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Medical Terminology

Medical Terminology. 1.01 Identify abbreviations commonly used in the health care setting. Medical abbreviations. Shortened forms of words They are an efficient way of communicating quickly and concisely with other health care workers.

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Medical Terminology

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  1. Medical Terminology 1.01 Identify abbreviations commonly used in the health care setting.

  2. Medical abbreviations • Shortened forms of words • They are an efficient way of communicating quickly and concisely with other health care workers. • Health care workers use abbreviations to convey information about their patients/clients.

  3. Medical abbreviations • help save time and space on medical documents. • Also known as short hand • usually just letters but #s are sometimes used. Examples am (before noon) H20 (water)

  4. Medical abbreviations • May be combined to give orders or directions • Varies depending upon facility or culture • Periods may or may not be used Example: a.m. or am

  5. Medical abbreviations • Each individual is responsible for making sure that they are using the appropriate abbreviations for their agency. • Incorrect / illegal abbreviations could lead to misunderstandings, confusion or anger.

  6. Abbreviation Usage • Be considerate when you use an abbreviation • Your patients do not always know what the abbreviations mean. Ex: NPO posted over the head of the bed (HOB) • As a HCP you know what it means but the patient doesn’t , you need to explain to the pt. what it means.

  7. Incorrect and illegal abbreviations • Sometimes used by personnel due to not knowing facilities approved list. • Ex: Jim is a FLK. • David Snow – 48 yoa SWM, dyspnea, s.o.b., HA, chest pain & N & V.

  8. Transcribe to abbreviated format Suzanne to be admitted to the hospital through the emergency room department. She came in complaining of headache, difficulty breathing, and chest pain. She has a past history of heart attacks, stroke and high blood pressure. Orders are as follows: • Monitor blood pressure every two hours • Complete blood count, potassium, sodium and magnesium levels • Chest x-ray and magnetic resonance imaging

  9. Abb. Written order Suzanne adm. through ER dept. Pt. c/o HA, dyspnea, and chest pain. Past hx. Of MIs, CVA & HBP. Orders are as follows: • ck BP Q2H • CBC, K, Na and Mg levels • Chest XR & MRI

  10. TPR & BP ASAP Stat CA HA WNL Ad lib am Rx tsp q2h mL EEG VS Commonly used Abb.

  11. abd - abdomen amb - ambulate/walk bid - twice a day CCU - coronary care unit or critical CVA - cerebrovascular accident / stroke po - by mouth OOB/oob - out of bed OR - operating room ER - emergency room PEDS - pediatrics P.T. - physical therapy Identification of common medical abbreviations

  12. Discussion time and hands on practice. FYI : You already use abbreviations. Ex: text messaging, email, time, etc…

  13. References • Health Careers Science Exploration Textbook – Chapter 7 pgs: • NCDPI

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