General Patient Care 1 and 2

Thermometer

Used to measure body temperature

Stethoscope

Used to amplify sounds in the body, such as the beating of the heart, respirations in the lungs, and bowel sounds in the abdomen

Sphygmomanometer

Used to measure blood pressure

Pulse oximeter:

Used to measure oxygen saturation in the blood

Reflex hammer:

Used for testing reflexes

Otoscope:

Used to examine the ears

Ophthalmoscope:

Used to examine the interior of the eye, especially the retina

Maintaining a Clean Examination Area

At the beginning of the day,

• check that all the rooms are adequately stocked, have been properly cleaned and equipment is properly functioning.

• Anticipating items that might be needed for a visit and preparing the room in advance

• ​​​​​​​Surfaces should be cleaned at the beginning and end of each day and between patients to reduce the risk of transmitting infectious agents.

• Clean the examination table with the proper disinfectant and allow it to dry before placing new paper on the table. The paper covering the exam table must be disposed of and replaced between each patient.

• If available, change pillow covers after each patient.

• Reusable equipment must be taken to the appropriate area for cleaning and disinfection, following standard precautions.

Maintaining a Clean Examination Area

​​​​​At the end of each day,

• disinfect the work area and stock the exam rooms.

• Stock routine items, such as gloves, paper towels, exam gowns, table paper, and sharps and biohazard waste containers, in each of the examination rooms.

• Other supplies and items may need to be added depending on the patient and procedure.

Preparing for the Examination

Prior to the patient’s arrival,

• review the patient’s medical record, including the completed history and physical examination, understand the procedure and what supplies and equipment will be needed.

  • several tests and procedures require specific patient preparation prior to the procedure, such as a colonoscopy or a fasting glucose test.

• Explain and review the needed preparation with the patient and verify that all instructions were followed before the procedure.

  • If the patient did not complete necessary preparation or they have any questions, direct them to the health care provider.

• Confirm that an informed consent has been signed and is in the patient’s medical record.

After Entering

• ​​​​​​​Explain the procedure and the importance of the procedure in an empathetic, simple, and direct manner.

• Avoid overly technical terms and encourage patient to ask questions and express any anxiety or concerns.

Undressing

• Ask patients to empty their bladder before undressing. If a urine sample is required, give complete and detailed instructions.

• Explain to the patient which items of clothing should be removed for the exam and instruct them whether to put on the gown with the opening in the front or the back.

• Assist patients with disrobing and with stepping up onto the examination table as needed.

• Inform patients where their personal clothing and belongings can be stored during the examination. Once the patient is ready, notify the health care provider.

• After the procedure, assist the patient down from the examination table if needed. The patient may become lightheaded when sitting up if they were lying down for the procedure.

• Allow the patient privacy when getting dressed. Assist the patient with getting dressed as needed.

Providing Patient Education

• Provide the patient information about any follow-up appointments, additional exams, aftercare instructions, and referrals.

• Let the patient know when to expect results from lab, radiology, or any other diagnostic tests.

• Ask if the patient has any questions and direct appropriate questions to the health care provider to answer.

Older Adults

• Often the medical assistant who is responsible for reviewing their medication list and verifying the dosages taken.

  • Allot extra time for a patient who has an extensive medication history.

• Maintain a calm, relaxed, and respectful manner when interacting. Do not rush, speak clearly and slowly, and repeat questions or instructions, if necessary.

• Allow ample time for the patient to process or recall information. Avoid affectionate terms, such as “sweetie” or “honey

Physical Disability

• You may need to provide additional assistance while escorting patients to the examination room or provide extra care when assisting them on or off the examination table.

• Offer any assistance if it appears the patient needs it.

• Allow the patient to do as much as possible independently and ask before you touch a patient.

• Do not leave the patient unattended if the patient is physically unstable or appears confused.

  • If you are unable to remain in the room, a family member or another medical assistant should sit with the patient until the health care provider is ready

• If a patient arrives in a wheelchair, assist as needed.

  • Communicate with the patient prior to touching them or their wheelchair.

  • If a transfer is necessary between a wheelchair to the exam table, request assistance from a team member.

  • Lock the wheels and to position the chair before trying to help the patient move from the chair to the exam table.

