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s/l careic? lesions. dental progress note

Posted By: need info on 2005-11-29
In Reply to:

Subject: s/l careic? lesions. dental progress note




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progress note
Subject: progress note

On this progress note it sounds like the doctor says "blood pressure 167/82, heart rate is 90, resperate 20, T max is 100.8."      


Should that be respirations 20, temperature at max 100.8?  thanks


progress note
Subject: progress note

thanks so much for your help you are right!!!
progress note
Subject: progress note

thanks for your help!!!
progress note help please!!!
Subject: progress note help please!!!

Blood pressure 167/82.  Heart rate is 90, respiratory rate 20, Temperature at max is 100.8.  No JVD lungs and expiratory wheezes.  There are some rales in the right base.  Heart without ** and edema.  **120, **3.4, chloride 94, ** 25, glucose 91, BUN 9, creatinine .6, calcium 8.5, white count is 5.7, hemoglobin 8.9 down from 10 yesterday, platelet count 234,000, 6 lymphs, 10 minus 1 basophiles, 7 bands, 76 segs.~~~~ after heart without--it sounds like a extremity then ssss sound.  the other sounds like Sims 120.  the other sounds like seven and a 3.4.  the other sounds like bacum.  ANY HELP WOULD BE GREATLY APPRECIATED!!!!
Progress note help
Subject: Progress note help

Heart: Without? lower extremity edema. Sodium 120, potassium 3.4, chloride 94, bicarb 25.

Also, probably should be temperature T-max is 100.8. No JVD. Lungs: End-expiratory wheezes.
progress note help
Subject: progress note help

You are wonderful. I can't thank you enough!!!!!!!!!!
help with progress note
Subject: help with progress note

This pat has a cough and post-nasal drip, as well as GERD

Begins s/l *effuncting* nausea and abnormal liver enzymes. This could be a title or description of the nausea, but I can’t find anything.

Then,
s/l *Cardiovicular*. She reports the nausea has resolved. . . . has post-nasal drip .. .cough is not constant. Reflux is under good control
Edit/Delete Message
Progress Note headings?
Subject: Progress Note headings?

I really want to hear Chief Complaint, but I’m sure he starts with Cardio. Thanks anyway.
Progress Note headings?
Subject: Progress Note headings?

I can’t hear the “tat” part, but that sure makes sense. I like the cardiovascular, too, except this is talking about GERD - could that be connected to Cardiovascular system?
Progress Note: Heart without ?, Help please
Subject: Progress Note: Heart without ?, Help please

Heart without _____ (s/l extra absoftness) without edema. 


 


Also in same report, dictator says:


Urine shows 5-10 red cells, occasional white cells, moderate bacteria, negative glucose, negative


_____ (s/l glucoside esterase).


 


Does anyone know what those 2 blanks might be?  I see “glucosylceramidase assay” in the Stedman’s Lab Words book, but I don’t hear that in the dictation.


I would appreciate any help at all.



The patient had 3 cc .5% Butithicane?...dental cariuos lesions tia...
Subject: The patient had 3 cc .5% Butithicane?...dental cariuos lesions tia...


progress note--right lower lobe pneumonia
Subject: progress note--right lower lobe pneumonia

this is what the doctor is saying--"She has been on half-normal.  Her (saline/sodium) drop will change to normal saline of 50cc an hour."  in the second sentence of this I am not sure if he is saying saline or sodium?  any help?
antibiotics for dental exams and dental work
Subject: antibiotics for dental exams and dental work

This is SBE prophylaxis (subacute bacterial endocarditis) which is given to patients with heart valve disease.  When dental work is done, this causes the bacteria from the mouth to go into the system and can cause vegetation on one or more of the heart valves....which is a very serious and possibly life-threatening situation.  Most surgeries require this be done before the procedure, even certain nonsurgical procedures that may be less invasive, require it as well.  However, the guidelines are less stringent than they were previously.  Hope this helps.
Making progress
Subject: Making progress

He said the first 3 letters again and spelled them:

I, B as in Bictor (meaning V as in Victor), F Laboratory.

So now we have IVF icksee Laboratory.
making a little progress
Subject: making a little progress

with this one, thanks to your answers... still hearing something like "Pradus" but instead of obturate, was saying on THE RIGHT. definitely NOT piriformis or sure does not sound like it, then goes on to gluteus medius and maximus.
It could be. If there is failure to progress. sm
Subject: It could be. If there is failure to progress. sm

I had to have an emergency C-section and they ruptured my membrane. They used this crochet hook looking thing. So it could possibly be assisted or even abrupt.
Psych note Axis III s/l VPS and neuropathy. No health history in the note. Only meds listed psych
Subject: Psych note Axis III s/l VPS and neuropathy. No health history in the note. Only meds listed psych


Work under progress on Word Board...
Subject: Work under progress on Word Board...

You may experience posting problems on Word Help Board only for next couple of hours.


Sorry for the trouble,


MTStars Administration.


diagnosis for operation includes intrauterine pregnancy at term, failure to progress and sm
Subject: diagnosis for operation includes intrauterine pregnancy at term, failure to progress and sm

and fetal s/l "a-sink-qua-sism".


dental
Subject: dental


Dental help
Subject: Dental help

Sentence:  Dissection buccally was carried inferiorly along the lateral cortical plate and the mandible to identify the mental, foramen and (S/L insexapine nerve). I've googled til I can't google any more. Wasted so much time already.
FYI - dental help
Subject: FYI - dental help

The other day I posted for dental help. FYI, got feedback today and could kick myself now.


