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16 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Anterior |
At or toward the front of the body Aka ventral |
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Clinical Record |
The legal account of a person's condition and response to treatment and care Aka medical record or chart |
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Distal |
The part farthest from the center or from the point of attachment |
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Dorsal |
At or toward the back of the body or body part Aka posterior |
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Kardex |
A type of card file that summarizes information found in the medical record |
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Lateral |
Away from midline Side of the body or body part |
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Medial |
At or near the midline of the body or body part |
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Progress Note |
Describes care given and the person's response and progress |
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Proximal |
The part nearest to the center or to the point of attachment |
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Right Upper Abdominal Quadrant |
Xiphoid process Liver Transverse colon Ascending colon |
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Left Upper Abdominal Quadrant |
Stomach Small intestine Descending colon |
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Left Lower Abdominal Quadrant |
Sigmoid colon Pubic symphysis |
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Right Lower Abdominal Quadrant |
Umbilicus Bladder |
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Flow Sheets |
Used to record frequent measurements or observations |
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Graphic Sheet |
Used to record measurements and observations made daily, every shift, or 3-4 times a day |
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In LTC, OBRA requires a written summary of the person every _______. |
3 months |
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