1. Clinic Assistant Training: Level 2
February 2017

2. Specialty Visits
Diabetic Patient Work-Ups
Asthmatic Patient Work-Ups

3. Diabetic Patients What is Type II Diabetes? What are the risk factors?
It is the most common form of diabetes, and occurs when the body does not produce enough insulin or when the body is unable to use the insulin produced.
What are the risk factors?
Smoking
High Blood Pressure
Poor Physical Activity
High Blood Glucose

4. Diabetic Patients How can patients prevent Type II Diabetes?
Eating well by consuming low-fat foods and whole, raw foods such as fruits and vegetables.
Maintaining a healthy weight by not eating more calories than those recommended.
Consuming an additional 500 calories per week results in gaining 1 pound!
Staying physically active by exercising 30 minutes a day, 5 days a week.

5. Diabetic Patient Work-Up
Clinic Assistants can assist our Diabetic Patients by…
Asking patients for the time of their last meal
Performing Blood Glucose Screenings (Level 2 CAs, as requested by Medical Provider)
Asking patient to remove shoes in the exam room for Diabetic Foot Exams

6. Vitals: Blood Glucose Screening
Step 1: Gather Supplies
Step 2: Test Blood Glucose
Gloves - put on BEFORE starting
Alcohol pad
Cotton balls
Small Band-Aid
Blood Glucose monitors: Found in the Lab. You have to sign out for the machine.
Blood Glucose monitor strips: Also found in the Lab. Make sure the strip code matches the monitor code.
Clean finger w/ alcohol pad and dry using a cotton ball
Activate NEW lancet and turn machine on. Instructions will read:
Insert strip (you should insert the test strip)
Wait
Apply sample.
Collect blood sample: To remove lancet cover, twist and pull. Then apply slight pressure to the finger until some blood appears. Wipe away the first drop of blood. Apply slight pressure again, until enough blood for a sample appears.
Record results: Wait until the glucometer beeps, for total blood sugar results.
Dispose of used materials & Return monitor - Remove used lancet and discard in Sharps container. Dispose of other materials (alcohol pad, cotton, etc.) in regular trash. Return monitor to its place in the work-up room
Remove gloves, and wash hands.

7. Diabetic Patient Work-Up (Next-Gen)
Blood Glucose Screening in Next-Gen
Click link on NextGen that says “Standing Orders”
On list, click “Blood Sugar”
Under Details type the results. Be sure to note when the patient last ate
Check “Submit to Superbill” and click “Place Order”
**If pt has TYPE I DM and has blood sugar over 400, flag for staff ASAP!**

8. Diabetic Patient Work-Up
Testing patients’ blood glucose monitors…
If a patient is in to visit a Diabetes Specialist:
Ask if they brought their machine
Administer their blood test on the VFC machine as well as the individual’s machine, using the same stick/sample
Note both results in “Office Diagnostics”

9. Vitals: Peak Flow & Pulse Ox
Measure Peak Flow & Pulse Ox
When a patient…
Is asthmatic
Has a common cold
Complains of coughing
Has a fever (Pulse Ox)
Is experiencing difficulty breathing

10. Vitals: Peak Flow & Pulse Ox
Measures patient’s ability to push air out of the lungs. Peak Flow is an indicator of lung efficiency.
How to test Peak Flow:
Use paper towel to insert tube into peak flow machine.
Ask the patient to stand up straight and take a deep breath, and exhale through mouthpiece.
Repeat 3 times, and record the highest reading.

11. Vitals: Peak Flow & Pulse Ox
Pulse Oximetry
Measures O2 saturation, which indicates the percentage of air in the lungs.
How to test Pulse Oximetry:
Locate the machine.
Turn on machine
Ask patient to stay still and quiet.
Clamp machine on patients finger.
Wait until reading stabilizes.
Record patient’s O2 Saturation reading.
Notify staff if Pulse Ox is less than or equal to 92% on room air

12. Acutely Ill Patients Eye Problems Urinary Complaints Cough Fever
If a patient complains of….
Take the following actions…
Eye Problems
Urinary Complaints
Cough
Fever
Ask MA to perform Visual Acuity Exam
Ask MA to perform Urinalysis
Give Patient a mask
Check 02 Saturation

13. Spanish for Clinic Assistants 101
Things to Know: Numbers, Dates, Body Parts, and Basic Phrases!
¡Que qué!
Months of the Year
Enero
January
Febrero
February
Marzo
March
Abril
April
Mayo
May
Junio
June
Julio
July
Agosto
August
Septiembre
September
Octubre
October
Noviembre
November
Diciembre
December
¿Habla usted inglés?
(Do you speak English?)
¿Cómo se llama?
(What is your name?)
Por favor tome un asiento en la sala espera.
(Please have a seat in the waiting room.)

