PCI

intervention

[in″ter-ven´shun] interposition or interference in the affairs of another to accomplish a goal or end; see also implementation.crisis intervention 1. counseling or psychotherapy for patients in a life crisis that is directed at supporting the patient through the crisis and helping the patient cope with the stressful event that precipitated it.2. in the nursing interventions classification, a intervention" >nursing intervention defined as use of short-term counseling to help the patient cope with a crisis and resume a state of functioning comparable to or better than the pre-crisis state.nursing intervention an action for which nurses are responsible that is intended to benefit a patient or client.percutaneous coronary intervention (PCI) the management of coronary artery occlusion by any of various catheter-based techniques, such as angioplasty" >percutaneous transluminal coronary angioplasty, atherectomy, angioplasty using the excimer laser, and implantation of coronary stents and related devices.intervention (omaha) in the omaha system, an action or activity undertaken to address a specific client problem and to improve, maintain, or restore health or to prevent illness. See also intervention scheme.

SERPINA5

A gene on chromosome 14q32.1 that encodes a member of the serine protease inhibitor (serpin) family that inhibits activated protein C as well as plasminogen activators.

PCI

Abbreviation for percutaneous coronary intervention.

index

(in'deks?) (in'di-sez?) plural.indexes, indices [L. index, pointer] 1. The forefinger. 2. The ratio of the measurement of a given substance to that of a fixed standard.

addiction severity index

A structured assessment tool that evaluates the impact of addictive behavior on seven areas of living: alcohol use, drug use, employment, family relationships, illegal activities, physical health, and psychological health.

alveolar index

Gnathic index.

ankle-brachial index

Abbreviation: ABI
A measure of the adequacy of blood flow to the arteries of the legs. It is used to gauge the severity of peripheral vascular disease.

Patient care

The index is obtained by measuring the systolic blood pressure in the upper and lower extremities after the patient has been lying on his or her back for about 5 min and then repeating the measurements after the patient walks for 5 min. There are several ways to obtain an ABI. The most accurate test results are obtained by measuring the blood pressure in both arms using a blood pressure cuff and Doppler ultrasound and recording the higher of these two pressures. The measurement is repeated in each leg, with measurement of blood pressures at both the posterior tibial and dorsalis pedis arteries. The pressure that should be recorded is the pressure found during the first return of a pulse to the cuffed limb. The blood pressure in each leg is divided by the blood pressure in the higher pressure of the two arms to obtain an ABI for each lower extremity. An ABI above 0.9 is normal, except when it exceeds 1.3 (an indicator of severe peripheral arterial obstruction). Severe obstruction is also indicated by an ABI of less than 0.5. Moderate peripheral arterial disease is suggested by an ABI of 0.8. A drop in the ABI after exercise also strongly suggests peripheral arterial disease. Patients with mild or moderately abnormal ABIs are usually treated with antiplatelet medications, an exercise regimen, and cholesterol-lowering drugs or diet. Those who smoke are encouraged to quit. Patients with severe disease may need angiography and, in some instances, arterial bypass surgery or stenting.

apnea-hypopnea index

Abbreviation: AHI
The number of times in an hour when a sleeping person either stops breathing completely or has limited airflow. Each episode must last at least 10 sec. The AHI is one indicator of obstructive sleep apnea, although it is recognized as an imperfect diagnostic tool. An AHI of 30 or more events in an hour indicates severe sleep apnea; 15 to 29 events suggests moderate apnea; and 5 to 14 events indicates mild apnea.

Barthel index

See: Barthel index

bispectral index

Abbreviation: BIS
An electroencephalographic measure of the effect of sedative and hypnotic drugs on an anesthetized patient. It is used (along with clinical assessment of the patient) to determine the level of central nervous system depression. The index ranges from zero (completely unresponsive to stimulation) to 100 (awake and alert). At levels below 60, most patients are adequately sedated for surgery.

