ANCC AGACNP-BC key terms

Sequential Organ Failure Assessment; a six-organ scoring tool covering respiratory, coagulation, liver, cardiovascular, central nervous system, and renal function, used to quantify dysfunction and predict mortality in critically ill patients.

Bedside screening tool for suspected infection using respiratory rate at least 22, altered mentation, and systolic blood pressure at most 100; two or more criteria flag high risk of poor outcome.

Life-threatening organ dysfunction caused by a dysregulated host response to infection, identified clinically by an acute rise in SOFA score of at least two points.

Ratio of heart rate to systolic blood pressure; a value above 0.9 suggests occult hypoperfusion and predicts need for transfusion or escalation in trauma and hemorrhage.

Average arterial pressure during a cardiac cycle, calculated as systolic plus twice diastolic divided by three; a common resuscitation target is at least 65 mm Hg in shock.

Percentage fall in serum lactate during resuscitation; failure to clear lactate suggests ongoing hypoperfusion and predicts higher mortality in sepsis and shock.

Acute onset within one week, bilateral opacities not fully explained by effusion or collapse, PaO2/FiO2 at most 300 with PEEP at least 5, and respiratory failure not primarily cardiac.

Ventilator strategy using tidal volume about 6 mL/kg predicted body weight, plateau pressure at most 30 cm H2O, and permissive hypercapnia; reduces mortality in ARDS.

Positive end-expiratory pressure applied during mechanical ventilation; it recruits and stabilizes alveoli and improves oxygenation, but can reduce venous return and cardiac output.

Placing a patient face down for 12 to 16 hours daily in moderate-to-severe ARDS; improves oxygenation and survival by recruiting dorsal lung and reducing ventilation-perfusion mismatch.

Calculated as sodium minus the sum of chloride and bicarbonate, corrected for low albumin; an elevated gap narrows the differential for metabolic acidosis to unmeasured anions.

Expected PaCO2 equals 1.5 times bicarbonate plus 8, with a range of plus or minus 2; used to judge whether respiratory compensation in metabolic acidosis is appropriate.

Difference between alveolar and arterial oxygen tension; widening indicates ventilation-perfusion mismatch, shunt, or diffusion impairment rather than pure hypoventilation.

Diabetic ketoacidosis: hyperglycemia with ketosis and high-anion-gap metabolic acidosis; treatment centers on isotonic fluids, intravenous insulin infusion, and careful potassium replacement.

Hyperosmolar hyperglycemic state: marked hyperglycemia and hyperosmolality with minimal ketosis; profound dehydration makes aggressive isotonic fluid resuscitation the first priority.

Continuous intravenous regular insulin titrated to hourly glucose measurements for DKA, HHS, or severe hyperglycemia; requires potassium monitoring and a transition plan to subcutaneous insulin.

First-line vasopressor for septic and most vasodilatory shock; predominantly alpha-1 with some beta-1 activity, raising mean arterial pressure; central administration is preferred but temporary peripheral use is acceptable.

Non-catecholamine vasoconstrictor acting on V1 receptors; added to norepinephrine in septic shock to raise mean arterial pressure and reduce catecholamine requirements when pressure remains low.

Central venous oxygen saturation reflecting the balance between oxygen delivery and consumption; low values suggest inadequate cardiac output, anemia, or hypoxemia.

Bedside maneuver that autotransfuses blood from the legs to the central circulation; a rise in cardiac output or pulse pressure suggests fluid responsiveness.

Continuous renal replacement therapy; slow, gentle solute and fluid removal used for hemodynamically unstable acute kidney injury, using modalities such as CVVH or CVVHD.

Staging system for acute kidney injury using serum creatinine rise and urine output thresholds; stage 2 or 3 prompts nephrology involvement and consideration of renal replacement.

Scores eye, verbal, and motor responses from 3 to 15; quantifies level of consciousness and detects neurologic deterioration in acute brain injury.

National Institutes of Health Stroke Scale; a 0 to 42 score of neurologic deficits used to assess stroke severity, guide reperfusion decisions, and monitor change over time.

Risk tool for undifferentiated chest pain using History, ECG, Age, Risk factors, and Troponin; low scores support discharge and high scores guide admission and stress testing.

Clinical prediction rule for pretest probability of deep vein thrombosis or pulmonary embolism; low probability with a negative D-dimer supports withholding imaging.

Pneumonia severity score using confusion, urea, respiratory rate, blood pressure, and age at least 65; helps decide outpatient, ward, or intensive care level treatment.

Dosing of heparin, low-molecular-weight heparin, or direct oral anticoagulants to prevent clot propagation; requires monitoring and dose adjustment for renal function and weight.

Agents that neutralize anticoagulant effect: protamine for heparin, vitamin K plus prothrombin complex concentrate for warfarin, idarucizumab for dabigatran, and andexanet alfa for factor Xa inhibitors.

Pharmacokinetic monitoring target of AUC/MIC 400 to 600 for serious MRSA infections; requires timed levels and Bayesian or two-level dosing to balance efficacy and nephrotoxicity.

Evidence-based list of medications potentially inappropriate for adults 65 and older; highlights anticholinergics, benzodiazepines, and other drugs linked to falls or confusion.

Patient-education technique where the learner explains or demonstrates instructions in their own words; reveals gaps in understanding before discharge.

Collaborative counseling style that strengthens a patient's own motivation for change using open questions, affirmations, reflections, and summaries.

Coordinated handoffs across settings that include medication reconciliation, timely follow-up, and clear responsibility; reduces readmissions and adverse events after discharge.

Ongoing discussion and documentation of a patient's values and preferences for future medical care, including surrogate decision-maker and code status.

Federal law requiring Medicare-participating hospitals to provide a medical screening examination and stabilizing treatment for emergency conditions regardless of ability to pay.

Legal boundaries defining the assessments, procedures, and prescribing an NP may perform; set by state law and institutional policy, often requiring collaborative agreements.

A blame-balanced safety framework that treats human error and system flaws with support and redesign while holding individuals accountable for reckless behavior.

Voluntary authorization for a procedure after disclosure of purpose, risks, benefits, alternatives, and the right to refuse, given by a patient with decision-making capacity.

Collaborative process where clinician and patient exchange evidence and values to choose an option together; useful when options have meaningful tradeoffs.