Here's the sentence:


Dissection buccally was carried inferiorly along the lateral cortical plate and the mandible to identify the mental foramen and (S/L insexapine nerve).


The word was mental foramen and its exiting nerve. He really mumbled that together.


Anyhow, thanks for trying to help.


dental elevators--sm
Subject: dental elevators--sm

I found a list of dental root elevators and the closest to what you are looking for is either Flohr elevators, or Warwick elevators. they are numbered by #1, #2, #3, and then angled left, right, straight or serrated. Don't know if this helps...hope so.
dental report: sm
Subject: dental report: sm

Restorative material utilized was bond 1A1 s/l Artisty? RTSD?
dental? Luxor? nm
Subject: dental? Luxor? nm

 


My dental book
Subject: My dental book

shows fetor exore and fetor oris.


Help with dental term
Subject: Help with dental term

Dictator is stating sounds like "abatine". From the way its used in the sentence, would be used for hemostasis.  Says "abatine" was packed to control the ooze. Any suggestions?
Dental term..Help!!
Subject: Dental term..Help!!

I need some help with a dental term that I have not yet heard of.. ..


She also has slight erythema and fullness to the gingiva in that area, consistent with possible early ??__________.


It sounds like it starts with peri/para and ends in gladstha/gladsa?  Any help is greatly appreciated! 


Dental anesthetic
Subject: Dental anesthetic

The patient received 2 s/l mepracain and epinephrine
Dental surgery retractor
Subject: Dental surgery retractor

Is there a ductal retractor? Thank you.
FlowIt dental composite?
Subject: FlowIt dental composite?

I'm doing a note dictated by a dentist, and he says he is using s/l Flow It composite and then covered with Clinpro sealant.  I can verify Clinpro sealant, but I can't document the proper spelling of the composite material.  Medcompare didn't seem to have any dental information.
Dental 4 mole curette?
Subject: Dental 4 mole curette?


A gentle curettage was accomplished using a number four mole curette and angled curette.


ASR put this, can't find it, anybody familiar with dental curettes?


 


Dental operative report
Subject: Dental operative report

sentence: Direct nasal endotracheal intubation was established with a size 5.5. nasal __________ tube.

Sounds like nasal 'ray' tube. Is 'ray' correct?
MOB & OL dental amalgams=MOB and OL stand for what exactly? TIA! sm
Subject: MOB & OL dental amalgams=MOB and OL stand for what exactly? TIA! sm

need to spell out in op report....
dental anesthesia link for you. sm
Subject: dental anesthesia link for you. sm

http://www.dentalcompare.com/matrix/271/Dental-Local-Anesthetic--Dental-Local-Anesthesia.html
single form of dental caries?
Subject: single form of dental caries?

?
single form of dental caries?
Subject: single form of dental caries?


Caries: Scientific name for dental cavities; it is both singular and plural.
dental surgery s/l taformo elevator nm
Subject: dental surgery s/l taformo elevator nm

xx
s/l Escustapes?? was prescribed for dental caries?
Subject: s/l Escustapes?? was prescribed for dental caries?


dental surgery reference web sites?
Subject: dental surgery reference web sites?

Dental surgeries always trip me up.  Anyone know of good web sites for reference or with samples?  Most of the dental surgeries I do are DDS's working on children. 


Dental S/L Copax did not anchor the tooth
Subject: Dental S/L Copax did not anchor the tooth

Copax or co-packs or Kopax ??? I can't find this anywhere
Dental glossary. Hope it helps. sm
Subject: Dental glossary. Hope it helps. sm

http://www.dentalglossary.net/


 


Dental is very hard and I have a Sted's ENT/Dental book.


dental anesthesia injection non caine
Subject: dental anesthesia injection non caine

anybody know?
HEENT: Absence of dental s/l keses. ??
Subject: HEENT: Absence of dental s/l keses. ??


s/l Eric arch bars on a dental procedure
Subject: s/l Eric arch bars on a dental procedure

TIA
s/l cevofluorine, a mask anesthetic given for a dental procedure
Subject: s/l cevofluorine, a mask anesthetic given for a dental procedure

nm
dental extraction procedure. name of throat pack.
Subject: dental extraction procedure. name of throat pack.

Sounds like:  A ''pej tail'' throat pack was inserted.  Thanks for any help.
Sted's Plastic Surgery/Dental has fleur-de-lis shape etc. sm
Subject: Sted's Plastic Surgery/Dental has fleur-de-lis shape etc. sm

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  1. NESPS - NESPS 2008 Annual Meeting Abstracts - Fleur-de-lis ...


    In addition, the fleur-de-lis incision provides the ability to create a better functional and cosmetic outcome by resecting redundant skin in both the ...
    www.nesps.org/abstracts/2008/71.cgi - 19k - Cached - Similar pages


  2. Plastic and Reconstructive Surgery - Fulltext: Volume 111(5) April ...


    This can be achieved by maximizing the skin island and the amount of subcutaneous tissue with a fleur-de-lis incision, as described by McCraw and Papp. ...
    www

Usually antibiotics are prescribed before dental work with mitral valve ...sm
Subject: Usually antibiotics are prescribed before dental work with mitral valve ...sm

regurgitation for prophylactic coverage, could doctor be slurring "antibiotics?"
Yes, but they sometimes have lesions from it.
Subject: Yes, but they sometimes have lesions from it.


Cam lesions sm
Subject: Cam lesions sm

Hip Arthroscopy for Femoral Acetabular Impingement, Labral Tears ...
Hip joint arthroscopy is performed for femoral acetabular impingement, ... Cam lesions on the femoral head lead to shear forces of the nonspherical portion ...
www.bryankellymd.com