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
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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)
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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
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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
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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
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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)
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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
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Equipment
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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
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Weight Conversions
© 2009 Delmar, Cengage Learning
Convert the following to kilograms:
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120 lbs
176 lbs
200 lbs
350 lbs
34 lbs
You must DIVIDE by 2.2 kg to perform this
conversion
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Convert the following weight to pounds:
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75 kg
100 kg
25 kg
99kg
145 kg
You must MULTIPLY by 2.2 to perform this
conversion
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Notes on Weight
• Most people are weight conscious
• Make only positive statements when
measuring all patients
• Remember to Ensure patient privacy at all
times
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Types of Scales
• Weight Bar Scales
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Types of Scales
• Wheelchair Scale
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Types of Scales
• Bed Scales
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Types of Scales
• Bed with Scale
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Types of Scales
• Infant Scales
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Height Measurement
• Assessed in older adults to assess for
osteoporosis
• Patient safety must always be considered
• Observe patients closely
• Prevent falls and injuries
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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
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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
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Student Assignment/ Skills Lab for 20:1
• Complete worksheet for 20:1
• Students will then perform Height & Weight
measurements on each other
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How to Weigh a Patient:
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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
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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
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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
1.
2.
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20.
54.5 KG
80 KG
90 KG
159 KG
15.4KG
165 LBS
220 LBS
55 LBS
217.8 LBS
319 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
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Positioning Patients
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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)
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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 selfinjury
(continues)
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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
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Positions
• Horizontal recumbent or supine position
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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
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Horizontal Recumbent or Supine
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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
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Supine vs. Prone
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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
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Lithotomy
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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
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Dorsal Recumbent Position
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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
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Trendelenburg Position
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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
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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
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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
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Fowlers Position
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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
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Knee Chest Position
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Tips
• REMEMBER
– to use good body mechanics while
positioning patients to protect
yourself as well as the patient!!
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© 2009 Delmar, Cengage Learning
20:3 Screening for Vision Problems
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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)
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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
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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)
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Assisting with Physical Exams
(continued)
• Tests done prior to physical examinations
• Be prepared to assist as needed
• Observe standard precautions
(continues)
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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
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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)
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Assisting with Minor Surgery
and Suture Removal
(continued)
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Skin prep
Local anesthetic
Will be expected to assist as needed
Sterile dressings available to use
Suture removal
Patients often fearful and apprehensive
(continues)
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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
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20:6 Recording and Mounting
an Electrocardiogram
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Electrical conduction pattern in the heart
Waves and what they show
Twelve-lead electrocardiogram (ECG)
Electrodes
Lead markings
(continues)
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Recording and Mounting
an Electrocardiogram
(continued)
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Basic parts of ECG machine
PQRST pattern
Reassure patient
Mounting ECG leads
Basic principles for recording and mounting
an ECG
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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)
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Using the PDR
(continued)
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Manufacturers’ index
Brand and generic names
Product classification
Product identification guide
Product information
Diagnostic product information
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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)
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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)
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Working with Math and Medications
(continued)
• Six rights to observe when giving
medications
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Right medication
Right dose or amount
Right patient
Right time
Right method or route of administration
Right documentation
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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
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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
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Household or English
System of Measurement
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Common system used in the United States
Many different units of measurement
Conversion of household to metric
Conversion of metric to household
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