Unit 19 Medical Assistant Skills

19:1 Measuring/Recording Height and Weight Use: to determine if a person is overweight or underweight Must be accurate When measurements are done Daily weights Observe safety factors Most patients are very weight conscious Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Measuring/Recording Height and Weight (continued) Wide variety of scales Recording weight Pounds and oz in infants Pounds in adults Kg other countries: Kg x 2.2= pounds Adult weight scales Infant weight scales Recording height- Feet and inches in US Conversion to cm= Inches x 2.5cm Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Measuring/Recording Height and Weight (continued) Tape measure for infant height Basic principles for measuring height and weight on clinical scale Same scale, same time of day, morning is best, same amount of clothing, void bladder, balance scale Basic principles for measuring height and weight of infants Every 2 months. Abnormal growth patterns may indicate nutritional deficiences or genetic disease Height, weight, chest circumference, head circumference on an infant are taken frequently because of rapid growth in an infant. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Length in an infant Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Head/chest Circumference Importance of head : Microcephaly Hydrocephalus Fetal alcohol syndrome Congenital defects Chest Heart and lung over or underdevelopment At about 1-2 yoa head and chest circumference are equal Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

19:2 Positioning a Patient Patient must be positioned correctly for variety of examinations, tests, and procedures Wide variety of positions used Patient may be on a bed, examination table, surgical table, diagnostic table, or treatment table Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Positioning a Patient (continued) Reassure patient Horizontal recumbent or supine position Prone position Sims’ or left lateral position Knee-chest position Fowler’s positions Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Positioning a Patient (continued) Lithotomy position Dorsal recumbent position Trendelenburg position Jackknife (proctology) position Basic principles for positioning patients Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

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19:3 Screening for Vision Problems Vision screening tests Visual Acuity is the ability to perceive and comprehend the sense of sight. Types of Snellen charts (E, Shapes, Letters Interpretation of readings on Snellen chart 20/20 means at 20 feet you can see characters that are 20 mm high Snellen chart tests only for defects in distant vision – hyperopia Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Screening for Vision Problems (continued) Terms or abbreviations OD, OS, OU Basic principles for screening vision with Snellen chart Near sightedness testing uses the Jaeger system where patient uses a printed card 14-16 inches from the face Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Jaeger Eye Chart Example Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

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Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. EYE terms Myopia- nearsightedness, defect in distant vision Hyperopia- farsightedness, defect in close vision Presbyopia- Occurs with age, lens does not accommodate to near and far, loses close vision, far not generally affected Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Color Blindness There are three main kinds of color blindness, based on photopigment defects in the three different kinds of cones that respond to blue, green, and red light. Red-green color blindness is the most common, followed by blue-yellow color blindness. A complete absence of color vision —total color blindness – is rare. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Test for color blindness- Ishihara Color plates Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

19:4 Assisting with Physical Examinations Large variety of physical examinations are performed Major types of examinations EENT GYN- Papanicolaou (Pap smear) General or complete physical: Xray, ECG, HT/Wt Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Assisting with PE Techniques used during the examination Auscultation and percussion Palpation Equipment used for examination (p 707) Cervical spatula laryngeal mirror Opthalmascope otoscope Reflex or percussion hammer Sigmoidoscope speculum Sphygmomanometer stethoscope Tongue depressor tuning fork Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Preparation of the Patient Ht/Wt Vital signs Vision Audiometric screening Blood tests ECG Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Assisting with Physical Exams (continued) Be prepared to assist as needed Handing instruments to doctor Positioning patient Observe standard precautions Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

19:5 Assisting with Minor Surgery and Suture Removal Done in medical, surgical, and other health care facilities Various types of procedures done, for ex. Removing warts, cysts, tumors, growths Biopsies, suturing wounds, incising and draining Instruments and equipment Strict sterile technique used to prepare surgery tray Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Instruments Scalpel Surgical scissors Hemostats Tissue forceps Splinter forceps Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Instruments cont… Towel Clamp Retractors Suture removal scissors Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Assisting with Minor Surgery and Suture Removal (continued) Will be expected to assist as needed Sterile dressings available to use Suture removal: Keep in mind infection is always possible Patients are often fearful and apprehensive Specimens Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Assisting with Minor Surgery and Suture Removal (continued) Observe standard precautions Basic principles of assisting with minor surgery and suture removal Skin Prep prior to surgery: Shaving Cleansing area with antiseptic soap https://www.youtube.com/watch?v=6P0rYS6LeZw (suturing video) Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

19:6 Recording and Mounting an Electrocardiogram Electrical conduction pattern in the heart Waves and what they show Twelve-lead ECG Electrodes Lead markings Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Recording and Mounting an Electrocardiogram (continued) Basic parts of ECG machine PQRST pattern Reassure patient Mounting ECG Basic principles for recording and mounting Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

19:7 Using the Physicians’ Desk Reference (PDR) Provides essential information about drugs and medications currently in use Need to know how to use PDR Published yearly with periodic supplements Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Using the Physicians’ Desk Reference PDR (continued) Physicians’ Desk Reference for Nonprescription Drugs Sections of the PDR Utilization of PDR Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

19:8 Working with Math and Medications Medication: a drug used to treat or prevent a disease or condition Extreme care is required while handling any medication Only authorized persons can administer medications Check legal requirements in your state Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Working with Math and Medications (continued) Forms of medications Routes of administration Safety rules to observe when working with medications Report all mistakes immediately Concentrate while handling any medication and avoid distractions Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Working with Math and Medications (continued) 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 Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Roman Numerals Used for some drugs and solutions, and used at times while ordering supplies Key symbols: I, V, X, L, C, D, M Any number can be formed Rules of using Roman numerals Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Converting Metric Measurements Metric system used in many health care fields Basic units: gram, liter, meter Based on unit of tens Rules of converting metric measurements Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Household or English System of Measurement Common system used in the United States Many different units of measurement Conversion of household to metric Conversion of metric to household Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.