Curriculum to Accompany
Medical Assisting:
Administrative and Clinical Competencies,
6th Edition
Course:
Diagnostic Tests, Equipment, and Procedures
1
Curriculum to Accompany Medical Assisting: Administrative and
Clinical Competencies, 6th Edition
Course: Diagnostic Tests, Equipment, and Procedures
Contents
Part A: Diagnostic Tests
Part B: Cardiology Procedures
Part C: Diagnostic Procedures
Part D: Diagnostic Radiologic Examinations
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Curriculum to Accompany Medical Assisting: Administrative and
Clinical Competencies, 6th Edition
Course: Diagnostic Tests, Equipment, and Procedures
Course Overview
In addition to building the medical database with the medical history, vital signs, and
laboratory tests, the medical assistant may have a key role in other diagnostic tests,
cardiology procedures, and diagnostic radiologic tests. In some cases, the extent of your
responsibility could include patient instruction for preparation of a test while in other
cases you may be assigned the task of actually administering the test. Either way, it is
important to have the foundational principles introduced to you so you will be adequately
prepared for your externship and employment after graduation. Remember that you
should only perform duties within the scope of your position and allowed by individual
state laws.
Resource List
Textbook: Medical Assisting: Administrative and Clinical Competencies, Sixth Edition,
by Lucille Keir, Barbara Wise, Connie Krebs, and Cathy Kelley-Arney. © 2008, Delmar
Cengage Learning, ISBN 1-4180-3266-2. Chapter 16.
Student CD-ROM: CD-ROM that accompanies Medical Assisting: Administrative and
Clinical Competencies, Sixth Edition. This CD-ROM contains StudyWARE, The Critical
Thinking Challenge, and an Audio Library.
Workbook: Workbook to accompany Medical Assisting: Administrative and Clinical
Competencies, Sixth Edition, by Lucille Keir, Barbara Wise, Connie Krebs, and Cathy
Kelley-Arney. © 2008, Delmar Cengage Learning, ISBN 1-4180-3267-0. Chapter 16.
Instructor’s Materials: Instructor’s Resource Manual to accompany Medical Assisting:
Administrative and Clinical Competencies, Sixth Edition, by Lucille Keir, Barbara Wise,
Connie Krebs, and Cathy Kelley-Arney. © 2008, Delmar Cengage Learning, ISBN 14180-3268-9.
Instructor’s CD-ROM: Electronic Classroom Manager to accompany Medical
Assisting: Administrative and Clinical Competencies, Sixth Edition, by Lucille Keir,
Barbara Wise, Connie Krebs, and Cathy Kelley-Arney. © 2008, Delmar Cengage
Learning, ISBN 1-4180-3269-2.
The Internet: It is strongly recommended that faculty and learners alike have a working
knowledge of the Internet.
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Equipment List
1. Multimedia projector
2. Computer with Internet access
3. Multimedia equipment
4. AAMA credentialing information
5. AMT credentialing information
6. DVD player
CAAHEP content
III.C.1.c.(1)
Legal guidelines/requirements for health care
III.C.1.g.(3)
Diagnostic testing
III.C.1.g.(4)
Patient care and instruction
III.C.1.g.(6)
Medical emergencies
ABHES content
VI.B.1.b.9.f.
Specialties
VI.B.1.b.9.d.1.
Medical equipment – electrocardiogram
VI.B.1.b.9.d.1.
