Common Nursing Terms And Abbreviations Used In The USA
As a USRN immigrant, it is important to learn and understand the different nursing terms and abbreviations commonly used across the USA. When I immigrated to the USA in 2019, I found that while many nursing terms and abbreviations were familiar, there were others that were new to me. To better help you during your transition to the USA as a Registered Nurse, I have listed the following nursing terms and abbreviations with their meanings:
AC (aka before meals): This abbreviation may be used to describe an intervention or medication that is to be completed or administered before meals. A reason may be that certain medication, such as ciprofloxacin, need to be given on an empty stomach for example and could be ordered AC.
Ad Lib (aka at liberty): This is a term often used to describe an action that a patient can take as much as they choose. For example, if an order states "PO clear fluid diet ad lib" this order would indicate that the patient can consume as much clear fluids by mouth as they choose.
CBR (aka complete bed rest): This abbreviation may be ordered when a patient is to remain resting in bed with no other activity. This is a common order for patients who are in the recovery room or PACU following a procedure or surgery.
DNR (aka do not resuscitate): This is an abbreviation ordered when a patient or appointed family member consents to not having full resuscitation efforts (compressions or intubation) completed by medical staff in the event of a cardiac arrest occurring.
Fluid Overload (aka hypervolemia): This is a term often used when a patient has either consumed too much fluid or is not excreting enough fluid. This may be indicated by sudden weight gain, edema, a greater fluid intake versus output, etc., especially with patients who have cardiac disease.
Hat (aka urine or stool container): A nurse may refer to a urine or stool container that is used in the toilet as a “hat.” A hat is often a white container that has measurements marked inside so that the nurse can measure the exact urine or stool output collected.
HS (aka at bedtime): This abbreviation is used when an intervention or medication is to be completed or administered at bedtime, but does not have to be completed at a specific time. An example of an order would be “Melatonin 10mg PO QHS PRN.” This order would indicate that the patient is able to receive Melatonin 10mg by mouth at bedtime as needed.
NPO (aka nothing by mouth): This is a commonly used abbreviation ordered to state that the patient cannot consume any fluid or food by mouth. At times, an order may have exceptions such as "NPO: except medications." This order would indicate that the patient cannot consume any fluid or food by mouth, but is permitted to take prescribed medications. This may be ordered for a patient who is scheduled for a procedure, but is taking an important medication such as tacrolimus to prevent organ rejection, for example.
OR (aka operating room): This is an abbreviation used referring to the “operating room.” If the patient is scheduled for the OR tomorrow, this means that the patient is scheduled for an operation or procedure tomorrow.
PPE (aka personal protective equipment): This abbreviation is used to describe what protective equipment is required to be worn by staff or individuals who are performing a procedure, handling a medication or blood product, or entering a patients room. For a patient on contact precautions, the nurse's PPE would refer to a gown and gloves.
PRN (aka as needed): This is a common abbreviation used to describe when an intervention or medication can be given as needed. For example, a patient may be prescribed Tylenol 350mg Q6H PO PRN. This would indicate that the patient is able to receive Tylenol 350mg PO as needed, but no sooner than 6 hours between doses.
Q (aka every): The letter Q often precedes a specific frequency or time for an intervention or medication to be completed. For example, “turn patient Q2H” would indicate that the patient is to be turned or repositioned every two hours.
Rx: (aka prescription): Although less common, this abbreviation is used to describe a prescription that is written or sent by a medical practitioner, such as a "discharge Rx" for medications that a patient will be required to continue to take after being discharged from the hospital setting.
Waste (aka extra or un-needed medicine that is to be disposed): A nurse may ask you "can you waste morphine with me?" This would refer to witnessing the amount of morphine and its proper disposal to ensure that the narcotic is not accidentally left unattended or taken. Often if you need to "waste" an item, it will require a co-signature in the chart from two nurses.
WNL or WDL (aka within normal limits or within defined limits): This is an abbreviation used in charting to describe when the patient's findings or assessment are normal. For example, a cardiac assessment charted as “WDL” would refer to the patient having pink, warm, and dry skin, with only S1 and S2 sounds auscultated and no murmur, with a normal sinus rhythm. The alternative to WNL or WDL is X.
X (aka exceptions to defined limits): This is an abbreviation used in charting to describe when the patient's findings or assessment are abnormal. For example, during a cardiac assessment if the patient has pink, warm, and dry skin, but has an audible murmur, the cardiac assessment would be charted that there are exceptions or an “X” to defined limits and a focused assessment of the abnormal findings would then be charted specifically. The alternative to X is WNL or WDL.