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Chapter 39 - Assisting with examinations in the basic specialties. This chapter introduces you to the basic specialties of internal medicine, pediatrics, and obstetrics and gynecology. You will learn about the types of examinations and diagnostic tests used in these specialties and about the common diseases and disorders seen in these specialities.
CHAPTER 39 Assisting with Examinations in the Basic Specialties © 2011 The McGraw-Hill Companies, Inc All rights reserved 392 Learning Outcomes 39.1 Describe the medical specialties of internal medicine, obstetrics and gynecology, and pediatrics 39.2 Identify the types of examinations and diagnostic tests performed in internal medicine, obstetrics and gynecology, and pediatrics 39.3 Discuss the role of the medical assistant in working in internal medicine, obstetrics and gynecology, and pediatrics 39.4 Identify common diseases related to internal medicine, obstetrics and gynecology, and pediatrics © 2011 The McGraw-Hill Companies, Inc All rights reserved 393 Learning Outcomes (cont.) 39.5 Describe typical treatments for diseases related to internal medicine, obstetrics and gynecology, and pediatrics 39.6 Identify common signs of domestic violence, elder abuse, and child abuse 39.7 Carry out the procedure for assisting with gynecological examinations and procedures 39.8 Carry out the procedure for meeting the needs of a pregnant patient during an examination © 2011 The McGraw-Hill Companies, Inc All rights reserved 394 Introduction • Specialties – Specialist – physician with additional training, residencies, and certification – Types of examinations and diagnostic tests – Common diseases and disorders • Medical assistant – Assist with specialty examinations – Observe for signs of domestic violence and child abuse © 2011 The McGraw-Hill Companies, Inc All rights reserved The Medical Assistant’s Role in Specialty Examinations • Medical practice act – Defines the exact duties of physicians and other healthcare personnel • 395 Medical assistants – May perform clinical procedures only under the supervision of the physician State laws vary You will need to know the scope of practice for medical assistants in the state where you work © 2011 The McGraw-Hill Companies, Inc All rights reserved The Medical Assistant’s Role in Specialty Examinations (cont.) 396 • Providing emotional support • Providing patient education – Effective communication – Provide educational materials – Verify understanding © 2011 The McGraw-Hill Companies, Inc All rights reserved 397 Apply Your Knowledge What defines the procedures health-care personnel can perform, and how you determine what you are able to as a medical assistant? ANSWER: In addition to education, training, and certification, the state’s medical practice act defines what duties and procedures health-care personnel can perform As a medical assistant, you have to know your scope of practice for the state where you work © 2011 The McGraw-Hill Companies, Inc All rights reserved 398 Internal Medicine • Diagnosis and treatment of disorders and diseases of the body’s internal organs • Internist – Often first to see patient – Uses medication and/or treatment modalities – Refers to a specialist © 2011 The McGraw-Hill Companies, Inc All rights reserved 399 Assisting with the Physical Examination • Usually the same as a general physical examination • Medical assistant responsibilities – Gathering information • Detect substance abuse, domestic violence, or elder abuse – Preparing patient for the examination © 2011 The McGraw-Hill Companies, Inc All rights reserved 3910 Detecting Substance Abuse • Signs vary and depend on – Type of drug – Patient’s response to the drug • Report suspicion of substance abuse to the physician Know state requirements for reporting â 2011 The McGraw-Hill Companies, Inc All rights reserved Assisting with the Pediatric Physical Examination (cont.) 3953 • Examining for growth abnormalities – Compare the child’s physical, intellectual, and social signs to national averages – Growth stages • • • • One and Two – first and second years Three – ages to years Four – age years to puberty Five – adolescence © 2011 The McGraw-Hill Companies, Inc All rights reserved Assisting with the Pediatric Physical Examination (cont.) • General eye exam – Pediatrician examines interior of the eye – Visual acuity testing • General ear exam – Children more susceptible to ear infections 3954 • Diagnostic testing – Most are same as for adults – Rapid test for presence of streptococcal bacteria – Throat cultures – Urine specimens – Blood specimens © 2011 The McGraw-Hill Companies, Inc All rights reserved Assisting with the Pediatric Physical Examination (cont.) 3955 • Immunizations – Store vaccines properly – Administer vaccines correctly – Maintain careful immunization records – Educate parents – Follow recommended schedule for follow-up appointments © 2011 The McGraw-Hill Companies, Inc All rights reserved 3956 Diseases and Disorders • Frequently seen in pediatric office – Common childhood diseases (Table 39-2) – Upper respiratory infections • Do not make assumptions regarding diagnosis or treatment • Do not recommend aspirin for fever in children © 2011 The McGraw-Hill Companies, Inc All rights reserved 3957 Diseases and Disorders (cont.) Condition Description AIDS Most transmitted from mother to infant; decreased chance of infected infant if mother is being treated Juvenile rheumatoid arthritis Autoimmune disease of the joints; occurs in children 