Medical equipment – spirometer
VI.B.1.b.9.d.3.a
Radiography – safety
VI.B.1.b.9.d.3.b
Radiography – patient preparation
VI.B.1.b.9.d.3.c
Radiography – radiography of chest and extremities
CAAHEP competencies
III.C.3.b.(3)(c)(iv)
Perform immunology testing
III.C.3.b.(4)(f)
Prepare patient for and assist with procedures, treatments,
and minor office surgeries
III.C.3.b.(4)(i)
Screen and follow up test results
III.C.3.b.(3)(a)
Perform electrocardiography
III.C.3.c.(3)(b)
Instruct individuals according to their needs
III.C.3.c.(3)(c)
Provide instruction for health maintenance and disease
prevention
III.C.3.b.(3)(b)
Perform respiratory testing
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ABHES competencies
VI.B.1.a.4.(e)
Recognize emergencies
VI.B.1.a.4.(h)
Prepare patient for and assist physician with routine and
specialty examinations and treatments and minor office
surgeries
VI.B.1.a.4.(l)
Screen and follow up patient test results
VI.B.1.a.4.(bb)
Perform immunology testing
VI.B.1.a.4.(dd)
Perform electrocardiograms
VI.B.1.a.4.(ee)
Perform respiratory testing
VI.B.1.a.4.(b)
Prepare patients for procedures
VI.B.1.a.5(g)
Monitor legislation related to current healthcare issues and
practices
VI.B.1.a.7.(b)
Instruct patients with special needs
Learning Activities
(HW) Terminology Notebook. Assign chapter for reading and have students define key
terms and retain in a key term notebook for future reference.
(ICA) Competency evaluation, Procedure 16-1. Demonstrate the proper technique for
performing a scratch test; have each student return the demonstration for evaluation of
competency of Procedure 16-1.
(ICA) Competency evaluation, Procedure 16-2. Demonstrate the proper technique for
performing a patch test; have each student return the demonstration for evaluation of
competency of Procedure 16-2.
(HW) Chapter 16, Unit 1 Workbook Assignment Sheet
(ICA) Role play lead placement. Have the students identify the proper placement of the
limb and chest electrodes
(ICA) Lead coding activity. Show the student a printed lead to observe the coding
system for ECG’s
(ICA) Competency evaluation, Procedure 16-3. Demonstrate the procedure for obtaining
and ECG; have each student to return the demonstration for evaluation of competency of
Procedure 16-3. Retain the ECG tracing as the work product documenting achievement
of the competency
(ICA) Standardization marks activity. Point out the standardization marks on the ECG
tracings to the students
5
(ICA) Competency evaluation, Procedure 16-4. Instruct the students on the use of
patient Holter monitors followed by evaluation of the competency of each student for
Procedure 16-4.
(HW) Chapter 16, Unit 2 Workbook Assignment Sheet
(ICA)(HW) Patient education brochure. Have students research and prepare a brief
pamphlet of instructions for patients scheduled for spirometry testing.
(ICA) Competency evaluation, Procedure 16-5. Explain the facility’s spirometer
operation and demonstrate the proper procedure for perform a spirometry test. Have the
students to return the demonstration for evaluation of competency of Procedure 16-5. If
the instrument provides a print-out of results, attach it as the work product for evidence of
achievement of the procedure.
(ICA)(HW) MRI Project. Have the students research the open MRI that is now
available and write a synopsis of their findings.
(HW) Chapter 16, Unit 3 Workbook Assignment Sheet
(ICA) Radiologic procedures patient education brochure. Make an assignment for the
students to prepare a comprehensive informational brochure outlining patient preparation
for each of the listed radiologic procedures presented in the text
(HW) Chapter 16, Unit 4 Workbook Assignment Sheet
(HW) The Critical Thinking Challenge, page 869.
(HW) The StudyWare Challenge, Chapter 16. Have students take the Quiz in “Quiz
Mode” and either email their scores to the instructor, or print the scores to turn in.
(ICA) Following review of the chapter and homework assignments, give a quiz on this
chapter that includes the content and competencies listed for CAAHEP and ABHES.
