看護上級英語：必須語彙とフレーズ

"haemodynamic instability"

A condition in which the cardiovascular system fails to maintain adequate blood flow and pressure to perfuse vital organs, requiring urgent intervention

"The patient developed haemodynamic instability post-operatively, prompting the ICU nurse to initiate a vasopressor infusion and notify the intensivist."

"ventilator-associated pneumonia"

A hospital-acquired lung infection that develops in patients on mechanical ventilation for more than 48 hours, preventable through evidence-based care bundles

"The critical care team implemented an oral hygiene protocol and head-of-bed elevation to reduce the incidence of ventilator-associated pneumonia on the unit."

"titrating sedation"

The process of adjusting the dose of sedative agents incrementally to achieve a target level of consciousness while minimising adverse effects

"The nurse spent the night shift titrating sedation to keep the intubated patient at a RASS score of −2, balancing comfort with the need for neurological assessment."

"septic shock"

A life-threatening subset of sepsis in which circulatory and cellular metabolism abnormalities cause organ failure despite adequate fluid resuscitation

"Following the Sepsis Six protocol, the nurse drew blood cultures and began broad-spectrum antibiotics within the first hour of identifying septic shock."

"central venous pressure"

The blood pressure measured in the thoracic venae cavae near the right atrium, used to estimate cardiac preload and guide fluid management in critically ill patients

"Serial central venous pressure readings helped the team determine that additional fluid boluses were unlikely to improve the patient's cardiac output."

"refractory hypoxaemia"

A dangerous drop in blood oxygen levels that does not respond to conventional supplemental oxygen therapy and may require advanced respiratory support

"With refractory hypoxaemia worsening despite high-flow nasal cannula, the team made the decision to proceed with endotracheal intubation."

"arterial blood gas interpretation"

The clinical analysis of pH, carbon dioxide, bicarbonate, and oxygen values obtained from an arterial blood sample to assess respiratory and metabolic status

"Accurate arterial blood gas interpretation allowed the nurse to identify a combined respiratory and metabolic acidosis requiring both ventilator adjustment and bicarbonate supplementation."

"multi-organ dysfunction syndrome"

The progressive failure of two or more organ systems in an acutely ill patient, often triggered by sepsis, trauma, or major surgery, carrying high mortality

"Despite aggressive resuscitation, the patient progressed to multi-organ dysfunction syndrome, with concurrent renal, hepatic, and coagulation failure documented within 48 hours."

"neutropenic precautions"

A set of infection-control measures implemented when a patient's neutrophil count is critically low, making them highly susceptible to opportunistic infections

"The haematology nurse explained neutropenic precautions to the family, stressing the importance of hand hygiene and avoiding visitors with respiratory illness."

"extravasation injury"

Accidental leakage of a vesicant chemotherapy agent from the vein into surrounding tissues, causing tissue necrosis and requiring immediate intervention

"On noticing swelling and patient-reported burning at the cannula site, the nurse stopped the infusion immediately and followed the extravasation injury management protocol."

"tumour lysis syndrome"

A metabolic emergency caused by the rapid release of intracellular contents following massive tumour cell death, leading to hyperkalaemia, hyperuricaemia, and renal failure

"The oncology nurse monitored urine output hourly and checked electrolytes every four hours to detect early signs of tumour lysis syndrome after the patient received high-dose chemotherapy."

"palliative intent"

A treatment approach focused on controlling symptoms, improving quality of life, and supporting comfort rather than achieving cure or prolonging life

"After a family meeting, the team agreed to shift to palliative intent, and the nurse coordinated with the palliative care specialist to develop a comfort-focused care plan."

"chemotherapy-induced peripheral neuropathy"

Nerve damage caused by certain chemotherapy agents that results in numbness, tingling, weakness, or pain in the hands and feet

"The nurse assessed the patient weekly for chemotherapy-induced peripheral neuropathy using a validated scale and documented any changes to inform dose modification decisions."

"mucositis grading"

The systematic clinical assessment of oral inflammation and ulceration caused by chemotherapy or radiotherapy, scored on a standardised scale to guide treatment

"The nurse completed mucositis grading each morning and escalated to Grade 3 after the patient could no longer swallow liquids, triggering parenteral nutrition referral."

"performance status"

A standardised measure of a patient's functional ability and overall wellbeing, used to guide treatment decisions and predict tolerance to cancer therapies

"The oncologist used the patient's declining performance status as a key factor in deciding against further aggressive chemotherapy."

"antiemetic prophylaxis"

The pre-emptive administration of medications to prevent nausea and vomiting before and during emetogenic cancer treatment

"The nurse administered the prescribed antiemetic prophylaxis regimen 30 minutes before the platinum-based chemotherapy infusion began."