16 years or younger ADHD All conditions identified as hyperactivity, hyperkinesis, and attention deficit Learning disabilities Conditions that interfere with learning, including dyslexia, dysgraphia, and dyscalculia © 2011 The McGraw-Hill Companies, Inc All rights reserved 3958 Diseases and Disorders (cont.) Condition Description Cerebral palsy Birth-related disorder of nerves and muscles; caused by brain damage occurring before, during, or after birth Congenital Cardiovascular malformations in the fetus before birth; heart disease causes include genetic mutations, maternal infections, maternal alcoholism, or maternal insulin-dependent diabetes Down syndrome Genetic disorder due to one extra chromosome in all cells formed during fetal development; characteristic facial features © 2011 The McGraw-Hill Companies, Inc All rights reserved 3959 Diseases and Disorders (cont.) Condition Description Hepatitis B Infection of liver; virus can be transmitted from the mother before or during birth; immunization available RSV Major cause of lower respiratory infections; highly contagious; difficult to treat; antibiotics only treat any secondary infections SIDS Unexplained sudden death of an infant during sleep; usually occurs before months old; “Back to Sleep” © 2011 The McGraw-Hill Companies, Inc All rights reserved 3960 Diseases and Disorders (cont.) Condition Description Spina bifida Defect of spinal development occurring during the first trimester of pregnancy; spinal cord not fully protected because tissues fail to close around it Viral gastroenteritis Inflammation of stomach and intestines; can cause dehydration and electrolyte imbalance due to fluid loss © 2011 The McGraw-Hill Companies, Inc All rights reserved 3961 Patient and Caregiver Education • Answer questions appropriately • American Academy of Pediatrics – Brochures and booklets © 2011 The McGraw-Hill Companies, Inc All rights reserved 3962 Apply Your Knowledge What are the responsibilities of the medical assistant relating to immunizations? ANSWER: The medical assistant should be sure that vaccines are stored properly, administer vaccines correctly (if within scope of practice), maintain careful immunization records, educate parents, follow recommended immunization schedule for follow-up appointments Super! © 2011 The McGraw-Hill Companies, Inc All rights reserved 3963 In Summary 39.1 Internal medicine practitioners diagnose and treat diseases and disorders of the internal organs An obstetrician/ gynecologist (OB/GYN) specializes in the female reproductive system, cares for pregnant women and delivers babies A pediatrician specializes in the health care of children 39.2 Examples of exams and diagnostic tests performed in internal medicine, obstetrics and gynecology and pediatrics include the basic physical exam, the gynecological exam, the cervical biopsy, and the well child exam © 2011 The McGraw-Hill Companies, Inc All rights reserved 3964 In Summary (cont.) 39.3 As a medical assistant in basic specialties, you might perform or assist with testing such as urine, blood tests, and bacterial cultures You might educate patients on diseases of aging, infectious diseases, and STDs 39.4 Some common diseases related to internal medicine include hypertension, coronary artery disease, and diabetes mellitus Childhood diseases include chickenpox, influenza, measles, mumps, rubella, scarlet fever, and tetanus Examples of diseases related to obstetrics and gynecology include cancer, endometriosis, and fibrocystic breast disease Other diseases are outlined in Tables 39-1, 39-3, and 39-5 © 2011 The McGraw-Hill Companies, Inc All rights reserved 3965 In Summary (cont.) 39.5 Typical treatments for diseases related to internal medicine, obstetrics and gynecology, and pediatrics include such things such as local or oral medication, including antibiotics, stress reduction, diet restrictions, and surgery Treatments are outlined in more detail in Tables 39-1, 39-3, and 39-5 39.6 Some common signs of domestic violence, elder abuse, and child abuse include unusual bruising or injuries that the patient tries to hide or excuse, foul odor, poor skin color, soiled clothing, and malnutrition Recognizing the signs of these three problems is essential to your role as a medical assistant © 2011 The McGraw-Hill Companies, Inc All rights reserved 3966 In Summary (cont.) 39.7 During a gynecological exam or procedure, you will need to ensure patient comfort and safety as well as assist the physician with patient positioning, draping, equipment, and specimens obtained 39.8 A pregnant woman will need to have her concerns and questions answered During late pregnancy, she may not be able to move into certain positions and will require assistance © 2011 The McGraw-Hill Companies, Inc All rights reserved 3967 End of Chapter 39 If pregnancy were a book they would cut the last two chapters ~ Nora Ephron © 2011 The McGraw-Hill Companies, Inc All rights reserved ... reserved 39 17 Diagnostic Testing • Radiologic testing – X-rays – CT scans – MRI scans – Ultrasound – Nuclear imaging • Medical assistant – Set up appointments – Explain procedures and preps... Specialist – physician with additional training, residencies, and certification – Types of examinations and diagnostic tests – Common diseases and disorders • Medical assistant – Assist with specialty... rights reserved 39 18 Diseases and Disorders • Diseases of aging – – – – Constipationdiarrhea cycle Hyperlipidemia Osteoporosis Alzheimer’s disease • Infectious diseases – – – – Lyme disease Pneumonia