Children

• Smile and speak to the child at eye level.

• Speak gently and calmly with an even tone, avoid using “baby talk,”

• Depending on the child, role playing can be helpful, particularly when preparing a patient for a procedure or trying to get more information from the patient, for example, asking the child to point on a stuffed animal where the pain may be located.​​​​​​​

• Children should never be left alone on an examination table, scale, toilet, or other place that could pose possible danger for falling or other injury.

• Always place a protective hand on infants to protect them from rolling or falling.

During Procedure - Children

• Plan extra time to explain to the child what is being done and to provide a sense of calmness.

• Explain in simple, age-appropriate terms exactly what you want them to do.

• Holding or entertaining an uncooperative child may be necessary so that an examination or procedure can be safely performed.

Examination rooms must conform to the standards

established by the Americans with Disabilities Act (ADA).

Americans with Disabilities Act (ADA) Standards

designed to make sure that people who have disabilities are not discriminated against in public places because of a lack of proper accommodations. Address such things as the width of doorways and hallways; placement of door handles, grab bars, and handrails; spatial accommodations for patients in wheelchairs; and floor surfaces.

Supine

also known as the horizontal recumbent position, patients lie flat on their back with hands at the sides. Be sure that the patient’s feet are supported by extending the examination table.

• Used to examine anything on the anterior or ventral (front) surface of the body (head, chest, stomach) and for certain types of x-rays.

• May not be comfortable for patients who have difficulty breathing or who have lower back problems. Placing a pillow under the head and under the knees may help alleviate pain and provide more comfort.

Prone

patient lies face down, flat on the stomach, with the head turned to one side, and arms either alongside the body or crossed under the head.

• Used for back exams and certain types of surgery

Dorsal Recumbent

patient is lying flat on the back with knees bent and feet flat on the examination table.

• Position relieves strain on the lower back and relaxes abdominal muscles.

• Used to inspect the head, neck, chest, vaginal, rectal, and perineal areas.

• Can be used for digital (using the gloved fingers) exams of the vagina and rectum. To drape the patient, place the drape at the patient’s neck or underarms and cover the body down to the feet.

Lithotomy

similar to the dorsal recumbent position, except the patient’s feet are placed in stirrups attached to the end and sides of the table. Stirrups locked in place to ensure patient safety. After the feet are in place in the stirrups, the patient is instructed to slide down until the buttocks are positioned at the edge of the table. The patient is draped from under the arms to the ankles.

• This position is used for vaginal examinations, often requiring the use of a vaginal speculum (an instrument used to hold open the walls of the vagina) and for obtaining cell samples of the cervix.

Fowler’s

patient sits on the examination table with the head of the table raised to a 90-degree angle. If able, the patient may be seated on the edge of the table with feet over the edge in an upright position.

• Useful for examinations of the head, neck, and upper body.

• Patients who have difficulty breathing in the supine position may find this position more comfortable.

• The drape should be placed over the patient’s lap and cover the legs.

Left Lateral

also known as lateral semi-prone recumbent position and formerly known as Sims' position. Patient is placed on the left side with the right leg sharply bent upward and the left leg slightly bent. The right arm is flexed next to the head for support. The patient is draped from under the arm or shoulders to below the knees at an angle.

• Used for rectal exams, taking rectal temperatures, enemas, and perineal and pelvic exams.

Knee–Chest

patient is placed in the prone position and then asked to pull the knees up to a kneeling position with thighs at a 90-degree angle to the table and buttocks in the air. The head is turned to one side, and the arms may be placed under the head or on either side of the head for comfort and support.

• Used for proctologic exams, sigmoidoscopy procedures, and rectal and vaginal exams

Parenteral medication administration

non-oral. Generally, the medication is injected directly into the body, bypassing the gastrointestinal tract

Nonparenteral, or enteral, administration

oral medication given by the mouth delivered to the gastrointestinal tract.

Intravenous

Injection administered directly into the vein

Sublingual

Placed under the tongue

Buccal

Between the cheek and gums resulting in rapid absorption

Inhalation

Inhaled through the mouth, passes through the trachea into the lungs; inhaled through the nose and absorbed through the nasal mucous membrane