1. Medical Assistant Skills
Chapter 20
Medical Assistant Skills

2. Skills Lab Measuring height & weight Positioning Patients
Chapter 20:1
Procedure 20:1A
Positioning Patients
Chapter 20:2
Procedure 20:2
Positioning, Turning, Moving and Transferring Patients
Chapter 21:2
Procedure 21:1 A, B,C, D, E, F

3. 20:1 Measuring/Recording Height and Weight
Use: to determine if a patient is overweight or underweight
Height & Weight charts are based on averages
Must be accurate
When and why measurements are required ?
Daily weights are commonly taken in hospitals– why?
(continued)

4. Height & Weight Measurements:
are routinely performed on admission to hospitals, LTC, doctors visits
Provide Information needed for performing and evaluation of certain laboratory tests
Calculation dosages of certain medications—
In all children
In all complex intravenous drip medications
In all IV TPN or total parenteral nutrition

5. Height & Weight Height, weight, head circumference:
Monitored frequently in children due to rapid growth
Commonly compared to the National Center for Health Statistics ( NCHS) growth graph
Goal it to identify early growth and developmental conditions in children
Plotting a child’s HT & WT allows the physician to check their G & D to percentile averages of other children their same age

7. Measuring/Recording Height and Weight (continued)
Basic procedure for infant weight
To evaluate nutrition & growth
Basic procedure for measuring height of infant
To evaluate abnormal growth patterns or genetic conditions
Measuring infant head circumference
To identify hydro or micro cephalic conditions
Measuring infant chest circumference
Recording growth graph

8. Measuring/Recording Height and Weight (continued)
Wide variety of scales
Recording weight
Adult weight scales
Both lbs. & kg are used however– kg is the standard
Infant weight scales
Recording height
Height bar on adult scale
(continues)

9. Height & Weight Height & weight charts are used as averages
A 10 % deviation in chart to patient is considered normal
Head circumference > 95 percentile is classified as hydrocephalus
Must be accurate– always recheck all calculations

10. Equipment Use the same scale for accuracy
Make sure the scale is balanced
Weigh at the same time each day
Wear the same amount of clothing
Patient should empty bladder before weight is taken

11. Weight Conversions

12. Convert the following to kilograms:
120 lbs
176 lbs
200 lbs
350 lbs
34 lbs
You must DIVIDE by 2.2 kg to perform this conversion

13. Convert the following weight to pounds:
75 kg
100 kg
25 kg
99kg
145 kg
You must MULTIPLY by 2.2 to perform this conversion

14. Notes on Weight Most people are weight conscious
Make only positive statements when measuring all patients
Remember to Ensure patient privacy at all times

15. Types of Scales
Weight Bar Scales

16. Types of Scales
Wheelchair Scale

17. Types of Scales
Bed Scales

18. Types of Scales
Bed with Scale

19. Types of Scales
Infant Scales

20. Height Measurement Assessed in older adults to assess for osteoporosis
Patient safety must always be considered
Observe patients closely
Prevent falls and injuries

21. Height Conversions 1 inch is equal to 2.35 centimeters (cm)
You must MULTIPY by 2.35 to perform this conversion:
Convert the following to cm:
60 in
45 in
25 in
75 in
18 in

22. Height Conversions You must DIVIDE by 2.35 to convert cm to inches.
Convert the following:
95 cm
120 cm
50 cm
18 cm
145 cm

23. Student Assignment/ Skills Lab for 20:1
Complete worksheet for 20:1
Students will then perform Height & Weight measurements on each other

24. How to Weigh a Patient: Assemble equipment Wash hands Prepare scale
Zero the scale
Greet & introduce self
Check patient ID
Explain the procedure
Patinent should remve shoes, jacket, purses, and all other heavy objects

25. Continued: Ask patient to step onto the scale
Move the large 50 pound weight to the right until the balance bar drops on the lower guide. Move this weigh back one notch
Move the smaller weight until the balance bar swings freely between the lower and upper guides
Assist the patient off the scale

26. How to Measure a Patient:
Raise the height bar
Assist the patient back onto the scale with is back to the scale
Instruct the patient to stand erect
Move the bar until it reaches the top of the patient head
Read the measurement in cm and inches
Elevate bar
Assist patient off the scale
Perform any necessary conversions
Replace equipment and wash hands

27. CONVERSION ANSWERS 54.5 KG 80 KG 90 KG 159 KG 15.4KG 165 LBS 220 LBS
141CM
105.7 CM
58.7 CM
176.2 CM
42.3 CM
40.4 IN
51 IN
21.2 IN
7.65 IN
61.7 IN
CONVERSION ANSWERS

28. Positioning Patients

29. 20:2 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
Know how to operate all equipment before using it with a patient
(continues)

30. Positioning a Patient (continued)
Reassure patient
Fully explain to the patient what you are going to do and why
Assess patient for any distress
Observe all safety factors to prevent falls and injury
Use correct body mechanics to prevent self-injury
(continues)