"decompensated heart failure"

An acute worsening of chronic heart failure in which the heart can no longer maintain adequate cardiac output, causing fluid overload and respiratory distress

"The nurse recognised decompensated heart failure from the patient's rapid weight gain, bilateral crackles, and elevated jugular venous pressure, and initiated the heart failure care pathway."

"12-lead ECG interpretation"

The systematic analysis of a twelve-electrode electrocardiogram to identify cardiac rhythm disturbances, ischaemia, conduction defects, and structural abnormalities

"The cardiac nurse's rapid 12-lead ECG interpretation identified ST-elevation in the inferior leads, triggering an immediate call to the catheterisation laboratory."

"atrial fibrillation with rapid ventricular response"

An irregular heart rhythm in which disorganised atrial electrical activity drives a fast ventricular rate, causing haemodynamic compromise and requiring urgent rate or rhythm control

"The patient went into atrial fibrillation with rapid ventricular response overnight, and the nurse administered intravenous metoprolol as per the standing orders while alerting the cardiologist."

"troponin trend"

The serial measurement of cardiac troponin blood levels over time to determine whether they are rising, falling, or stable, which guides the diagnosis of acute myocardial injury

"A rising troponin trend over three blood draws confirmed myocardial infarction, and the team activated the primary percutaneous coronary intervention protocol."

"cardiac tamponade"

A life-threatening compression of the heart caused by fluid accumulation in the pericardial sac, impairing cardiac filling and output

"Beck's triad — hypotension, muffled heart sounds, and distended neck veins — alerted the nurse to the possibility of cardiac tamponade following the pericardiocentesis."

"transcutaneous pacing"

An emergency procedure that delivers electrical impulses through adhesive chest electrodes to stimulate the heart when the natural conduction system fails

"The nurse applied transcutaneous pacing pads and initiated capture at 80 beats per minute while waiting for transvenous pacing to be established by the cardiology team."

"fluid responsiveness"

The likelihood that a patient will increase their cardiac output in response to the administration of intravenous fluids, assessed through dynamic haemodynamic measures

"A passive leg-raise test was used to assess fluid responsiveness before giving further saline boluses to the hypotensive post-operative cardiac patient."

"intra-aortic balloon pump"

A mechanical circulatory support device inserted into the aorta that inflates during diastole and deflates during systole to reduce cardiac workload and improve coronary perfusion

"The cardiac ICU nurse monitored intra-aortic balloon pump timing, limb perfusion, and diastolic augmentation every hour as part of the post-cardiogenic shock care bundle."

"surgical site infection prophylaxis"

The pre-operative administration of antibiotics and application of evidence-based skin preparation measures to prevent post-operative wound infections

"The scrub nurse confirmed that surgical site infection prophylaxis antibiotics had been given within 60 minutes of incision before signing off on the surgical safety checklist."

"anaesthetic reversal"

The pharmacological process of counteracting residual neuromuscular blockade or opioid sedation at the end of surgery to restore spontaneous breathing and consciousness

"Following anaesthetic reversal in theatre, the nurse observed the patient for signs of re-sedation and ensured airway reflexes were intact before transferring to recovery."

"ileus"

A temporary paralysis of normal intestinal peristalsis following abdominal surgery or critical illness, causing bowel obstruction symptoms without a mechanical cause

"The post-operative patient developed an ileus on day two; the nurse withheld oral intake, inserted a nasogastric tube, and documented absent bowel sounds for the surgical team."

"wound dehiscence"

The partial or complete separation of a surgical wound's edges, which may result from infection, poor healing, excessive strain, or technical factors

"The nurse discovered wound dehiscence during the morning dressing change and immediately applied a sterile dressing, notified the surgeon, and reassured the distressed patient."

"venous thromboembolism prophylaxis"

Preventive measures including anticoagulant medications and mechanical compression devices used to reduce the risk of deep vein thrombosis and pulmonary embolism after surgery

"The nurse ensured that graduated compression stockings were applied and low-molecular-weight heparin administered as part of the venous thromboembolism prophylaxis protocol before the patient went to theatre."

"post-operative cognitive dysfunction"

A decline in memory, concentration, and information-processing speed that occurs in older adults following major surgery, linked to anaesthesia, inflammation, and stress

"The ward nurse flagged post-operative cognitive dysfunction in the elderly patient when her family noted she was confused and unable to recall conversations from earlier that day."

"anastomotic leak"

A failure of a surgical join between two sections of bowel or other hollow organ, causing contents to leak into the abdominal cavity and posing a serious infection risk

"Rising inflammatory markers and abdominal pain on day four raised clinical suspicion of an anastomotic leak, prompting an urgent CT scan and surgical review."

"enhanced recovery after surgery"

A multimodal, evidence-based care pathway designed to reduce the physiological stress of surgery, accelerate recovery, and shorten hospital stay through pre-, intra-, and post-operative optimisation

"Under the enhanced recovery after surgery protocol, the nurse encouraged the patient to mobilise and take oral fluids within six hours of returning from the operating theatre."

