Medical Assistant- Medical Abbreviations

Medical Terminology

Certified Nursing Assistant

CNA; direct patient care in hospital setting, skilled nursing facility, long term care

Doctor

MD; assesses, evaluates, and treats patients

Emergency Department

ED; Life threatening/ accident and in need of immediate care

Labor & delivery

L&D; Patient giving birth and after delivery

Licensed Vocational Nurse

LVN; licensed entry-level nurse in some hospital setting, long-term care, clinical settings

Medical assistant

MA

Newborn

NB; baby that is less than 28 days old

nurse practitioner

NP

Occupational Therapy

OT; therapist treats smaller tasks, bathroom, eating, bathing

Pediatrics

Peds; patients < 18 years old

Physical Therapy

PT

Physician Assistant

PA

Primary Care Physician

PCP, patients first stop, non emergency

Registered Nurse

RN

Patient

PT/pt

Beats per minute

BPM (vital sign)

Blood Pressure

BP (vital sign)

Body Mass Index

BMI (body fat percentage that a person has, calculate patients’ height and weight)

Chief complaint

CC; issue patient presents to clinic

Complains of

c/o

Ex: pt c/o difficulty breathing. (patient complains of difficulty breathing)

Date of birth

DOB

Diagnosis

dx (after the patient sees a doctor and is evaluated)

Discontinue/Discharge

dc (can be used to stop medication or releasing from clinic/hospital)

Do Not Resuscitate

DNR (Life saving measure will not be performed for this person)

Family History

fhx

Follow up

f/u FU

Heart Rate

HR or P ( P is also for posterior)

Height

ht

History

hx

History of Present Illness

HPI (another way of saying history)

Last Menstrual Period

LMP (first day of their last menstrual period)

Loss of consiousnes

LOC

Ex: pt c/o LOC last week

patient complains of loss of consciousness last week

Medical Runner Number

MRN (used to identify patient)

Minute

min (min can also be used as minimum, attention to context)

Oxygen Saturation/ Pulse Oximetry

sat; O2sat; POx;

(Vital sign taken during patient intake)

(Oxygen saturation: measures amount of oxygen in a patient’s blood. Clamped onto patients’ blood)

(Pulse Oximetry is the testing of the patient’s oxygen saturation, can be used interchangeably)

Patient

pt

Pulse

P or HR

Range of Motion

ROM

Range a person’s join is able to move, measured to see after they had trauma

Respirations

R (vital signs)

Return to clinic

RTC

Review of Systems

ROS

rule out

r/o

signs and symptoms

sx

subjective/objective/assessment/plan

SOAP

sub: info that patient tells us

Obj: measurable, we can see with our own eyes

Assess: MD observations

Plan: measurable treatments

symptoms

sx

Unknown

UNK

Visual acuity

VA (vision test and snellen eye chart)

Vital signs

V/S

temperature (T)

respirations (R)

Heart rate (HR)

blood pressure (BP)

pain

Weight

wt

wheelchair

w/c

with

w/ or a slash with a c below it

by mouth

PO

Drop (medication)

gtt (one drop)

ggts (multiple drops)

can be used for eye drops or ear drops

Injection

inj

Intramuscular

IM

(Medication being injected into the muscle, Flu vacc, covid, pneu vacc)

Intravenous

IV

Medication being administered into a vein

Nothing by mouth

NPO

invasive medical procedure then patient is instructed to be NPO

Subcutaneous

SUBQ

Injection given into the patient’s adipose tissue (fatty) tissue, Insulin meds-diabetes, heparin-anticoagulant (blood thining)

Sublingual

SL

Medication administered under the tongue; never chewed, dissolve under the tongue

tablespoon

tbsp

teaspoon

tsp

Topical

TOP

Applied on patients’ skin

Kilogram

kg

Left or Liter

L

Microgram

mcg

milligram

mg

milliliter

mL

Minimum

min

negative

neg

postive

pos

Pounds

lb or lbs

volume

vol

As needed

PRN

day

d

every

q

every 2 hours

q2h

Every bedtime

qhs

Everyday

qd

Every evening

qpm

Every hour

qh

Every morning

qam

Every other day

qod

every week

qwk

Expiration

exo

four times a day

qid

hours

h or hr

Immediately

STAT

Three times a day

TID

Twice a day

BID

Week

wk

Year

yr

antibiotics

abx

Used to treat bacterial infections NOT viral infections

Capsules

cap or caps

Dispense

disp

Lot number of medication (lot#)

Important for outpatient clinics and injections

Medication

med or meds

Metered Dose Inhaler

MDI

Med that comes in inhaler, with every puff is a measured dose

nebulizer

neb

Similar to inhaler but it’s more of a machine that provides immediate relief. Takes liquid medication and turns it into a mist

No known allergies

NKA

No known drug allergies

NKDA

Nonsteroidal anti-inflammatory drug

NSAID

Relieves pain and helps with fever, inflammation includes warmth, swelling, redness. this drug decreases this

motrin/aleve/aspirin