BODY MASS INDEX

body mass index

Abbreviation: BMI
An index for estimating obesity. The BMI can be obtained by dividing weight in kilograms by height in meters squared, or according to the following formula: BMI = (Weight/2.205) / (Height/39.37)². In adults, a BMI greater than 30 kg/m² indicates obesity; a BMI greater than 40 kg/m² indicates morbid obesity; and a BMI less than 18.5 kg/m² indicates a person is underweight. The lowest overall death rate is found in people with a BMI of 20 to 24.9 kg/m². Synonym: Quetelet index See: illustration

burn scar index

A rating scale developed to assess hypertrophic burn scars and their rate of development or resolution. It is available at Burnsurgery.org. Synonym: Vancouver scar index; Vancouver scar scale

cardiac index

The cardiac output (expressed in liters per minute) divided by the body surface area (expressed in square meters).

cephalic index

The biparietal diameter of the skull divided by its occipitofrontal diameter, all multiplied by 100.

cerebral index

The ratio of greatest transverse diameter to the greatest anteroposterior diameter of the cranium.

chemotherapeutic index

The ratio of the toxicity of a drug, expressed as the maximum tolerated dose per kilogram of body weight to the minimal curative dose per kilogram of body weight. This index is used in judging the safety and effectiveness of drugs.

clinical risk index for babies

Abbreviation: CRIB
An index of the severity of illness, used to estimate the likelihood of mortality in very low birth weight infants who are cared for in a neonatal intensive care unit.

color index

An outmoded method of expressing the amount of hemoglobin present in each red cell.

Cumulative Index to Nursing and Allied Health Literature

See: Cumulative Index to Nursing and Allied Health Literature

dental index

A system of numbers for indicating comparative size of the teeth.

DMF index

The index of dental health and caries experience based on the number of decayed, missing, and filled (DMF) teeth or tooth surfaces.

dynamic gait index

Abbreviation: DGI
A semiquantitative tool used to evaluate a patient's ability to modify gait by changing task demands, esp. in patients with dizziness and balance deficits. This test is used to identify patients, esp. older adults, who are predisposed to falling. Patients are graded on their ability to vary speed, turn their heads, turn their bodies, step over and around obstacles, climb stairs, turn while walking, pick objects up from the floor, and perform alternate step-ups on a stool.

exposure index

A relative value indicating the quantity of ionizing radiation received by a digital radiographic image receptor. Although vendors currently use many kinds of exposure indices, e.g., Sensitivity Numbers, standardization is being developed by physicists' organizations.

fatigue index

The difference between the muscle power generated during peak exertion and the power that can be generated after repeated loading and unloading of the muscle.

Frenchay Activities Index

A formal interview for patients who have suffered a stroke to compare their functional abilities preceding and following the stroke. The patient describes how employment, meal preparation and clean up, gardening, shopping, and other activities of daily living have been altered by the stroke.

gas exchange index

One of several measurements of the efficiency of respiration, esp. of the extent of intrapulmonary shunting in respiratory failure. Among the commonly used gas exchange indices is the alveolar-arterial oxygen tension difference (a measurement derived from an analysis of the oxygen tension of an arterial blood gas compared with the atmospheric oxygen content).

glycemic index

A ratio used to describe the ability of a food to increase blood glucose levels as compared with consumption of either glucose or white bread as the standard. Foods with a low glycemic index result in a slower rise and lower maximum elevation of blood glucose levels than foods with a higher glycemic index. Consumption of low glycemic index foods can contribute to blood glucose regulation in patients with diabetes mellitus. Another use for the index is to identify the choice of food that will raise blood sugar levels after, e.g., endurance exercise.

gnathic index

A measure of the degree of projection of the upper jaw by finding the ratio of the distance from the nasion to the basion to that of the basion to the alveolar point and then multiplying by 100. Synonym: alveolar index

human development index

A measure of national quality of life used by the United Nations Development Program. It consists of three elements: life expectancy at birth, mean years and expected years of schooling, and the gross national income at purchasing power parity per capita.

Insall-Salvati index

See: Insall-Salvati index

International Sensitivity Index

Abbreviation: ISI
A laboratory standard for thromboplastins, the reagents used to determine the prothrombin time (PT). Because thromboplastin contents vary, PT results performed on the same sample of blood in different laboratories can be markedly different, even though the patient's actual level of anticoagulation is a constant. The ISI is used to calculate the international normalized ratio, a standardized measure of anticoagulation, thus enabling health care professionals working with different laboratories to compare results and adjust anticoagulant doses according to a single set of guidelines.

Karnofsky Index

See: Karnofsky Index

labeling index

The rate at which cells take up identifiable chemicals that they use in cell division. The index is a measure of the rate of the reproduction of the cells, as in fetal tissue development or the growth of cancers.

leukopenic index

A test formerly used to determine hypersensitivity to foods, in which the white blood cell count is checked 90 min after the consumption of a suspected allergen. A precipitous decrease in the white blood cell count within 90 min after ingestion of the test food was thought to indicate that the food was incompatible with that person.

life satisfaction index

Abbreviation: LSI
A self-reporting instrument to measure personal fulfillment or contentment, esp. with one's social relationships, occupation, maturation, or aging. A total of five rating scales are used.

