Here is my working list for HIV drugs most often dictated in notes
Posted By: Kathie on 2006-09-20
In Reply to: Pt on Kaletra, Invirase and ______. (s/l a-ru-vi-da). nm - HIV med
Subject: Here is my working list for HIV drugs most often dictated in notes
Abacavir
Amprenavir
Atovaquone
AZT
Combivir
Delaviridone
Didanosine
3TD
3TC
d4T
Efavirenz
Indinavir
Kaletra
Lamivudine
Nelfinavir
Nevirapine
Ritonavir
Stavudine
Sustiva
Tipranavir
Trizivir
Viread
Zalcitabine
Zidovudine
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Pt list of drugs s/l "thy a do laj" 120 micrograms p.o. q.d. Problem list in message. sm
Subject: Pt list of drugs s/l "thy a do laj" 120 micrograms p.o. q.d. Problem list in message. sm
1. Dementia of undetermined etiology.
2. Hypothyroidism.
3. Osteoporosis. History of depression.
I'm not sure if this is one or two drugs being dictated. SM
Subject: I'm not sure if this is one or two drugs being dictated. SM
I will refill her Armour Thyroid and her s/l modratic and estrace
or maybe it s/l modratic in estrace??? any clue what this is ???
List of drugs
Subject: List of drugs
In a list of medications the physician says the patient is on what sounds like "diapran" any ideas? No idea what it is for or the dosage...
List of drugs
Subject: List of drugs
It is being dictated in the allergy list. Thanks.
Subject: It is being dictated in the allergy list. Thanks.
Here is list of some thyroid drugs. sm
Subject: Here is list of some thyroid drugs. sm
Generic Thyroid Drug Names
Levothyroxine /L-thyroxine | Liothyronine | Liotrix | Methimazole | Propylthiouracil / PTU | Natural Thyroid | Thyrotropin alfa
drugs.com will list by condition
Subject: drugs.com will list by condition
list of drugs s/l *isotears*??? Thanks. nm
Subject: list of drugs s/l *isotears*??? Thanks. nm
nm
No, unfortunately it is just being dictated in the list of medications for the patient.
Subject: No, unfortunately it is just being dictated in the list of medications for the patient.
Is this drug for the sleep study or in a list of drugs?
Subject: Is this drug for the sleep study or in a list of drugs?
need help w/2 drugs, s/l thermadon and s/l knee-po-tir? They are just in a list no dosages or usage
Subject: need help w/2 drugs, s/l thermadon and s/l knee-po-tir? They are just in a list no dosages or usage
Medication - s/l Endrion? Dictated in general medication list. TIA
Subject: Medication - s/l Endrion? Dictated in general medication list. TIA
Nurses' notes or nurse's notes or nurses notes?
Subject: Nurses' notes or nurse's notes or nurses notes?
I am so confused on this one. I have typed it several different ways over the years. Do I really need to put any apostrophe in there at all? Thanks!
Nurse's notes reviewed or nurses notes reviewed? nm
Subject: Nurse's notes reviewed or nurses notes reviewed? nm
x
Just as you have it if that's what was dictated. If "one fourth" was dictated, sm
Subject: Just as you have it if that's what was dictated. If "one fourth" was dictated, sm
it would be 1/4 pill or one fourth of a pill.
Def an 'N' dictated - Diabetes unsure of - no PMH dictated
Subject: Def an 'N' dictated - Diabetes unsure of - no PMH dictated
for drugs phonetic guessing, etc. I do Drugs.com
Subject: for drugs phonetic guessing, etc. I do Drugs.com
worth a dry, can also search part of drug ie *threx
We type it as dictated, if dictated
Subject: We type it as dictated, if dictated
c spine we transcribe C-spine, if cervical then cervical spine.
In list of meds...Full bee 1 tab q.a.m. sm for problem list :)
Subject: In list of meds...Full bee 1 tab q.a.m. sm for problem list :)
1. Diffuse Lewy body disease mixed with Alzheimer’s disease.
2. Generalized anxiety disorder.
3. Benign prostatic hypertrophy. 4 Gastroesophageal reflux disease.
Med list, s/l mylar? drops. No context as in list only. Tx. nm
Subject: Med list, s/l mylar? drops. No context as in list only. Tx. nm
xx
I think you have been working too much
Subject: I think you have been working too much
It is plural not pleural! LOL. But I think of it as singular because small and large are adjectives describing the same bowel. If you were prepping the arm for surgery, you would put the upper and lower arm WAS prepped, not the upper and lower arms WERE prepped.
Thank you, first day... working
Subject: Thank you, first day... working
op notes
Here is a list from my favorites. Hope they are a little bit helpful. I think they are all still good sites.
