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Ch 2 HLHS101
Introduction To Health Records- word parts, terms and/or abbreviations
Term | Definition |
---|---|
A SOAP note is | A pattern used in writing medical notes; Subjective, Objective, Assessment, Plan |
afebrile AY-FEH-brail | to not have a fever |
unremarkable | Another way of saying "normal" |
morbidity mor-BID-ih-tee | the risk for being sick |
idiopathic ih-dee-oh-PA-thik | no known specific cause; it just happens |
prophylaxis PROH-fuh-LAK-sis | preventative treatment |
supine SOO-pain | laying down on back |
H&P (abbreviation common on health records) | history and physical |
HPI (abbreviation common on health records) | history of present illness |
PICC (abbreviations associated w/ orders and administering medicine) | peripherally inserted central catheter |