CEN key terms

Acute coronary artery occlusion producing persistent ST elevation in two contiguous ECG leads. It requires emergent reperfusion because time to treatment determines how much myocardium survives.

A tear in the aortic intima allows blood to track within the vessel wall, causing sudden severe tearing chest or back pain and unequal arm blood pressures. It is a surgical emergency requiring rapid blood pressure control and imaging.

Compression of the heart by fluid or blood in the pericardial sac that impairs ventricular filling. Signs include hypotension, distended neck veins, muffled heart sounds, and pulsus paradoxus; treatment is fluid resuscitation and emergent pericardiocentesis.

A cardiac arrest rhythm with organized electrical activity on the monitor but no effective mechanical contraction or palpable pulse. Care focuses on high-quality CPR and correcting reversible causes such as hypovolemia, hypoxia, tamponade, and tension pneumothorax.

An irregularly irregular rhythm with no distinct P waves and a ventricular rate fast enough to impair cardiac filling. Rapid rates may cause hypotension, ischemia, or heart failure; treatment targets rate or rhythm control and reversible triggers.

Inadequate tissue perfusion caused by pump failure, most often after a large myocardial infarction. Findings include hypotension, cool clammy skin, altered mentation, and elevated filling pressures; treatment includes vasopressors, inotropes, and reperfusion.

Acute diffuse lung inflammation producing noncardiogenic pulmonary edema and severe hypoxemia that resists supplemental oxygen. Care is mainly supportive: lung-protective ventilation, prone positioning, and treatment of the underlying cause.

A severe asthma attack that does not respond to repeated bronchodilator therapy. The patient may show a silent chest, exhaustion, and rising carbon dioxide, signaling impending respiratory failure that needs aggressive treatment and possibly ventilation.

Air trapped in the pleural space accumulates under pressure, collapsing the lung and shifting mediastinal structures. Signs include unilateral absent breath sounds, hypotension, distended neck veins, and tracheal deviation; immediate needle decompression is required.

Hypoperfused brain tissue surrounding an infarcted core that is still viable but at risk. Rapid reperfusion can salvage this tissue, which is why stroke care emphasizes fast imaging and treatment times.

Rising pressure inside the rigid skull from edema, hemorrhage, or mass effect. Signs include decreasing consciousness, pupil changes, vomiting, and Cushing triad of hypertension, bradycardia, and irregular respirations; treatment protects airway, ventilation, and cerebral perfusion.

Continuous seizure activity, or repeated seizures without regaining consciousness, lasting five minutes or longer. Prolonged seizures cause hypoxia, hyperthermia, and neuronal injury; benzodiazepines are first-line treatment.

Bleeding into the space between the arachnoid and pia mater, classically from a ruptured cerebral aneurysm. Patients report a sudden worst-ever thunderclap headache with neck stiffness, photophobia, vomiting, and possible decline in consciousness.

A standardized 11-item bedside examination scoring consciousness, gaze, visual fields, facial movement, limb strength, coordination, sensation, language, and neglect. Scores guide treatment decisions and give nurses a common language for reporting changes.

A systematic initial trauma assessment covering airway, breathing, circulation, disability, and exposure, treating life-threatening problems as they are found. It is repeated whenever the patient's condition changes.

A head-to-toe trauma examination performed after the primary survey and initial resuscitation, including history, full physical assessment, and indicated imaging. It identifies injuries that are not immediately life-threatening.

Inadequate perfusion caused by blood loss, graded in four classes by heart rate, blood pressure, mental status, and urine output. Treatment prioritizes hemorrhage control, warmed blood products, and avoiding excessive crystalloid resuscitation.

Fracture of three or more consecutive ribs in two or more places, creating a free-floating segment that moves paradoxically with breathing. The underlying pulmonary contusion often causes more hypoxia than the chest wall defect.

Hyperglycemia with ketone production and metabolic acidosis from absolute insulin deficiency, often triggered by infection or missed insulin. Treatment includes isotonic fluids, an insulin infusion, potassium replacement, and identifying the precipitant.

Life-threatening organ dysfunction caused by a dysregulated response to infection. Warning signs include fever or hypothermia, tachycardia, tachypnea, hypotension, and altered mentation; early antibiotics and fluid resuscitation improve survival.

