Jane Dare Abbreviations

Instructions
Complete the medical abbreviations chart. (Note that the medical abbreviations are the same as those highlighted in yellow in Jane Dare’s Health Record). In the second column, list what each of the individual letters in the abbreviation represents. In the third column define the context or meaning of the term that the abbreviation represents. Use simple terms. Finally, in the far right column, identify the source document. For example, face sheet, discharge summary, progress notes, or x-ray report. Abbreviation | Letters Represent | Context Definition or Application within the Patient’s Chart | Source Document | 1. ICD | International Classifications of Diseases, Ninth Revision | Published by WHO This is a systematic classification of diagnosis codes. These codes are numeric and alphanumeric codes that represent medical diagnoses | Admission Summary | 2. CM | Clinical Modification | This abbreviation out of context belongs collectively as the ICD-9-CMThese codes are added to ICD codes and can be used for diagnosis or procedure for Jane | Admission Summary/ Face Sheet | 3. N/A | Not Available | No answer necessary | Admission Summary | 4. ER | Emergency Room | Arrived at Emergency Room | History and Physical | 5. C/O | Complains Of | Patient complains of shortness of breath | History and Physical | 6. SOB | Shortness of Breath | While in the emergency room jane complains of sob 3 to 4 times a day | History and physical | 7. mg | Milligram | Patient must take capoten 25 mg by mouth 3 times a day | Medications/ History and physical | 8. po | Orally by mouth | Patient must take by mouth furosemide 40 mg | Medications/ History and Physical | 9. tid | Three times daily | Patient must take by mouth three times daily Capoten 25 mg | Medications/ history and physical | 10. qd | One a Day | Patient must