14. ? Number Spanish cero 17 diecisiete 1 uno 18 dieciocho 2 dos 30
cero 17
diecisiete 1
uno 18
dieciocho 2
dos 30
treinta 3
tres 40
cuarenta 4
cuatro 50
cincuenta 5
cinco 60
seisenta 6
seis 70
setenta 7
siete 80
ochenta 8
ocho 90
noventa 9
nueve
100
cien 10
diez
200
dos cientos 11
once
500
quinientos 12
doce
1000
un mil 13
trece 14
catorce 15
quince
451 ? 16
dieciséis
2009
Number 451: cuatrocientos cincuenta y uno
Number 2009: dosmil nueve

15. Spanish Work-Up: Date of Birth
Clinic Assistant: ¿Cuál es su fecha de nacimiento?
Patient: Mi fecha de nacimiento es... _________.
Date of Birth (Spanish)
Date of Birth (English)
el 20 de Junio 1972
el 04 de Noviembre 1993
June 20, 1972
November 4, 1993

16. Spanish Work-Up: Common Phrases
Common Complaints
Dolor en mi espalda
Calambres
Back Pain
Cramps

17. Spanish Work-Up: Common Phrases
Useful Phrases
Would you like the flu shot?
Usted quiere la vacuna contra gripe?
What brings you to the doctor today?
Qué le trae al doctor hoy?

18. Spanish Work-Up Guide Clinic Assistant Work-Up in Spanish English
Work-Up: Step-by-Step
English
Spanish
Hello, I am name , a clinic assistant. Nice to meet you!
Hola, soy name un(a) asistente de clínica, mucho gusto.
What is your date of birth?
¿Cuál es su fecha de nacimiento?
I am here to check your vital signs.
Vengo a tomarle los signos vitales – la temperatura, la presión arterial, y el pulso.
Please stand on the scale.
Por favor, párese en la balanza.
Take off your shoes. We will measure your height.
Quítese Los zapatos. Mediremos su estatura.
I am going to take the temperature. Put this under your tongue, please.
Voy a tomar la temperatura. Póngase esto abajo su lengua, por favor.
I am going to take your blood pressure.
Voy a tomar su presión.
Clinic Assistant Work-Up in Spanish
Work-Up: Step-by-Step
English
Spanish
When was your last menstrual period?
¿Cuándo fue su última menstruación? (aka "regla" or "período“)
Do you have any allergies to medication?
¿Tiene alergia a algún medicamentos?
Do you drink alcohol? Do you smoke cigarettes?
¿Bebes alcohol? ¿Fuma cigarros?
Do you take medication for diabetes, hypertension, or heart disease?
¿Toma medicamentos para la diabetes, alta presión, o enfermedades del corazón?
Do you need a medication refill?
¿Necesita una dosis adicional de sus medicamento?
What brings you here today? What is going on with you?
¿Qué es a lo que viene hoy? ¿Qué es lo que tiene?
I’m sorry, but I don’t understand. I am going to find a translator.
Lo siento, pero no entiendo. Voy a pedir un traductor.
Introduce Yourself: State your name and your role.
Ask patient for – Last Menstrual Period (LMP).
Ask patient for – Allergies.
Ask patient for – Date of Birth.
Ask patient for – Alcohol & Cigarette Use.
Communicate what you are going to do – Patient Vitals.
Ask patient for – History of Diabetes & Hypertension.
Measure patient’s – Weight.
Measure patient’s – Height.
Ask patient about Medication.
Ask patient for – Reason for Visit.
Measure patient’s – Temperature.
Exit with courtesy – if necessary.
Measure patient’s – Blood Pressure.