If the patient is not alert and oriented, use another way to describe Alert and oriented x 4 used in medical notes, often abbreviated as A&Ox4, refers to the cognitive status of the patient. (b) If the patient is alert, you can reported your results as a patient oriented score from 1 (lowest) to 4 (highest), noting any areas not oriented to. I was a little surprised, so I decided to google and see what I can come up with. The example they used was: Patient is well nourished, well developed (Constitutional), alert and oriented x3 (Psych), in no acute distress (Neuro). Orientation I always count as Psych. oriented score from 1 (lowest) to 4 (highest), noting any areas not oriented to. For example, you can state the patient is “A and O X 4” (fully alert and oriented) or “A and O x 2 and does not know time and place.” (2) V: Responds to verbal stimulus. Alert and Oriented Mental Status Exam. A common practice is to substitute full documentation of the mental status exam with brief phrases such as "alert and oriented" or "alert and oriented to person, place, and time"—abbreviated as "A&O×3." oriented x 3 means that they know who they are (and who u r), wear they are, and about what time of day it was. I look at the chief complaint and sometimes will count it as psych. A 79-year-old male with coronary artery disease, hypertension, non-insulin-dependent mellitus, moderate dementia, and chronic renal insufficiency is admitted after a fall evaluation. X1 means “oriented to self or person” – patient knows own name, significant others. 6- 4 ACRONYMS USED DURING PATIENT ASSESSMENT MOI – stands for mechanism of injury AVPU – used to classify the patient’s mental status: • A = awake, alert, and oriented • V = alert to voice, but not oriented • P = alert to painful stimuli only • U = unresponsive to voice or painful stimuli CUPS – used as an additional tool to prioritize the patient for transport: by Betty McDowell, Heartbeat International Director of Ministry Services As a social worker in the mental health field, I was trained to assess a patient’s level of alertness and orientation by asking them four questions: (1) Who are you? He is widowed and lives in an assisted living facility. What is your opinion of counting alert and oriented (not stating x3) as constitutional vs. psych? or something similar to that. if they know where they are and that it is morning time, but they think u r their mom, then you would call that oriented x2. X2 means “oriented to person and place” – knows where he/she is. You can change it up a bit. you know it would be adjusted accordingly. Alert and oriented--x4? x3? We started discussing how there is so much variability in how facilities expect RN's to assess (and chart) patient orientation status. As well as other common A/O confusion. Nor can a patient who is psychotic, suicidal, or homicidal have capacity. For example, you can state the patient is "A and O X 4" (fully alert and oriented) or "A and O In the medical field, A&Ox4, A/Ox4 or AOx4 means the patient is alert and oriented to person, place, time, situation.. No definitive answers yet. "Alert," though, to me is an indication of whether or not the patient APPEARS to be awake, vs. lethargic/drowsy. Capacity goes beyond just being alert and oriented. However, a patient who isn’t alert and oriented can’t have capacity. I was having this conversation with a number of other students in my cohort yesterday, along with a couple of instructors. He’s accompanied by his niece, is alert, and oriented … X3 means “oriented to person, place, and time” – knows the date/day.