31. Positioning a Patient
Never expose a patient during any exam or procedure
Door should be closed and curtain drawn
Properly drape/cover patient to ensure privacy but at the same time allow proper access for examination

32. Positions Horizontal recumbent or supine position
Pt is lying flat on their back with legs slightly apart
One small pillow is under the head
Arms flat on the side of the body
Patient drape is always used
Used to examine or treatment of the front part of the body

33. Horizontal Recumbent or Supine

34. Prone Position Used to examine or treat the back of the patient
Patient lies on his or her abdomen with head turned to either side – a small pillow may be used under the head
Arms may be flexed at the elbow or positioned on either side
Drape is always used

35. Supine vs. Prone

36. Lithotomy Position (continued)
Used for gynecological examinations- vaginal, PAP tests, urine catherizations, cystoscopy exams and surgery of the pelvic area
Position on the back
Knees separated and flexed and feet are placed in stirrups
Arms rest at the sides
Buttock at the lower end of the table/bed
Drape is always used

37. Lithotomy

38. Dorsal Recumbent Position
Similar to Lithotomy but patient has feet on the bed not in stirrups
Knees are bent
Feet flat on the bed
Draping is always used
Do Not Confuse with HORIZONTAL RECUMBENT

39. Dorsal Recumbent Position

40. Trendelenburg Position
Used to increase blood flow to the head and brain
Patient lies in the horizontal position
The head is lower than the feet
Commonly used when a patient is in shock

41. Trendelenburg Position

42. Jackknife Position Mainly used for rectal surgery
Patient is in prone position
Table is elevated at the center so that the rectal area is at a higher elevation
Special table is required for this position
Draping as indicated

43. Sims Lateral Position
Used for simple rectal exams, enemas, and other rectal treatments
Patient lies on the left side
Left are is extended behind the back
Head turned to the side
Right arm is in front of the patient and elbow is bent
Left leg is slightly bent
Right leg is bent sharply at the knee and brought into the abdomen
Drape the patient accordingly

44. Fowlers Position
Used to help facilitate breathing, receive distress, encourage drainage and exam the head, neck & chest
Patient lies on their back
Legs flat and slightly bent
Drape the patient for privacy
Head is in one of three different elevations
Low fowler- 25 degree angle
Semi-fowlers- 45 degree angle
High fowlers- 90 degree angle

45. Fowlers Position

46. Knee- Chest Position Used for rectal exams
Patient rests on the body weight
Arms are flexed slightly at the elbows and extended above the head
Knees are slightly separated and the thighs are at the right angles to the table

47. Knee Chest Position

48. Tips
REMEMBER
to use good body mechanics while positioning patients to protect yourself as well as the patient!!

50. 20:3 Screening for Vision Problems
Vision screening tests
Types of Snellen charts
Interpretation of readings on Snellen chart
Snellen chart tests only for defects in distant vision
Nearsightedness or myopia
(continues)

51. Screening for Vision Problems (continued)
Test for color blindness
Terms or abbreviations
Basic principles and procedure for screening vision with Snellen chart
Procedure for screening vision by the Jaeger system

52. 20:4 Assisting with Physical Examinations
Large variety of physical examinations are performed
Major types of examinations
Techniques used during the examination
Equipment used for examination
Preparation of the patient
(continues)

53. Assisting with Physical Exams (continued)
Tests done prior to physical examinations
Be prepared to assist as needed
Observe standard precautions
(continues)

54. Assisting with Physical Exams (continued)
Basic principles for eye, ear, nose, and throat (EENT) examination
Guidelines for assisting with a gynecological examination
Procedure for assisting with a general physical examination

55. 20:5 Assisting with Minor Surgery and Suture Removal
Done in medical, surgical, and other health care facilities
Various types of procedures done
Instruments and equipment
Strict sterile technique used to prepare surgical tray
(continues)

56. Assisting with Minor Surgery and Suture Removal (continued)
Skin prep
Local anesthetic
Will be expected to assist as needed
Sterile dressings available to use
Suture removal
Patients often fearful and apprehensive
(continues)

57. Assisting with Minor Surgery and Suture Removal (continued)
Specimens
Observe standard precautions
Basic principles of assisting with minor surgery
Basic guidelines for assisting with suture removal

58. 20:6 Recording and Mounting an Electrocardiogram
Electrical conduction pattern in the heart
Waves and what they show
Twelve-lead electrocardiogram (ECG)
Electrodes
Lead markings
(continues)

59. Recording and Mounting an Electrocardiogram (continued)
Basic parts of ECG machine
PQRST pattern
Reassure patient
Mounting ECG leads
Basic principles for recording and mounting an ECG

60. 20:7 Using the Physicians’ Desk Reference (PDR)
Provides information about drugs and medications currently in use
Published yearly—periodic supplements
Consists of six main sections
(continues)

61. Using the PDR (continued)
Manufacturers’ index
Brand and generic names
Product classification
Product identification guide
Product information
Diagnostic product information

62. 20:8 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
(continues)

63. 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
(continues)

64. 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

65. 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

66. 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

67. 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