Op note sites:
http://www.mt-stuff.com/ent.html
http://mtdesk.com/gen.shtml
http://www.medical-library.org/journals2a/tubal_ligation.htm
http://www.mtdaily.com/samples.html
http://www.nezhat.com/oplap_abst.htm
http://www-personal.umich.edu/~aalin/vitalsigns/contentappendix/cntappsamplenotes.html
op notes
Subject: op notes
I have never encountered such a rule. I don't generally listen to where the dictators want their paragraphs, though. They usually put in way too many. I start a new paragraph after the prep and drape description and a I start a new paragraph for the closing of the wounds. I add new paragraphs when the surgeon is addressing a new area. That's just my style of transcribing. I'm not saying it's the right way to do it. It just makes sense to me and I would think it is easier to read and comprehend that way.
take notes!
Subject: take notes!
Whenever I have to spend a lot of time looking something up, I make sure to write it down. It's worth it.
I don't do op notes! LOL
Subject: I don't do op notes! LOL
Working not testing
Subject: Working not testing
I am not taking a test, but working!!!!!!!!!!!!!!!!!!!!!!!!! Thanks for the help 
I'm afraid that is not working..
Subject: I'm afraid that is not working..
There is no other mention of the *gram in the report, either, so that is no help. Definitly not phlebogram. I am wondering if maybe she is saying A radiogram? Would like to know what you think. Thank you for your help
Thank you! Been working since 7 a.m. In need of sleep.
Subject: Thank you! Been working since 7 a.m. In need of sleep.
nm
Thank you, thank you, thank you. Was working on this one way too long.
Subject: Thank you, thank you, thank you. Was working on this one way too long.
Where in the body is he working? nm
Subject: Where in the body is he working? nm
.
Aggrenox - still working on the second one
Subject: Aggrenox - still working on the second one
.
thanks - i usually do ER notes so not familiar with that!
Subject: thanks - i usually do ER notes so not familiar with that!
Resources for OP notes?
Subject: Resources for OP notes?
Is there anyone here who does operative notes and gynecology notes who could give me some websites to use for resources? I am on an OB/GYN account and have operative notes. I have trouble sometimes with the specific surgical instrument names and would greatly appreciate any help. Thanks in advance.
Resources for OP notes?
Subject: Resources for OP notes?
My suggestion would be to purchase (if you do not already have)OB/GYN, equipment and surgical word books (Steadman's) my choice and you would be equipped to better perform your job.
OP notes resources
Subject: OP notes resources
I would do that but we are on a tight budget as we just bought a house and are getting in married in september.
Paragraphs in Op notes
Subject: Paragraphs in Op notes
I have noticed that when I transcribe an Op note as the dictator dictates it, starting a new paragraph as dictated...that QA always removes the spacing between the paragraphs.
Is there some rule in transcription that you don't break an op note into paragraphs? The client profile does not say anything about this.
SOAP notes
Subject: SOAP notes
Was wondering if there are any websites out there that gives sample reports for SOAP notes. Just trying to figure out which is the best way to do it with paragraphs between each heading or all scrunched together. Just want to see what is done more of. I realize it might depend on the clinic, dr, hospital, etc, but just want to get an idea.
Thanks Carla
Thanks so much! I'm taking notes!
Subject: Thanks so much! I'm taking notes!
SOAP notes
Subject: SOAP notes
transcribing for 7 1/2 week old child. Dictator states fontanels are flat, sound like "contrapendalence" are normal.
I have parascapular in my notes.
Subject: I have parascapular in my notes.
Think just nurses notes. IMO. nm
Subject: Think just nurses notes. IMO. nm
Nurse's notes..
Subject: Nurse's notes..
An apostrophe shows ownership. :-)
what part of the body are they working in? nm
Subject: what part of the body are they working in? nm
s
links not working for some reason. Just SM
Subject: links not working for some reason. Just SM
passthru
Found Potts ligature in Sted's Equip. sm
Tue Jan 20 09:08:52 2004
from Sted's online--
ligature (lig-choor)
A thread, wire, fillet, or the like, tied tightly around a blood vessel, the pedicle of a tumor, or other structure to constrict it.
In orthodontics, a wire or other material used to secure an orthodontic attachment or tooth to an archwire.
[L. ligatura, a band or tie, fr. ligo, to tie]
working on the small bone in the ear
Subject: working on the small bone in the ear
nm
Wow, no idea, but I admire you working
Subject: Wow, no idea, but I admire you working
thanks Nancy for the working link! *S*...nm
Subject: thanks Nancy for the working link! *S*...nm
Brain and ears not working
Subject: Brain and ears not working
I have been out of the loop for a while and need help with the usual verbiage used in a review of systems. Where can I go to find it? Please help. Thanks
Male or female? What are they working them up for? nm
Subject: Male or female? What are they working them up for? nm
s
thanks to working late, Teri, SM
Subject: thanks to working late, Teri, SM
mt, sassee and clsk.... it was WATSON-ROCK! I certainly appreciate your help. You are all so generous with your time and knowledge..I hope to become one of you one of these days! Thanks again.
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