McMurtryindex

See: McMurtry index

Index Medicus

A publication of the National Library of Medicine that lists biomedical and health sciences journal articles by title, subject, field, and country of publication. The major national and international medical and biological journals are indexed.

Mentzer Index

See: Mentzer index

mitotic index

The number of mitoses seen in a biopsy specimen per square millimeter of tissue examined. Mitoses in tissue are indicative of malignancy. The higher the mitotic index, the more rapidly a tumor is dividing and the worse the prognosis.

nasal index

The greatest width of the nasal aperture in relation to a line from the lower edge of the nasal aperture to the nasion.

notch width index

The width of the femoral intercondylar notch divided by the width of the femoral condyles.

opsonic index

A ratio of the number of bacteria that are ingested by leukocytes contained in the serum of a normal individual compared with the number ingested by leukocytes in the study patient's blood serum.

oral hygiene index

Abbreviation: OHI
A popular indicator developed in 1960 to determine oral hygiene status in epidemiological studies. The index consists of an oral debris score and a calculus score. Six indicator teeth are examined for soft deposits and calculus. Numerical values are assigned to the six indicator teeth according to the extraneous deposits present. The scores are added and divided by the number of surfaces examined to calculate the average oral hygiene score.

Oswestry Disability Index

Abbreviation: ODI
A questionnaire that requires a patient to rate the effect of back pain on 10 different activities, each having six levels of disability. The test was designed to assess patients with failed back surgery, but it is widely used for nonsurgical patients with other spinal conditions. Synonym: Oswestry disability score

oxygenation index

Abbreviation: OI
A measure of the efficiency of oxygen exchange by the lungs. The index is used in critical care medicine to assess the severity of acute lung injury and to gauge the effectiveness of ventilator management strategies. Mathematically it is represented as the product of the fractional concentration of inspired oxygen and the mean airway pressure, divided by the arterial oxygen concentration.

Pearl index

See: Pearl index

pelvic index

The ratio of pelvic conjugate and transverse diameters multiplied by 100.

periodontal (Ramfjord) index

An extensive consideration of the periodontal status of six teeth by evaluating gingival condition, depth of gingival sulcus or pocket, appearance of plaque or calculus, attrition, tooth motility, and extent of tooth contact.

phagocytic index

The average number of bacteria ingested by each leukocyte after incubation of the leukocytes in a mixture of serum and bacterial culture.

physiological cost index

Abbreviation: PCI
The metabolic expenditure per unit of distance traveled. It is expressed as the number of heartbeats per meter traveled and is calculated by subtracting the resting heart rate from the exercise heart rate divided by the distance traversed.

Pneumonia Severity Index

, pneumonia severity indexA diagnostic scoring system for predicting the level of care a patient with pneumonia will require. It includes demographic factors (such as the patient's age, whether he or she resides in a nursing home); findings on physical examination (such as altered mental status, fever, tachycardia, and low blood pressure); laboratory data (including serum pH, glucose and sodium levels); and the presence of other illnesses (such as heart, lung, brain, liver, or kidney disease). Synonym: pneumonia PORT score.

ponderal index

The ratio of an individual's height to the cube root of his or her weight; used to determine body mass. See: body mass index

proliferative index

Abbreviation: PI
The proportion of cells within a tumor specimen that are actively reproducing. In general, as the number of replicating cells in a tumor increases, the cancer behaves more aggressively and the prognosis for the patient worsens.

index of refraction

1. The ratio of the angle made by the incident ray with the perpendicular (angle of incidence) to that made by the emergent ray (angle of refraction). 2. The ratio of the speed of light in a vacuum to its speed in another medium. The refractive index of water is 1.33; that of the crystalline lens of the eye is 1.413. Synonym: refractive index

refractive index

Index of refraction.

rapid shallow breathing index

Abbreviation: f/TV; RSBI.
The ratio of the respiratory rate (f) and the tidal volume (TV) of a patient treated with mechanical ventilation while breathing on a T-piece (or at minimal levels of positive airway pressure or pressure support). Levels less than 105/min/L indicate that a patient may be able to be weaned successfully from the ventilator and breathe unassisted.

