. Some common uses in short bowel syndrome include: as an antacid, as a supplement to offset carbon dioxide imbalances from chronic diarrhea, as a treatment to correct D-lactic acidosis, and as a lock therapy to prevent central line infections. There are many other uses in medicine ranging from cardiac arrest to renal disease to drug overdose.
sphincter
a ring of muscle that opens and closes, acting like a valve to control the flow of bodily fluids, such as bile, urine, and stool.
spleen
an organ of the lymphatic system whose main purpose is to filter the blood, keeping body fluid levels in balance and protecting against infection.
split gauze
a gauze pad with a slit in the middle to help it fit around catheters and tubes.
StatLock®
an adhesive securement device that comes in a variety of designs to stabilize a variety of medical catheters and tubes without tape.
stem cells
a special type of human cell that has unique properties not found in other cells. Stem cells can provide new cells for the body as they grows and have the potential to become many different kinds of cells instead of only replicating as a single type of cell. They also can self-renew, replacing cells that are damaged or lost.
stenosis
a narrowing of the diameter of a passage in the body, from large passages like the intestine to small passages like blood vessels.
STEP procedure, serial transverse enteroplasty
a surgical procedure that lengthens and narrows a portion of dilated intestine by making a series of alternating v-shaped cuts along the small intestine that are stabled closed along the edges, resulting in a length of intestine that is longer and thinner.
sterile
1) completely clean and free from living germs and microorganisms.
2) intended to be kept free from microorganisms in order to prevent infection.
3) (technique) designed or planned to maintain sterility and prevent infection. Aseptic is often used to specifically denote technique, though the two words are used interchangeably.
4) prepared using sterilization techniques.
5) cleaned and then packaged to ensure that a product is completely clean and free from living germs, bacteria, fungi, and other microorganisms.
6) unable to bear children, barren.
sterilization
1) the process of cleaning, preparing and/or packaging something in such a way that it is entirely free of germs such as bacteria, fungi, and viruses that could cause infection.
stoma
a surgically created opening from an organ inside the body to the outside. A stoma can be used to drain waste, vent, or feed.
stoma appliance
see ostomy appliance.
stoma powder
a powder, usually made of pectin, cellulose, and gelatin, that absorbs moisture and helps protect skin from irritants, especially around an ostomy.
stoma reversal
a surgery that removes a stoma and closes an ostomy, rejoining the intestine. Also known as stoma takedown, ostomy reversal, ostomy takedown.
stoma takedown
see ostomy reversal.
stool
the waste from the intestines. This term can be used both for waste from a bowel movement and waste from an enterostomy.
stopcock
a three-way valve used to attach two different fluids to the same line and control the flow of those fluids by turning a handle to open and close each fluid pathway.
straight-angle connector
a g-tube feeding extension that is straight where it connects to the button.
stricture
an abnormally narrowing of a tube-like passage in your body. The term usually refers to an area of muscle that has narrowed. Strictures can be congenital, or they can be the result of scar tissue, tumors, etc.
subclavian veins
a pair of central veins that carries blood to the arms, shoulders and neck and is located behind the collarbone.
subcutaneous
located, occurring, or administered under the skin.
subcutaneous port
see port.
sublingual
located or administered under the tongue.
superior mesenteric artery (SMA)
the major artery of the abdomen that provides blood to the midgut, from the duodenum to the transverse colon, including all of the small intestine.
superior vena cava (SVC)
the very large vein at the top of the heart through which all of the upper major vessels return blood to the heart.
superior vena cava (SVC) syndrome
a group of symptoms that occur when blood flow through the superior vena cava becomes partially or completely blocked. Fluid buildup can cause swelling of the face and upper body as well as shortness of breath. Severe cases can be life-threatening. Chronic central line use is a common cause of this syndrome.
susceptibility
the degree to which a bacteria or pathogen responds to treatment with a given antibiotic.
suture
1) a stitch or row of stitches holding together a wound or incision.
2) to stitch or sew up a cut in a person's body.
syringe pump
a motor-driven pump that uses a precise dose and timing of medication by moving the plunger of a syringe. Some syringe pumps are electronic, using software to control the rate of delivery. Other pumps use non-electric wind-up or spring-loaded motors to push the syringe plunger and precision flow rate tubing to control the infusion rate.
T
TauroLock™
an antimicrobial lock therapy used to help prevent central line-associated bloodstream infections by breaking down biofilm and reducing growth of bacteria using a combination of taurolidine and 4% citrate. Taurolock is approved for use in several countries but is not commonly used in the United States.
Tegaderm™ a clear occlusive dressing often used as a dressing on IV's and central lines.
tetrasodium EDTA
1) the main ingredient in Kitelocks, a substance that helps prevent central line-associated bloodstream infections by breaking down the biofilm in a central line.
2) the salt that results from the neutralization of EDTA with 4 sodium hydroxide.
taper
1) (nutrition therapy) the process of slowly increasing or decreasing the rate of an infusion to increase the body's tolerance of it, such as with TPN which has high levels of dextrose, to allow the body's insulin levels to adjust to the changing levels of sugar in the blood.
