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I transcribe: 5- to 6-mm nodule. NM

Posted By: Chickadee on 2006-03-31
In Reply to: 5 to 6 mm nodule (sm) - dash dilemma

Subject: I transcribe: 5- to 6-mm nodule. NM

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5 to 6 mm nodule (sm)
Subject: 5 to 6 mm nodule (sm)

How should this be noted with dashes?  I usually use 6-mm nodule but not sure about it since it has 2 numbers.  Would it be 5-to-6-mm nodule?  Thanks.
RE: 5 to 6 mm nodule (sm)
Subject: RE: 5 to 6 mm nodule (sm)

5-6 mm nodule
nodule on ear
Subject: nodule on ear

The nodule is at the junction of the s/l "skafa" and conchal bowl.  Any suggestions?
nodule maybe?
Subject: nodule maybe?


BOS prefers 5-6-mm nodule. nm
Subject: BOS prefers 5-6-mm nodule. nm

x
thyroid nodule
Subject: thyroid nodule

thyroid lumpectomy is scheduled
could be suprasellar nodule
Subject: could be suprasellar nodule

nm
Lisch nodule
Subject: Lisch nodule


Pt has pulmonary nodule
Subject: Pt has pulmonary nodule

Patient has nodules in right lobe, doctor just mentions the upcoming surgery under HPI but does not list past surgeries or other health problems/surgeries so unsure... the doc does stumble over her words when she says the word patent and then she says what sounds like immunovalley, thanks!
radiopex nodule?
Subject: radiopex nodule?

On chest CT.  (This is a smoker/drinker with opacities all over.) 
photopenic? thyroid nodule
Subject: photopenic? thyroid nodule

s/l "photopenic" right solitary nodule of the thyroid.


Can't find this term. Help would be appreciated. Thanks.


Voltaneous function of nodule?
Subject: Voltaneous function of nodule?

Observation of resolution or decrease in size of her nonfunctioning nodules as well as evidence of ___________ function in other nodules suggested that none of these are at significant increased risk for being malignant.


 


blank s/l voltaneous?


Could it be..Subcentimeter nonpulmonary nodule??
Subject: Could it be..Subcentimeter nonpulmonary nodule??

Just a guess.
Cardiac consult for nodule
Subject: Cardiac consult for nodule

There was no s/l medius and lefinopaptine? No other hypermetabolic activity in the lung.


stable lung nodule please sm
Subject: stable lung nodule please sm

...stable lung nodule consistent with a s/l hemartoma.


Don't know of this is hamartoma or hematoma? TIA


thyroid nodule/renal ultrasound
Subject: thyroid nodule/renal ultrasound

The doctor mentions the patient has a thyroid nodule with benign renal biopsy.  Why would it be a renal biopsy?  I am not familiar with the association between the two or perhaps I am just not hearing it correctly.  Feedback from anyone? 
Lung nodule that is possible a "coccideoma". Is this a word, or is he making stuff up?
Subject: Lung nodule that is possible a "coccideoma". Is this a word, or is he making stuff up?


Doc dictates "monitor for change in size or (s/l) retina. Talking about a breast nodule. SM
Subject: Doc dictates "monitor for change in size or (s/l) retina. Talking about a breast nodule. SM

Is there a word that sounds like retina or another definition for retina I am not aware of?  Here is the part of the note "She is reassured that the nodule on her chest wall is benign.  I did ask her to monitor it for any changes in size or retina."
how do you transcribe this??
Subject: how do you transcribe this??

Doctor says * cardiac-wise the patient is doing well *    OR  * GI-wise he has had, blah blah blah blah...


I personally do not like the phrase * dash wise *   The only way around it, seems to me, is to add a bunch more words like * as far as his cardiac condition is concerned * which does not sound like the dictator.


What do you do? 


I would transcribe it as pus-like...nm
Subject: I would transcribe it as pus-like...nm

nm
I transcribe it like so..
Subject: I transcribe it like so..

Last, First, M.D.  But, I why?  I just do.  I have never had a complaint.  But, I'll transcribe Last, Reverend First (pastor), or Last, Sister First (nun). 


need to know the right way to transcribe....
Subject: need to know the right way to transcribe....

the doctor says---discharge medications and patient is still on---  Do I type it like this?  DISCHARGE MEDICATION AND PATIENT IS STILL ON:  or do I leave all caps and headings out and start a new paragraph?
Thank you-Is that how I transcribe it
Subject: Thank you-Is that how I transcribe it

too?
Tib-fib, how to transcribe it? Thanks. NM
Subject: Tib-fib, how to transcribe it? Thanks. NM


That's how I transcribe it
Subject: That's how I transcribe it


How would you transcribe this?
Subject: How would you transcribe this?

I'm doing a report on a hip arthroplasty, and the doctor says the Secur-Fit shell was driven into place in approximately 4520 parameter based off the sciatic notch.


Is that 45 x 20 or 45-20 or just as I have it above?  I'm stumped!


How would you transcribe this?
Subject: How would you transcribe this?