Reid index

See: Reid index

respiratory index

Abbreviation: RI
Alveolar/arterial gradient.

respiratory disturbance index

A measurement of the number of disordered breathing cycles during sleep. Sleep disordered breathing, which includes both apneas and hypopneas, results in daytime fatigue. It is also associated with an increased prevalence of cardiovascular disease.

sacral index

The sacral breadth multiplied by 100 and divided by the sacral length.

satiety index

The relative degree to which different foods of the same caloric value satisfy hunger.

saturation index

In hematology, the amount of hemoglobin present in a known volume of blood compared with the normal amount.

Science Citations Index

Abbreviation: SCI.
An electronic database of scientific journal articles published and referred to by other authors.

The Index is a proprietary product of the Thomson Corporation.

shock index

1. The systolic blood pressure divided by the heart rate.2. The heart rate divided by the systolic blood pressure.

sulcus bleeding index

Abbreviation: SBI.
A sensitive measure of gingival condition that involves probing of all sulci. The score is based on six defined criteria. It is calculated by counting the number of sulci with bleeding, dividing by the total number of sulci, and multiplying by 100.

sunscreen protective factor index

In preparations for protecting the skin from the sun (using sunscreens), the ratio of the amount of exposure needed to produce a minimal erythematous response with the sunscreen in place divided by the amount of exposure required to produce the same reaction without the sunscreen. This index assesses the ability of sunscreens to block (short-wavelength) ultraviolet B rays but does not measure the protective effect of sunscreens against (long-wavelength) ultraviolet A radiation. See: erythema dose

therapeutic index

The maximum tolerated dose of a drug divided by the minimum curative dose.

thoracic index

The ratio of the thoracic anteroposterior diameter to the transverse diameter.

Vancouver scar index

Burn scar index.

ventilation index

Abbreviation: VI.
1. A calculation used to determine the severity of respiratory illness (acute lung injury and/or respiratory distress syndrome) in critically ill patients. The VI is the partial pressure of arterial CO₂ multiplied by the peak airway pressure multiplied by the rate of ventilation, all divided by 1000.

Symbolically, the ventilation index is calculated as follows: VI = [RR x (PIP - PEEP) × PaCo₂]/1000.

2. In environmental science, a measure of air pollution based on the speed of the wind and the height of the column of air in which smoke or other pollutants mix.

vital index

The ratio of the number of births to the number of deaths in a population over a stated period of time.

Western Ontario McMaster Osteoarthritis Index

See: Western Ontario McMaster Osteoarthritis Index

physiological cost index

irradiation

(i-rād″ē-ā′shŏn) 1. The diagnostic or therapeutic application of x-ray photons, nuclear particles, high-speed electrons, ultraviolet rays, or other forms of radiation to a patient. 2. The application of a form of radiation to an object or substance to give it therapeutic value or increase that which it already has.3. A phenomenon in which a bright object on a dark background appears larger than a dark object of the same size on a bright background.4. The spreading in all directions from a common center, e.g., nerve impulses, the sensation of pain.

food irradiation

The preservation of foods with ionizing radiation. Radiation extends the shelf life of foods by decreasing the number of germs and insects present in them. The process is expensive and has met with considerable resistance from consumers.

interstitial irradiation

Therapeutic irradiation by insertion into the tissues of capillary tubes or beads containing radon (a radioactive isotope). It may be temporary or permanent.

lymphoid irradiation

Exposure of an organ recipient's lymphocytes to ionizing radiation before organ transplantation, in an effort to decrease the likelihood of rejection of the donor graft.

prophylactic cranial irradiation

Abbreviation: PCI
Radiation therapy used to prevent cancers, e.g., small cell carcinoma of the lung, from metastasizing to the brain.

irradiation of reflexes

The spreading of reflexes through the central nervous system whereby impulses entering the cord in one segment activate motor neurons located in many segments.

prophylactic cranial irradiation

Abbreviation: PCI
Radiation therapy used to prevent cancers, e.g., small cell carcinoma of the lung, from metastasizing to the brain. See also: irradiation

percutaneous coronary intervention

PCI

Any procedure in which catheters are placed within the coronary arteries to study them or open them when they are obstructed. Examples of this are balloon angioplasty, atherectomy, and stent placement.