2) (surgery) to decrease dilation surgically.
tapering enteroplasty
a surgical treatment for dilated intestine that cuts off the portion of the bowel opposite the mesentery and uses staples to narrow the total caliber of the intestine. The remaining intestine is narrower, but the same length.
taurolidine
an antimicrobial agent that is used to prevent central line-associated bloodstream infections by disrupting the cell wall of bacteria and breaking down biofilm. The main ingredient in Taurolocks.
teduglutide
marked under the brand name Gattex, a GLP-2 analog medication that promotes intestinal adaptation by stimulating the growth of the intestinal villi. It is a daily injection that is approved for use in adult and pediatric patients. This was the first drug of its type and was specifically designed for use in short bowel syndrome patients, making it an orphan drug.
tegaderm
a transparent, sterile film occlusive dressing often used to protect IV catheter sites.
thrombosis
when a blood clot blocks a blood vessel such as a vein or artery.
thrombus
a blood clot.
thrombolytic
an agent designed to dissolve blood clots.
topical
applied directly to the body and intended to affect only the area to which it is applied, such as a cream to the skin or a spray to the nose.
total parenteral nutrition (TPN)
complete nutrition that is given intravenously (through a vein) instead of through the digestive system, and may include carbohydrates, proteins, fats, vitamins, minerals, and other nutrients.
total volume
the intended total dose of an infused medication, calculated as flow rate x infusion time.
tPA, tissue plasminogen activator
or alteplase, an injectable medication that dissolves blood clots. It was developed for the treatment of stroke and is used for treatment of blood clots. Smaller doses can be used to dissolve clots in central lines.
trace elements
minerals that are present in tissues in small amounts. Some are essential to body functions, such as iron, zinc, fluoride, selenium, copper, chromium, iodine, manganese, nad molybdenum. Others are non-essential and may be ingested as contaminants, including aluminmum, cadmium, mercury, arsenic, and lead.
transaminitis
when certain elevated liver enzymes are detected in blood tests.
transdermal
applying a medication to be absorbed through the skin, usually through a patch so that it is absorbed slowly into the body.
transient bacteremia
when bacteria is in the bloodstream for a short amount of time, usually less than three days before being cleared by the body, often causing no or few symptoms.
transit time
a measure of how long it takes for food to move from where it is taken in (via mouth or feeding tube) to where it exits the body (anus or ostomy).
translocation
when bacteria leaks from the gut into other parts of the body such as the blood, liver, spleen, or kidneys.
transplant
a surgical procedure where organs, tissues, or cells are removed from one person and transplanted into another person or moved from one site in a person's body to another in the same body.
transplant rejection
a process where the transplant recipient's immune system attacks the transplanted organ or tissue.
transverse colon
the second portion of the colon, which moves left to right across the abdomen.
triamcinolone cream
a corticosteroid cream used to treat a variety of skin conditions, including granulation tissue.
tube feed, tube feeding
nutrition given via a tube into the stomach or intestine, usually in a liquid form.
tubie
a slang term for a person, especially a child, with a feeding tube.
tunneled catheter, tunneled central line, tunneled line
a central line that is tunneled under the skin before entering a major vessel. Broviac, Hickman, Groshong, and PowerLine are well-known brands of tunneled lines.
tunnel infection
an infection of the skin and tissue inside the path where a central line such as a broviac or hickman line has been tunneled under the skin.
U
urine
the watery, yellow fluid produced as waste by the kidneys and discharged through the urethra; pee.
V
vancomycin flushing syndrome
see red man syndrome.
vascular
relating to blood vessels.
vascular access, venous access
1) the act and process of inserting a catheter into a blood vessel to draw blood or administer medicines.
2) a long-term implanted IV catheter such as a central venous catheter.
the potential for a patient to have future vascular access devices such as peripheral or central lines, based on the health of their veins.
vascular access device, venous access device, VAD
any type of catheter that can be used to access a patient's blood vessels, though most often, this term refers to long-term devices such as central lines.
venogram, venography
a test that uses contrast dye and x-ray to examine the health and path of veins in the body and evaluate venous access.
venous access
see vascular access.
venous mapping
also known as arterial and venous mapping, an ultrasound test that creates a picture, or "map" of a patient's blood vessels to help guide procedures and evaluate health and patency of major vessels for future venous access. See also doppler ultrasound.
venous thromboembolism
a blood clot that blocks the flow of blood through the vein.
vent
(g-tube or j-tube) to open a feeding tube to release pressure of gas, or in some cases, bile.
vesicant
an intravenous medication that is irritating to the veins and can cause tissue injury if it leaks outside the blood vessels into surrounding tissues. TPN, high dextrose fluids, amino acids, and many antibioticss are considered vesicants, which is why they are usually given via central line. When given in a peripheral line, IV extravation is common and, if unnoticed, can cause significant tissue damage.
villi
the tiny finger-like projections that cover the wall of the small intestine and are primarily responsible for the absorption of nutrients.
volvulus
1) when the intestine twists on itself, causing an obstruction. This is a life-treatening emergency. See also midgut volvulus.
volume
1) the capacity of a container.
2) the quantity of a liquid or gas.
Vygon Lectrospiral™ tubing
sterile IV extension tubing that is curly like a telephone cord.
W
wafer
see ostomy wafer.
waste
1) stool, urine, or other byproducts or body processes.
2) when drawing labs, the first few milliliters drawn off of the line that is not put into the lab sample so any medication residue in the line does not contaminate the sample. Waste is usually discarded.
wound and ostomy care
a specialized field of nursing for those with stomas, incontinence, pressure injuries, or other skin conditions, or severe or chronic wounds and skin problems.
withdraw
1) to remove the contents of a line by pulling back on the plunger of a syringe. This term is often used to describe removing a lock from a line.
2) see also draw.
X Y Z
Y-site
1) a point where an IV line branches into two.
2) an extension that allows two lengths of IV tubing to be joined together to run into one.
yeast
1) a type of single-celled fungi that reproduce by budding. Some types of yeast exist on the body without causing problems; however, others can cause disease.
2) a common name for Candida, a type of fungus that is associated with thrust, diaper rash, finger and toenail infections, and vaginal infections. It can cause serious issues when it enters the bloodstream, a condition known as candidemia.
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