Part A: Diagnostic Tests
Learning Objectives
Cognitive
1. Read and define the Words to know in the unit.
2. Describe scratch, patch, and intradermal skin tests and state their purpose.
3. Describe the schedule and instructions for administering allergy injections.
4. Describe patient education concerning allergies and treatment.
Psychomotor
5. Perform a scratch skin test.
6. Perform a patch skin test.
6
Key Concepts
References & Activities
Slides
Skin tests
Pages 833-835
3-5
(HW) Terminology
Notebook
Anaphylactic shock
Page 834
Alternating pattern for injections
Page 835
Figure 16-2A
Scratch test/skin prick test
Pages 836-837
Procedure 16-1
(ICA) Competency
evaluation, Procedure
16-1
Intradermal test
Page 838
6
Patch test
Page 839
4
Procedure 16-2
(ICA) Competency
evaluation, Procedure
16-2
RAST testing
Page 839
Nasal smear
Page 840
8
(HW) Chapter 16, Unit 1
Workbook Assignment
Sheet
(ICA) In-Class Activities
1. Competency evaluation, Procedure 16-1. Demonstrate the proper technique for
performing a scratch test; have each student return the demonstration for
evaluation of competency of Procedure 16-1.
2. Competency evaluation, Procedure 16-2. Demonstrate the proper technique for
performing a patch test; have each student return the demonstration for evaluation
of competency of Procedure 16-2.
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(ICD) In-Class Discussion
1. What are three common procedures used to determine allergic reactions?
The scratch, intradermal, and patch tests
2. What is a severe allergic reaction called and what are some of the symptoms?
The medical term for such a reaction is anaphylaxis or anaphylactic shock; some of the
symptoms include intense anxiety, weakness, sweating, shortness of breath, hypotension,
shock, cardiac arrhythmia, respiratory congestion, laryngeal edema, nausea, and/or
diarrhea
3. Identify the difference(s) between an allergy injection and allergy testing.
Allergy injections are used as a desensitizing agent after a patient has been diagnosed
with specific allergies; allergy testing is the tool used to identify what those allergies may
be.
4. Where on the body are scratch tests usually administered?
The arms and back.
5. How soon do reactions occur following the application of the antigens?
Reactions will usually be visible within the first 20 minutes after application.
6. What medication should be injected if a patient experiences a severe allergic
reaction to an antigen?
A health care provider will order a subcutaneous injection of epinephrine (adrenalin) to
reverse the symptoms and prevent anaphylaxis.
7. Name a long-standing allergy screening test performed on a nasal smear.
The eosinophil count has been used for many years.
(HW) Homework Assignments
1. Terminology Notebook. Assign unit for reading and have students define key
terms and retain in a key term notebook for future reference.
2. Chapter 16, Unit 1 Workbook Assignment Sheet
Presentation Tools
Note to Instructors: If you change Objectives or Assignments, don’t forget to change the
slides accordingly.
Chapter
Introduce the course and unit.
8
16, Unit 1,
Slides 1-2
Slides 3-4
Scratch skin tests
Slide 5
Patch skin tests
Slide 6
Intradermal skin tests
Slide 7
Allergy injections
Slide 8
RAST testing
 Identify what RAST represents as an abbreviation
Slide 9
Have students answer the checkpoint questions on the slide to review
the content in the unit.
