Test 1

ac

before meals

ABD

abdomen

ad lib

as desired

AEB

as evidenced by

amb

ambulate

BM

bowel movement

BID

twice per day

BLE

bilateral lower extremities

BP

blood pressure

BPM

beats per minute

BRP

bathroom privileges

BUE

bilateral upper extremities

C̄

with

c/o

complains of

C & S

culture and sensitivity

DC

discontinue

CBC

complete blood count

dx

diagnosis

DNR

Do Not Resuscitate- a physician order to not perform CPR and resuscitate a patient if their heart stops beating

fx

fracture

FSBS

finger stick blood sugar

g

gram

gtt

drop

HOB

head of bed

HTN

hypertension

Hx

history

I&O

intake & output

IM

instramuscular

mcg

microgram

mEq

milliequivalents

mg

milligram

mL

milliliter

NC

nasal cannula

NG

nasogastric

NKA

no known allergies

NPO

nothing by mouth

NS

normal saline

N/V/D

nausea vomiting diarrhea

O2

oxygen

pc

after meals

PO

by mouth

PRN

as needed

pt

patient

PVD

peripheral vascular disease

QID

four times per day

q day

every day

r/o

rule out

RBC

red blood cell

ROM

range of motion

r/t

related to

Rx

prescription

s̄

without

SOB

shortness of breath

s/p

status post

STAT

immediately

sc/sq

subcutaneous

sx

symptoms

TBI

traumatic brain injury

TID

three times per day

TCDB

turn cough deep breathe

tx

treatment

UA

urinalysis

UTI

urinary tract infection

VS

vital signs

WBC

white blood cell

WNL

within normal limits

>

greater than

<

less than

Δ

change

ethics

philosophic studies that examine the actions, values, and moral principles of human behavior

comfort measures

a care plan that includes physician orders that address patients bodily symptoms of discomfort to implement when curative treatment has been stopped & death is expected

HIPAA

a federal regulation that governs standards for storage and transmission of person health information

advanced directive

a legal document that expresses wishes regarding continuing, withholding, or withdrawing treatment in the event a person can no longer make those decisions for themselves

living will

a legal document that expressly outlines specific desires and circumstances for continuing or discontinuing treatment

DPOA (Durable power of attorney for healthcare)

a legal document that gives another individual power to make decisions about treatment if the patient is no longer able to make their own decisions

Good Samaritan Act

a legal protection for individuals that render emergency care without compensation

ethical behavior

a moral philosophy guiding human conduct determining right versus wrong

morals

a person’s standards of behavior or beliefs concerning what is and is not acceptable for them to do

mandatory reporting

a requirement that license holders call the police and make a written statement if they observe unprofessional conduct, falsification of records, mistreatment of patients

standards of care

a set of treatments that is accepted by medical experts as a proper treatment for a certain type of disease and that is widely used by healthcare professionals

assault

a threat or an attempt to do bodily harm, including physical or verbal intimidation

defamation of character

an act that harms a person’s reputation and good name by making false statements that cause damage to the victim

POLST

an agreement between a physician and a patient that documents code level

abuse

any action that intentionally harms or injures another person

negligence

neglecting duties, procedures, or ordinary precautions while providing care

euthanasia

deliberately ending a person’s life to stop suffering

malpractice

improper treatment of a patient that results in illness or injury, when a professional is aware of the potential consequences of their actions and proceeds anyway

AMA

leaving treatment without permission, against the advice of a healthcare provider after being informed of the benefits of treatment and the risks for leaving without treatment

psychiatric emergency

occurrence or serious threat of extreme violence, personal injury, or attempted suicide

battery

physical contact with a person without a person’s consent, even if no physical harm is caused

false imprisonment

restraint of movement by physical or chemical means

legal requirements

rules governing society administered by the government punishable with fines or imprisonment

code of ethics

set forth values, ethical principles, and ethical standards to which professionals aspire and by which their actions can be judged

informed consent

tests, treatments, and medications have been explained to the person as well as outcomes, possible complications & alternative procedures before they agree to proceed

values

the culmination of heritage, culture, one’s family origin, and life experiences. Ones judgement of what is important in life

AWOL

when a patient leaves without any discussion or documentation

denial

unconscious refusal to accept facts or reality (ex: denial of having diabetes)

projection

displacing unwanted feelings onto another individual, as if it is the other person who has the problem (ex: overweight patient)

repression

moving the awareness of an unwanted idea or act by pushing it into the subconscious (ex: put in back burner)

regression

reverting to an earlier stage of emotional development; becoming less mature