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KNH 209- Roots > Health Record Terms > Flashcards

Health Record Terms Flashcards

1
Q

abrupt

A

all of the sudden

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2
Q

acute

A

it just started recently or is a sharp, severe symptoms

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3
Q

afebrile

A

to not have a fever

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4
Q

chronic

A

it has been going on for a while now

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5
Q

genetic/hereditary

A

runs in the family

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6
Q

exacerbation

A

it is getting worse

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7
Q

febrile

A

to have a fever

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8
Q

lethargic

A

a decrease in the level of consciousness; in a medical record, this is generally an indication that the patient is really sick

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9
Q

noncontributory

A

not related to this specific problem

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9
Q

malaise

A

not feeling well

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10
Q

progressive

A

more and more each day

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11
Q

symptom

A

something a patient feels

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12
Q

alert

A

able to answer questions; responsive; interactive

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13
Q

auscultation

A

to listen

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14
Q

marked

A

it really stands out

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15
Q

oriented

A

being aware of who they are, where they are, and the current time; patient who is aware of all 3 is “oriented x 3”

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16
Q

palpation

A

to feel

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17
Q

percussion

A

to hit something and listen to the resulting sound or feel for the resulting vibration

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18
Q

unremarkable

A

normal

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19
Q

impression

A

another way of saying assessment

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20
Q

diagnosis

A

what the health care professional thinks the patient has

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21
Q

differential diagnosis

A

a list of conditions the patient may have based on the symptoms exhibited and the results of the exam

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22
Q

benign

A

safe

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23
Q

malignant

A

dangerous; a problem

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24
Q

degeneration

A

to be getting worse

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25
Q

etiology

A

the cause

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26
Q

remission

A

to get better or improve; most often used when discussing cancer; remission does NOT mean cure

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27
Q

idiopathic

A

no known specific cause; it just happens

28
Q

localized

A

stays in a certain part of the body

29
Q

systematic
generalized

A

all over the body (or most of it)

30
Q

morbidity

A

the risk of being sick

31
Q

mortality

A

the risk of dying

32
Q

prognosis

A

the chances for things getting better or worse

33
Q

occult

A

hidden

34
Q

pathogen

A

the organism that causes the problem

35
Q

lesion

A

diseased tissue

36
Q

recurrent

A

to have again

37
Q

sequelae

A

a problem resulting from a disease or injury

38
Q

pending

A

waiting for

39
Q

discharge

A
  1. to send home
  2. fluid coming out of a part of the body
40
Q

disposition

A

what happened to the patient at the end of the visit; often used at the end of ED notes to reference where the patient went after the visit

41
Q

observation

A

watch; keep an eye on

42
Q

pallative

A

treating the symptom but not actually getting rid of the cause

43
Q

prophylaxis

A

preventative treatment

44
Q

reassurance

A

to tell the patient that the problem is not serious or dangerous

45
Q

sterile

A

extremely clean, germ-free conditions; especially important during medical procedures and surgery

46
Q

supportive care

A

to treat the symptoms and make the patient feel better

47
Q

distal

A

farther away from the center

48
Q

proximal

A

closer in the center

49
Q

lateral

A

out to the side

50
Q

medial

A

toward the middle

51
Q

dorsal/posterior

A

the back

52
Q

ventral/antral/anterior

A

the front

53
Q

caudal

A

toward the bottom

54
Q

cranial

A

toward the top

55
Q

inferior

A

below

56
Q

superior

A

above

57
Q

prone

A

lying down on belly

58
Q

supine

A

lying down on back

59
Q

contralateral

A

opposite side

60
Q

ipsilateral

A

same side

61
Q

bilateral

A

both sides

62
Q

unilateral

A

one side

63
Q

dorsum

A

top of hand or foot

64
Q

palmar

A

palm of the hand

65
Q

plantar

A

sole of the foot

66
Q

coronal

A

divides body into slices front to back

67
Q

sagittal

A

divides body into slices right to left

68
Q

transverse

A

divides body into slices top to bottom

KNH 209- Roots (7 decks)

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