Busy. Please wait.

show password
Forgot Password?

Don't have an account?  Sign up 

Username is available taken
show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Remove Ads
Don't know
remaining cards
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
restart all cards

Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Chapter 1


Attending physician Physician responsible for the care of a hospitalized patient.
Charting The process of making written entires about a patient in the medical record.
Consultation Report Narrative report of an opinion about patients condition by a practitioner other than the attending physician.
Diagnosis The scientific method of determining and indentifying a patient's condition.
Diagnosis procedure A procedure performed to assist in the diagnosis, management, or treatmeant of a patient's condition.
Discharged summary report A brief summary of the significant events of a patients hospitalization.
Electronic medical record A medical record that is stored on a computer.
Familial Occurring or affecting members of a family more frequently than would be expected by chance.
Health history report A collection of subjective data about a patient.
Informed consent The consent given by a patients for medical procedure after being informed of the procedure.
Inpatient A patients who has been admitted to the hospital for atleast one overnight stay.
Medical impressions The conclusions reached by the physician from an interpretation of data.
Medical Records A wriiten record of the important information regarding a patient.
Objective symptom A sympton that can be observed by an examiner.
Patient An individual receiving medical care.
Physical examination report A report of the objective finding from the physican;s assessment of each body system.
Problem Any condition that requires further observation, diagnosis, management, or patient education.
Prognosis The probable course and outcome of a disease and the prospect for recovery.
Subjective symptom A symptom felt by the patient but not observed by an examiner.
Symptom Any changes in the body or its functioning indicative that a disease is present.
SOAP Format a method of organization for recording progress notes.
reverse chronological order arrangingg documents with the most recent document on top or in the front
physical examination an assensmentof each part of tge patients body to obtain objective data
Paper-based ptient record A medical record in paper form
medical record format the way a medical record is organized.
home health care the provision od medical and non medical care in a patients home
Created by: heathertaylor