Medical assisting Administrative and clinical procedures (5e) Chapter 38 Assisting with general physical examination
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CHAPTER
38
Assisting with
General Physical
Examination
38-2
Learning Outcomes (cont.)
38.1 Identify the purpose of a general
physical exam.
38.2 Describe the role of the medical
assistant in a general physical exam.
38.3 Explain safety precautions used during
a general physical exam.
38-3
Learning Outcomes (cont.)
38.4 Carry out the steps necessary to
prepare the patient for an exam.
38.5 Carry out positioning and draping a
patient in each of the nine common
exam positions.
38.6 Apply techniques to assist patients
from different cultures and patients with
physical disabilities.
38-4
Learning Outcomes (cont.)
38.7 Identify the six examination methods
used in a general physical exam.
38.8 List the components of a general
physical exam.
38.9 Describe follow-up steps after a
general physical exam.
38-5
Introduction
• Physical
examination – 1st
step in the
diagnosis or
treatment process
• The medical
assistant
– Make the client
comfortable
– Assist the
physician
A skilled medical assistant can create an
atmosphere that results in a positive outcome
for the patient during the physical examination.
38-6
The Purpose of General Physical Exam
• To confirm an overall state of health and
provide baseline values
• To diagnose a
medical problem
The Purpose of General Physical Exam
(cont.)
• Clinical diagnosis
– Sign ~ objective
– Symptom ~ subjective
• Laboratory and diagnostic tests
– Confirm clinical diagnosis
– Help determine the differential diagnosis
and prognosis
– Formulation of treatment plan
38-7
38-8
Apply Your Knowledge
Why does the physician perform a general physical
examination?
ANSWER: A physical examination is used to confirm the
patient’s overall state of health or to diagnose a medical
problem.
38-9
The Role of Medical Assistant
• To assist the licensed practitioner and the
patient
• Begins prior to the physical exam
– Interview
– Write an accurate history
– Determine vital signs
– Measure weight and height
38-10
The Role of Medical Assistant (cont.)
• Responsibilities
– Ensuring instruments and
supplies are available
– Ensuring patient comfort
• Helping into position
• Keeping them informed
• Observing them for distress or need for assistance
38-11
Apply Your Knowledge
What are your responsibilities when assisting with
a general physical exam?
ANSWER: Ensuring all supplies and instruments are
available for the physician and making sure the patient
is comfortable by
•Helping the patient into position
•Telling them what will happen
•Observing the patient for signs of distress or need for
assistance.
Hooray!
38-12
Safety Precautions
• OSHA standards and guidelines
– Protect employees
– Make the workplace safe
• CDC guidelines – protect patients and
health-care workers
38-13
Safety Precautions (cont.)
• Aseptic hand washing
– Before and after each
patient contact
– Before and after each
procedure
• Wear gloves if there may be contact with
– Blood
– Nonintact skin
– Body fluids
– Moist surfaces
– Also when handling specimens
38-14
Safety Precautions (cont.)
• Respiratory hygiene/cough etiquette
• Wear a mask to prevent exposure to an
infectious disease transmitted by
airborne droplets
• Isolation precautions – personal protective
equipment
38-15
Safety Precautions (cont.)
• Discard all disposable equipment and
supplies appropriately
• Clean and disinfect the exam
room after each patient
• Sanitize, disinfect, and sterilize
equipment appropriately
38-16
Apply Your Knowledge
Impressive!
Mrs. Jefferson brings her daughter, Laura, to the office
because of what she describes as an upper respiratory
infection. Laura is coughing and the medical assistant
notices a blister-like rash on her arms. What actions
should the medical assistant take?
ANSWER: Laura and her mother should be moved away from
other patients in the waiting room to a private area. Since she is
coughing and could have an infection spread by droplet, the
medical assistant and physician should wear a mask and gloves
when in the room. In addition, the room should be cleaned and
sanitized following the appointment.
38-17
Preparing the Patient for an Exam
• Emotional preparation
– Explain exactly what will occur and what they
will feel
– Use simple direct language
38-18
Preparing the Patient for an Exam
• Physical
– Offer the bathroom
– Ask the patient to disrobe and put on an exam
gown or cover with a drape
– Be aware of
modesty and
comfort
38-19
Apply Your Knowledge
What can you do to elicit the patient’s cooperation
during a physical exam?
ANSWER: Explain what she can expect to
happen during the examination and that her
cooperation will help the exam proceed
smoothly.
Way to go!
38-20
Positioning and Draping
• Proper patient position facilitates the
examination
– Assist the patient to appropriate position
– Make as comfortable as possible
– Cover with appropriate drape
• Keep patient warm
• Maintain privacy/modesty
38-21
Positioning and Draping (cont.)
• Sitting
• Supine/recumbent
– Symmetry
• Dorsal recumbent
38-22
Positioning and Draping (cont.)
• Lithotomy
• Fowler’s
38-23
Positioning and Draping (cont.)
• Prone
• Sims’
38-24
Positioning and Draping (cont.)
• Knee-Elbow
– Fenestrated drape
• Proctologic
38-25
Apply Your Knowledge
An elderly female patient needs her lower abdomen and
genitalia examined by the physician. What would be the
best position to place her in and why?
ANSWER: The dorsal recumbent position is recommended over
the lithotomy position because an elderly patient may have
difficulty placing her legs in stirrups.