Patient care

When the patient returns to the nursing unit after a PCI procedure, the nurse should be alerted to the type of procedure performed, the site of the sheath, the type of the sheath, the flush system in use, and any adverse events that have occurred. A cardiovascular assessment is performed immediately, including vital signs and an ECG. The invaded artery, peripheral perfusion in the limb on the side of the intervention (typically the right foot), urine output, and pain level are assessed and documented. The physician's orders are reviewed concerning vital signs, intravenous fluids (IV), activated clotting time, and the plan for sheath removal. If any bleeding is suspected, hemoglobin and hematocrit levels are checked and compared to preprocedural values. During sheath removal, two nurses work together, one monitoring the patient, the other removing the sheath. The patient’s IV line must be patent, with fluid infusing and 500 mL normal saline available. A bedside monitor with noninvasive blood pressure capability, an ECG, and pulse oximeter should also be available. The patient is placed in a supine position, the dressing removed, and the arterial puncture site inspected for bleeding or hematoma. The patient should be advised that he or she will probably feel mild to moderate discomfort and pressure during and after removal of the sheath. Pain relievers are provided as prescribed. A syringe is attached to the stopcock, and blood is drawn to ensure there is no clot in the sheath. If a suture has been used to close the access site, it is removed. The femoral artery is palpated, and pressure is applied with fingers placed along the artery, beginning about 1 cm above the puncture site (because the sheath is inserted on an angle and therefore enters the artery proximal to the skin puncture site). Using the free hand, the nurse then gently withdraws the sheath (pulling it toward the patient’s foot). Manual pressure is maintained on the site to stop bleeding but should not be strong enough to obscure the pedal pulse (checked by the other nurse). The site is re-examined for bleeding, swelling, and hematoma formation. Vital signs are assessed every 3 to 5 min after the sheath is removed. Continuous manual pressure or mechanical compression should be applied to an arterial site for 10 to 20 min or longer and to a venous site for 10 min. When bleeding has ceased, compression is discontinued, and a dressing is applied to the insertion site. The head of the bed may now be elevated slightly. Frequent patient assessment continues according to protocol, typically q15m X4, then q30m X4, then q1h X4. Bedrest is maintained for 2 to 6 hr (longer if the patient is not stable), with the affected leg kept straight to minimize bleeding at the insertion site. This position may be uncomfortable, and the patient may require reminders to maintain it. Oral intake can be resumed once the sheath has been removed and the potential for vasovagal-induced vomiting has passed. The dressing is removed after 24 hr and the wound assessed for complications. Vascular closure devices (suture-placement and collagen-delivery) may be employed. Adverse reactions to sheath removal include bleeding, hypotension (during or following removal), or vasovagal-induced bradycardia. The patient is assessed for symptoms such as dizziness, altered mental status, nausea, bradycardia, or hypotension. Patients must be monitored for complications related to PCI (e.g., coronary ischemia, contrast-induced nephropathy, and problems at the site of insertion). Trauma to the femoral vessels may be minor or serious. When patients have both femoral arterial and venous sheaths, the arterial sheath is removed first to reduce the risk of vascular complications. Bleeding frequently complicates the procedure. For mild bleeding, pressure is applied to the puncture site; for more serious bleeding (e.g., bleeding that compromises vital signs or the punctured limb), pressure is applied, and the cardiologist or a vascular surgeon notified. Ecchymosis is common at the site immediately or after dressing removal, often extending into surrounding tissues and accompanied by pain and minor swelling. Retroperitoneal hematoma should be suspected if the patient experiences flank, abdominal, or back pain, unexplained hypotension, or a marked drop in hematocrit. Other complications include arterial occlusion by clot formation, pseudoaneurysm, arteriovenous fistula, and infection. The patient and family should receive clear written and verbal instructions for home care before discharge. The patient should be advised to avoid strenuous activities for 3 days after a PCI and not to attempt to lift anything heavier than 10 lb until after a follow-up visit with the cardiologist. Reclining is recommended rather than sitting. The patient may shower but should not take tub baths or swim until the groin is fully healed. If a dressing is in place, it may be removed in 24 hr, and the site kept clean and dry. Some bruising and development of a small lump at the site are normal. If light bleeding occurs, the patient or a family member should apply pressure to the site for 10 Min and then apply an adhesive bandage. For heavy bleeding, pressure should be applied 1 in above the puncture site and 911 should be called. The site should also be observed for infection (redness, warmth, pain, drainage) and the physician notified if any of these signs occur.

picocurie

(pi'ko-ku-re),

pCi

An amount of radiation equal to 10^-12 curies. See: becquerel

PCI

A type of radiotherapy that is used to prevent tumors from growing in the brain.Mentioned in: Lung Cancer, Small Cell