Low vision Accessible version of Guide To Approved Medical Abbreviations

The following approved abbreviations may be used in medical records documentation.

A to C

ABBREVIATION

EXPLANATION

a.c.

before meals

ADL

activities of daily living

ad lib

as much as needed or requested

alb

albumin, a blood protein

a.m.

morning

AMA

against medical advice

ARF

acute renal failure

BEE

basal energy expenditure

bid

twice a day

BMI

body mass index

BM

bowel movement

BMR

basal metabolic rate

BMT

bone marrow transplant

BP

blood pressure

BUN

blood urea nitrogen

with

Ca+

calcium

CA

cancer

CBC

complete blood count

CC

chief complaint

CHF

congestive heart failure

CHO

carbohydrate

CHD

coronary heart disease

CNS

central nervous system

c/o

complains of

COPD

chronic obstructive pulmonary disease

CPN

central parenteral nutrition

CVA

cerebral vascular accident /stroke)

CVD

cardiovascular disease

 

D to H

ABBREVIATION

EXPLANATION

DKA

diabetic ketoacidosis

DM

diabetes mellitus (also see IDDM, NIDDM)

DNR

do not resuscitate

Dx

diagnosis

ea (or q)

each

ESRD

end stage renal disease

FBS

fasting blood sugar (or glucose)

Fe

iron

fld

fluid

FTT

failure to thrive

F/U

follow up

GB

gallbladder

GI

gastrointestinal

H ( )

hour

Hct

hematocrit

HDL

high density lipoprotein

Hgb or Hb

hemoglobin

A1C Hgb

Glycosylated (aka glycated) hemoglobin

Hi Cal or H.C.

high calorie

Hi Vit

high vitamin

h.s. (should no longer be used)

hour of sleep (bedtime)

ht

height

HTN

hypertension (high blood pressure)

Hx

history

 

I to N

ABBREVIATION

EXPLANATION

IDDM

Insulin Dependent Diabetes Mellitus (Type 1)

I/O or I & O

intake and output (commonly for fluid balance)

KCI or K+

potassium chloride

kcal

kilocalorie = Calorie

LDL

tow density lipoprotein

mcg

microgram

Ml

myocardial infarction (heart attack)

Na

sodium

NAS

no added salt

NB

note well

NCP

nursing care plan

NG (NGF)

nasogastric tube (NG feeding)

NIDDM

Non-insulin dependent diabetes (Type 2)

noc

night (nocturnal)

NPO

nothing by mouth

N&V

nausea and vomiting

 

P to R

ABBREVIATION

EXPLANATION

p.c.

after meals

PE or Px

physical exam

PEM

protein energy malnutrition

PH

past history

p.m.

evening

p.o.

by mouth

prn

as often as necessary

pt.

patient

PTA

prior to admission

q

every (each)

q.h.

every hour

q.i.d.

four times a day

q.3.h.

every three hours

q.n.

every night

RBC

red blood cells

RO

rule out

Rx

treatment or prescription

 

S to Y

ABBREVIATION

EXPLANATION

s

without

SOB

shortness of breath

stat

immediately

sub-Q

subcutaneous (under the skin)

Sx

symptom (s)

TC

total cholesterol

TG

triglycerides

t.i.d.

three times a day

TPN (TNA)

total parenteral nutrition (total nutrient admixture)

WNL

within normal limits

wt.

weight

y.o.

years old

 

SYMBOLS

 =    female

  =   male

↑ =  increase

↓   =  decrease

ø  =  none

 #   =  pounds

 >   =  greater than (examples: 8 > 4  OR DRI goal for dietary fiber> 25g per day)

 <   =  less than (examples 4 < 8  OR DRI goal for fat < 30% kcal)

 ≥   =  greater than or equal to (example: DRI goal for Vit C intake ≥ RDA for Vit C)

 ≤  =  less than or equal to (example: DRI goal for saturated fat ≤ 10% of total calories)

 

Numbers: Never write a zero by itself after a decimal point (example: 10.0—mistaken for 100)

Always use a zero before a decimal point (example: 0.1 to indicate 1/10 = 10%)

 

Medical errors have been identified as common causes of patient deaths in the U.S. For information about the National Patient Safety Goals of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) related to use of medical abbreviations, see JCAHO website: www.jcaho.org Links to an external site.

Also see Institute for Safe Medication Practices (ISMP) website: www.ismp.org. Links to an external site.