A severe systemic hypersensitivity reaction causing rapid airway swelling, bronchospasm, and vasodilatory shock. Intramuscular epinephrine is the first-line treatment; antihistamines and corticosteroids are only adjuncts.

A recognizable cluster of signs and symptoms suggesting a specific class of poisoning, such as opioid, anticholinergic, cholinergic, sympathomimetic, or sedative-hypnotic. Identifying the pattern guides supportive care and antidote selection.

Poisoning from organophosphate or carbamate exposure producing salivation, lacrimation, urination, diarrhea, vomiting, bronchorrhea, bradycardia, and miosis. Atropine and pralidoxime are key treatments along with decontamination and airway support.

Inhalation of an odorless gas that binds hemoglobin with high affinity and causes tissue hypoxia. Standard pulse oximetry reads falsely normal; treatment is high-flow oxygen and consideration of hyperbaric therapy.

Excess serotonergic activity after combining serotonergic medications, causing agitation, tremor, clonus, hyperreflexia, diaphoresis, and hyperthermia. Treatment is stopping the offending agents, cooling, benzodiazepines, and supportive care.

Bleeding proximal to the ligament of Treitz, often from peptic ulcer or esophageal varices, presenting with hematemesis, coffee-ground emesis, or melena. Priorities are airway protection, intravenous access, volume resuscitation, and acid suppression or vasoactive drugs.

Mechanical or functional blockage of intestinal flow causing colicky abdominal pain, vomiting, distension, and inability to pass stool or gas. Nurses watch for strangulation signs such as fever, tachycardia, severe localized pain, and peritonitis.

New hypertension after 20 weeks of pregnancy with proteinuria or evidence of end-organ damage. It can progress to seizures or HELLP syndrome; magnesium sulfate is given to prevent and treat eclamptic seizures.

Implantation of a fertilized egg outside the uterine cavity, most commonly in a fallopian tube. It causes amenorrhea, abdominal pain, and vaginal bleeding and can rupture, producing life-threatening internal hemorrhage.

Premature separation of a normally implanted placenta, causing painful vaginal bleeding, uterine tenderness, and fetal distress. Concealed hemorrhage may produce hypovolemic shock that appears out of proportion to visible blood loss.

Twisting of the spermatic cord that interrupts blood flow to the testis, causing sudden severe scrotal pain, nausea, and a high-riding testis. It is a surgical emergency with a short window to preserve the organ.

Increased pressure within a closed fascial compartment that compromises tissue perfusion, causing pain out of proportion, paresthesias, and pain with passive stretch. Pulses often remain palpable; fasciotomy is the definitive treatment.

A rapidly spreading bacterial infection of deep fascia causing severe pain, swelling, erythema, bullae, and systemic toxicity that seems out of proportion to skin findings. Emergent surgical debridement plus broad-spectrum antibiotics are required.

Breakdown of skeletal muscle releasing myoglobin and potassium into circulation, risking acute kidney injury and dysrhythmias. Causes include crush injury, prolonged immobilization, and stimulant use; treatment is aggressive intravenous fluid resuscitation.

Severe alcohol withdrawal with agitation, tremor, hallucinations, disorientation, fever, tachycardia, and hypertension, typically 48 to 96 hours after the last drink. It is a medical emergency treated with benzodiazepines, fluids, thiamine, and close monitoring.

Purposeful, goal-directed interaction using active listening, empathy, open-ended questions, and reflection to build trust and de-escalate distress. It supports assessment and helps patients feel safe and understood.

A federal law requiring Medicare-participating hospitals to provide a medical screening examination and stabilizing treatment for emergency conditions regardless of insurance or ability to pay, with strict rules for transfers.

A structured handoff format covering Situation, Background, Assessment, and Recommendation. It reduces omissions and communication errors when transferring care between providers, units, or shifts.

A safety framework that separates human error, at-risk behavior, and reckless conduct so staff feel safe reporting events while remaining accountable for their choices. It promotes learning rather than blame.

The documented, unbroken record of who collected, transferred, and handled forensic specimens from the scene to court. Each transfer is logged with names, dates, and times to preserve admissibility.