"Glasgow Coma Scale"

A standardised neurological scoring tool that assesses a patient's level of consciousness based on eye opening, verbal response, and motor response, with scores ranging from 3 to 15

"The neurology nurse performed hourly Glasgow Coma Scale assessments and documented a drop from 14 to 9, triggering an urgent medical review."

"raised intracranial pressure"

An increase in pressure within the skull caused by swelling, bleeding, or hydrocephalus that can compress brain tissue, impair cerebral perfusion, and lead to herniation if untreated

"Head positioning at 30 degrees and strict fluid management were maintained to manage raised intracranial pressure in the head-injured patient."

"thrombolytic therapy window"

The time-critical period, typically up to 4.5 hours after stroke symptom onset, during which clot-dissolving medication can be safely administered to restore cerebral blood flow

"The stroke nurse confirmed the onset time and absence of contraindications to ensure the patient fell within the thrombolytic therapy window before administering alteplase."

"status epilepticus"

A medical emergency defined as a seizure lasting more than five minutes or two or more seizures without full recovery of consciousness between them, requiring immediate treatment to prevent neuronal injury

"The nurse administered intravenous lorazepam according to the status epilepticus protocol while simultaneously calling for medical support and protecting the patient's airway."

"pupillary reactivity"

The assessment of how each pupil constricts in response to light, used as a key indicator of brainstem function and potential third cranial nerve compression

"The neuro nurse charted a new fixed and dilated pupil on the right and escalated immediately, recognising it as a potential sign of uncal herniation."

"neurogenic bladder"

A dysfunction of normal bladder control caused by damage to the central or peripheral nervous system, requiring specialised urinary management strategies

"Following spinal cord injury, the patient was established on an intermittent catheterisation schedule to manage neurogenic bladder and reduce infection risk."

"decerebrate posturing"

An abnormal body position characterised by rigid extension of the limbs and arching of the back, indicating severe brainstem or upper brain injury

"The nurse documented decerebrate posturing in response to painful stimuli and included the finding in the urgent neurosurgical handover."

"therapeutic hypothermia"

The deliberate cooling of a patient's core body temperature to 32–36°C to reduce metabolic demand and protect the brain following cardiac arrest or severe brain injury

"The ICU nurse monitored core temperature, shivering scores, and potassium levels throughout the 24-hour therapeutic hypothermia protocol following the patient's out-of-hospital cardiac arrest."

"clinical reasoning"

The structured cognitive process by which nurses gather information, recognise patterns, formulate differential diagnoses, and select appropriate interventions

"The advanced nurse practitioner demonstrated clinical reasoning by integrating the patient's history, physical findings, and investigation results to diagnose community-acquired pneumonia rather than heart failure exacerbation."

"differential diagnosis"

A list of possible conditions that could account for a patient's presenting signs and symptoms, ranked by probability and used to guide further investigation

"The nurse specialist presented a differential diagnosis of pulmonary embolism, pneumothorax, and acute coronary syndrome to the registrar based on the patient's acute dyspnoea and pleuritic chest pain."

"SBAR communication"

A structured handover and escalation tool using four sections — Situation, Background, Assessment, and Recommendation — to ensure safe transfer of critical clinical information

"Using SBAR communication, the ward nurse clearly conveyed the urgency of the deteriorating patient to the on-call doctor, resulting in immediate bedside attendance."

"early warning score"

A composite physiological scoring system that aggregates vital sign deviations to identify patients at risk of deterioration and trigger escalation responses

"The nurse calculated an early warning score of 6 and, following the trust protocol, escalated directly to the critical care outreach team for urgent review."

"capacity assessment"

The clinical and legal process of determining whether a patient has the cognitive ability to understand, retain, weigh, and communicate a decision about their own care

"Before obtaining consent for the procedure, the nurse documented a formal capacity assessment confirming the patient could explain the risks and alternatives in their own words."

"prescriptive authority"

The legal right held by certain advanced nurses to independently prescribe medications within a defined scope of practice, without requiring a doctor's signature

"As a non-medical prescriber with full prescriptive authority, the nurse practitioner adjusted the patient's diuretic dose and added a new analgesic without waiting for the medical team."

"point-of-care testing"

Diagnostic testing performed at or near the patient's bedside using portable devices, delivering rapid results that support immediate clinical decisions

"Point-of-care testing for troponin, lactate, and glucose allowed the emergency nurse to initiate the correct treatment pathway within 15 minutes of patient arrival."

"advance care planning"

A proactive process in which patients, their families, and healthcare professionals discuss and document the patient's preferences and values for future care, including end-of-life decisions

"The clinical nurse specialist facilitated an advance care planning conversation with the patient and family, documenting their preference for hospital-at-home care if the disease progressed."