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Chpt 2 Abbr 2

APHY

TermDefinition
Dx diagnosis
DDx differential diagnosis
Tx treatment
Rx prescription
H&P history and physical
Hx history
CC chief complaint
HPI history of present illness
ROS review of symptoms
PMHx past medical history
FHx family history
NKDA no known drug allergies
PE physical exam
Pt patient
y/o years old
h/o history of
PCP primary care provider
f/u follow up
SOB shortness of breath
HEENT head eyes ears nose throat
PERRLA pupils are equal, round, reactive to light and accommodation
NAD no acute distress
CV cardiovascular
RRR regular rate and rhythm
CTA clear to asucultation
WDWN well developed, well nourished
A&O alert and oriented
WNL within normal limits
NOS not otherwise specified
NEC not elsewhere classified
PO per os (by mouth)
NPO nil per os (nothing by mouth)
PS per rectum (anal)
IM intramuscular
SC subcutaneous
IV intravenous
CVL central venous line
PICC peripherally inserted central catheter
Sig instructions short for signa (label)
Created by: JodyWitt