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© 2009 Delmar, Cengage Learning Chapter 20 Medical Assistant Skills
© 2009 Delmar, Cengage Learning Skills Lab Measuring height & weight 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
© 2009 Delmar, Cengage Learning 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)
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning
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 Measuring/Recording Height and Weight (continued)
© 2009 Delmar, Cengage Learning 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)
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning Weight Conversions
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning Notes on Weight Most people are weight conscious Make only positive statements when measuring all patients Remember to Ensure patient privacy at all times
© 2009 Delmar, Cengage Learning Types of Scales Weight Bar Scales
© 2009 Delmar, Cengage Learning Types of Scales Wheelchair Scale
© 2009 Delmar, Cengage Learning Types of Scales Bed Scales
© 2009 Delmar, Cengage Learning Types of Scales Bed with Scale
© 2009 Delmar, Cengage Learning Types of Scales Infant Scales
© 2009 Delmar, Cengage Learning Height Measurement Assessed in older adults to assess for osteoporosis Patient safety must always be considered Observe patients closely Prevent falls and injuries
© 2009 Delmar, Cengage Learning 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: 1. 60 in 2.45 in 3.25 in 4.75 in 5.18 in
© 2009 Delmar, Cengage Learning Height Conversions You must DIVIDE by 2.35 to convert cm to inches. Convert the following: 1.95 cm 2.120 cm 3.50 cm 4.18 cm 5.145 cm
© 2009 Delmar, Cengage Learning Student Assignment/ Skills Lab for 20:1 Complete worksheet for 20:1 Students will then perform Height & Weight measurements on each other
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning CONVERSION ANSWERS 1.54.5 KG 2.80 KG 3.90 KG 4.159 KG 5.15.4KG 6.165 LBS 7.220 LBS 8.55 LBS 9.217.8 LBS 10.319 LBS 11.141CM 12.105.7 CM 13.58.7 CM 14.176.2 CM 15.42.3 CM 16.40.4 IN 17.51 IN 18.21.2 IN 19.7.65 IN 20.61.7 IN
© 2009 Delmar, Cengage Learning Positioning Patients
© 2009 Delmar, Cengage Learning 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)
© 2009 Delmar, Cengage Learning 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)
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning Horizontal Recumbent or Supine
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning Supine vs. Prone
© 2009 Delmar, Cengage Learning Lithotomy Position (continued) Lithotomy position –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
© 2009 Delmar, Cengage Learning Lithotomy
© 2009 Delmar, Cengage Learning Dorsal Recumbent Position 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
© 2009 Delmar, Cengage Learning Dorsal Recumbent Position
© 2009 Delmar, Cengage Learning Trendelenburg Position 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
© 2009 Delmar, Cengage Learning Trendelenburg Position
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning Fowlers Position
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning Knee Chest Position
© 2009 Delmar, Cengage Learning Tips REMEMBER – to use good body mechanics while positioning patients to protect yourself as well as the patient!!
© 2009 Delmar, Cengage Learning
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)
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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)
© 2009 Delmar, Cengage Learning Assisting with Physical Exams (continued) Tests done prior to physical examinations Be prepared to assist as needed Observe standard precautions (continues)
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning (continues) 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
© 2009 Delmar, Cengage Learning 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)
© 2009 Delmar, Cengage Learning Specimens Observe standard precautions Basic principles of assisting with minor surgery Basic guidelines for assisting with suture removal Assisting with Minor Surgery and Suture Removal (continued)
© 2009 Delmar, Cengage Learning 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)
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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)
© 2009 Delmar, Cengage Learning Using the PDR (continued) Manufacturers’ index Brand and generic names Product classification Product identification guide Product information Diagnostic product information
© 2009 Delmar, Cengage Learning 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)
© 2009 Delmar, Cengage Learning 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)
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning 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
© 2009 Delmar, Cengage Learning Chapter 20 Medical Assistant Skills.
Unit 19 Medical Assistant Skills. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.2 19:1 Measuring/Recording Height and Weight Use:
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© 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.
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