Medical Assistant Skills Chapter 21 Medical Assistant Skills

21:1 Measuring/Recording Height and Weight Used to determine if a patient is overweight or underweight Part of general physical examination Daily weights ordered for some patients For adults, height measurements assess osteoporosis

21:1 Measuring/Recording Height and Weight Wide variety of scales Recording weight Pounds and ounces or kilograms Recording height Feet and inches or centimeters Refer to Procedures 21:1A and 21:1B in text Changed Text to text

21:2 Positioning a Patient Patient must be positioned correctly for variety of examinations, tests, and procedures Wide variety of positions used (refer to Figures 21-10 to 21-18 in text) Patient may be on a bed, exam table, surgical table, diagnostic table, treatment table

21:2 Positioning a Patient Horizontal recumbent (supine) position Prone position Sims’ (left lateral) position Knee–chest position Fowler’s positions Lithotomy position

21:2 Positioning a Patient Dorsal recumbent position Trendelenburg position Jackknife (proctologic) position Follow basic principles and procedures for positioning patients (refer to Procedure 21:2 in text)

21:3 Screening for Vision Problems Screening tests of visual acuity Snellen charts test distant vision for nearsightedness (myopia) Interpretation of readings on Snellen chart Refer to Figure 21-20 and Procedure 21:3 in text

21:3 Screening for Vision Problems Jaeger system tests close vision for farsightedness (hyperopia) Ishihara method tests for defects in color vision or color blindness Abbreviations and terms related to visual acuity

21:4 Assisting with Physical Examinations Three major types of examinations EENT GYN General or complete physical

21:4 Assisting with Physical Examinations Techniques used during the examination Observation Palpation Percussion Auscultation Equipment used for examination

21:4 Assisting with Physical Examinations Equipment Sigmoidoscope Speculum Cervical spatula Laryngeal mirror Sphygmomanometer Stethoscope Ophthalmoscope Tongue depressor Otoscope Tuning fork Percussion hammer

21:4 Assisting with Physical Examinations Preparation of the patient Tests done prior to physical examination Be prepared to assist physician as needed Observe standard precautions Refer to Procedures 21:4A–21:4C in text

21:5 Assisting with Minor Surgery and Suture Removal In medical, dental, other health care facilities Various types of procedures done Instruments and equipment Use strict sterile technique to prepare surgical tray Refer to Procedures 21:5A and 21:5B in text

21:5 Assisting with Minor Surgery and Suture Removal Instruments/supplies Retractors Scalpels Surgical scissors Suture materials Needle holder Hemostats Needle Tissue forceps Bandage scissors Splinter forceps Towel clamps

21:5 Assisting with Minor Surgery and Suture Removal Strict sterile technique must be used to prepare surgical tray Skin prep may be done before minor surgery Physician may administer local anesthesia Be prepared to assist as need during procedure

21:5 Assisting with Minor Surgery and Suture Removal Sterile dressings must be available for use Suture removal also requires sterile technique Suture removal sets Patients often fearful and apprehensive Reassure patients Refer specific questions to physician

21:5 Assisting with Minor Surgery and Suture Removal Removed body tissues, growths, or specimens are sent to laboratory for examination Biopsy specimen Observe standard precautions Dispose of sharp objects properly

21:6 Recording and Mounting an Electrocardiogram Electrocardiogram (ECG) measures electrical conduction pattern in the heart Waves and what they show (refer to Figure 21-44 in text) PQRST complex Refer to Procedure 21:6 in text

21:6 Recording and Mounting an Electrocardiogram Complete ECG consists of 12 leads (refer to Figure 21-46 in text) Basic parts of ECG machine Explain procedure and reassure patient Computerized ECG machines will retain the ECG in computer memory for EHR Changed twelve to 12

21:7 Using the Physicians’ Desk Reference (PDR) PDR provides information about drugs and medications currently in use Published yearly with periodic supplements for up-to-date information Also available in an online version

21:7 Using the PDR Sections of the PDR Manufacturers’ index Brand and generic names Product classification, or category, index Product identification guide Product information Diagnostic product information section

21:7 Using the PDR Sections in the back of the PDR Poison control centers Discontinued products U.S. Food and Drug Administration telephone directory Key to FDA Use-in-Pregnancy ratings

21:8 Working with Medications Drug used to treat or prevent a disease or condition Only authorized persons can administer medications Check legal requirements in your state

21:8 Working with Medications Forms of medications Liquids, solids, semisolids Routes of administration Oral, rectal, topical, inhalation, sublingual Changed semi-solid to semisolid

21:8 Working with Medications “Six rights” to observe when giving medications Right medication Right dose or amount Right patient Right time Right method or route of administration Right documentation

21:8 Working with Medications Know the safety rules to observe when working with medications Report all mistakes immediately Concentrate while handling any medication and avoid distractions