 I have a doctor who keeps saying axillosubclavian brachiocephalic vein as if this is one vein he is referring to, but I think it has to be two, so how would you transcribe it when he lists the procedures performed as:


1. Right axillosubclavian brachiocephalic vein mechanical venous thrombectomy using the Trellis-8 device.


2.  Right axillosubclavian brachiocephalic vein balloon angioplasty using a 10 mm x 4-cm long balloon followed by 6 mm x 4-cm long balloon followed by 7 mm x 4-cm long balloon.


3. Supervision and interpretation of fluoroscopy for performance of right axillosubclavian brachiocephalic vein mechanical thrombectomy, thrombolytic therapy and balloon angioplasty.


He doesn't pause between the words axillosubclavian and brachiocephalic vein.  Should there be a dash between the two or the word and?


 


how would you transcribe this
Subject: how would you transcribe this

8 instances of property damage level 1, 27 episodes of major noncompliance,
I transcribe it as
Subject: I transcribe it as

bilateral eye, bilateral knee replacement.
Transcribe 5.3
Subject: Transcribe 5.3

nm
Here is how I always transcribe it (sm)
Subject: Here is how I always transcribe it (sm)

Gram stain and gram-negative/gram-positive. 
I would transcribe it exactly as you have it. nm
Subject: I would transcribe it exactly as you have it. nm

.
If that is what he says, that is what you transcribe.
Subject: If that is what he says, that is what you transcribe.

x
How would you transcribe this? (SM)
Subject: How would you transcribe this? (SM)

"Sublingual nitroglycerin 0.4 mg "q.5's" p.r.n. for chest pain."

Is it okay to leave as is?


Yes, transcribe as 4.0 (sm)
Subject: Yes, transcribe as 4.0 (sm)

If dictated as "four point oh," you would transcribe as 4.0.

The zero after the decimal indicates the precision of the measurement. In lab values, you would need to transcribe as dictated in order to avoid "changing" the measure.

If you transcribed it as 4, the reader would wonder what you left off. A zero in other locations might be optional or up to the preference of the facility, but not this one.






how do you transcribe this?
Subject: how do you transcribe this?

We will need some ongoing p.r.n.'s of the MSIR.
gotten - when a doc says this, what do YOU transcribe?
Subject: gotten - when a doc says this, what do YOU transcribe?


That is how I transcribe it too.
Subject: That is how I transcribe it too.

We try not to use all caps even if the manufacturer uses all caps.
How do I transcribe this?
Subject: How do I transcribe this?

The patient will return in four weeks/weeks' time.
How would you transcribe this?
Subject: How would you transcribe this?

"The patietn is a 59-year-old who presented yesterday with shortness of breath and a hypertensive urgency of 120 over approximately 120 blood pressure."


Would the last part be "120/approximately 120 blood pressure" or just spell everything out like I have it?


TIA!


How would you transcribe this???
Subject: How would you transcribe this???

The doctor is saying that the wound was packed with 4 x 4s.  Would you transcribe it as 4 x 4s or 4 x 4????  TIA
Can someone tell me the correct way to transcribe
Subject: Can someone tell me the correct way to transcribe

A fib. I learned in school that it's A-fib. I used to type for cardio docs on my own account, and they wanted A fib. Stedman's Abbrv. has AFib, and another book has A Fib. Is there a "correct" or most preferred way? Thanks.
CORRECT WAY TO TRANSCRIBE
Subject: CORRECT WAY TO TRANSCRIBE

pt developing increasing pulmonary pressures in the 60s and 70s - or 60's and 70's?


Also, if doc dictates calcium one every day, calcium one q.d. or calcium q.d.? 


THANKS!!!


It's okay. I'd transcribe it as dictated. nm
Subject: It's okay. I'd transcribe it as dictated. nm

/
How do you transcribe this sentence?
Subject: How do you transcribe this sentence?

MRI scan has reportedly shown central herniation at C4, 5 and C5, 6
how do you transcribe q 6 h for a prescription?
Subject: how do you transcribe q 6 h for a prescription?

as in 1-2 p.o. (q 6 h) p.r.n. pain.
Omigosh - I think we transcribe for the same doc!
Subject: Omigosh - I think we transcribe for the same doc!

One doc I transcribe for just does his doctor "thing" to support his dog habit - breeding Labradors, training them for field trials, etc. And he has a habit of saying things backwards, like Tenmo needle for Temno needle and even things like humerotibial joint instead of femorotibial joint!
how do I transcribe 10 to the 5th power?
in MS Word?  Thanks
Do you transcribe 'teed' or 'T'd'
Subject: Do you transcribe 'teed' or 'T'd'

Hip replacement OP note:


"The posterior capsule was T'd and the head removed without difficulty."


 


I peeked in my Stedman's Ortho and on-line and cannot find a definitive answer to this.  Thanks in advance if you can help!


transcribe like any other note. It was not necessary for you to
Subject: transcribe like any other note. It was not necessary for you to

nm
correct way to transcribe.....
Subject: correct way to transcribe.....

I know this is very basic, but what is the correct way to transcribe the dimensions of a wound - 12 x 15 cm or 12 by 15 cm, 12 cm x 15 cm, etc...?