Part B: Cardiology Procedures
Learning Objectives
Cognitive
1. Spell and define the Words to Know in the unit.
2. Explain the reasons for performing an ECG.
3. Describe the electrical conduction system of the heart.
4. Describe methods of a routine 12-lead ECG.
5. Define artifacts and list their causes on an ECG.
6. Describe the reason for mounting an ECG tracing.
7. State the purpose of a Holter monitor, and explain the procedure to a patient.
8. State the purpose of defibrillation.
9. Describe cardiac stress testing, and discuss the proper placement of the electrodes.
10. State the purpose of cardiac stress testing.
11. Describe patient education regarding the heart.
Psychomotor
12. Apply limb and chest electrodes properly.
13. Perform a routine 12-lead ECG.
14. Demonstrate the procedure for proper hook-up of a Holter monitor.
9
Key Concepts
References & Activities
Slides
Electrocardiogram—overview and
equipment
Page 841
11
Cardiac impulses
Page 842
Anatomy of the heart
Page 843
(HW) Terminology
Notebook
12-14
Figure 16-16
Proper ECG lead placement
Pages 843-845
Figures 16-18, 16-19,
and 16-20
(ICA) Role play lead
placement
Lead types, connections, and placement
Page 845
Figure 16-19
Obtaining a standard ECG
Pages 846-848
15
Procedure 16-3
Patient Education Box,
page 853
(ICA) Lead coding
activity
(ICA) Competency
evaluation, Procedure
16-3
Artifacts and interference
Pages 848-851
16-24
Figure 16-23
Standardization
Pages 851-853
25
(ICA) Standardization
marks activity
Stress testing
Page 853
29
Holter monitor testing
Page 855
26-27
Procedure 16-4
10
(ICA) Competency
evaluation, Procedure
16-4
Defibrillator and other cardiovascular
equipment
Page 856
28
(HW) Chapter 16, Unit 2
Workbook Assignment
Sheet
(ICA) In-Class Activities
1. Role play lead placement. Have the students identify the proper placement of the
limb and chest electrodes
2. Lead coding activity. Show the student a printed lead to observe the coding
system for ECG’s
3. Competency evaluation, Procedure 16-3. Demonstrate the procedure for obtaining
and ECG; have each student to return the demonstration for evaluation of
competency of Procedure 16-3. Retain the ECG tracing as the work product
documenting achievement of the competency
4. Standardization marks activity. Point out the standardization marks on the ECG
tracings to the students
5. Competency evaluation, Procedure 16-4. Instruct the students on the use of
patient Holter monitors followed by evaluation of the competency of each student
for Procedure 16-4.
(ICD) In-Class Discussion
1. What part of the ECG instrument prints the tracing?
The stylus
2. When the sinoatrial node fires an electrical impulse causing the atria to contract,
this is the beginning of what part of the cardiac cycle?
This is known as atrial depolarization.
3. Identify the leads of a 12 lead ECG.
The first three are standard/bipolar leads with the next three being augmented leads.
The final six are known as chest or precordial leads.
4. What might cause a wandering baseline?
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Improperly applied electrodes or improperly cleaned skin may result in the electrodes not
making good contact, thus causing a wandering baseline.
5. Give the dimensions of the usual standardization mark.
The dimensions are 2 mm wide by 10 mm tall.
6. What is the normal running speed of the ECG tracing?
25 mm/sec
7. When should an individual have their first screening ECG?
The baseline ECG should be performed between ages 35-40.
8. How does a Holter monitor assist in diagnosing cardiac problems?
The heart is monitored for a 24 hours period with the patient maintaining a diary of any
cardiac related events. The tracing reveals arrhythmias, effectiveness of medications,
and helps to correlate symptoms with the patient’s activities.
(HW) Homework Assignments
1. Terminology Notebook. Assign the unit for reading and have students define key
terms and retain in a key term notebook for future reference.
2. Chapter 16, Unit 2 Workbook Assignment Sheet.
Presentation Tools
Note to Instructors: If you change Objectives or Assignments, don’t forget to change the
slides accordingly.
Introduce the unit.
Chapter
16, Unit 2,
Slide 10
Slide 11
Reasons to perform an ECG
Slides 1213
Electrical conduction system
Slide 14
Impulse pathway
Slide 15
Obtaining an ECG
 Click on the icon to show a brief video clip.
Slides 1617
Artifacts and types of artifacts
 When discussing somatic tremor, give examples of patient
12
movement—such as talking, Parkinson’s, epilepsy
Slides 1824
Various arrhythmias
Slide 25
Mounting an ECG
Slides 2627
Holter monitoring
Slide 28
Defibrillation
Slide 29
Stress testing
 On Slide 27, click on the icon to show a brief video clip.
 Tell the students that there are also non-exercise stress tests
available
Slide 30
Patient education
Slide 31
Have students answer the checkpoint questions on the slide to review
the content in the unit.
Part C: Diagnostic Procedures
Learning Objectives
Cognitive
1. Spell and define the Words to Know in the unit.
2. Describe a spirometry test, and state the purpose of it.
3. Explain what magnetic resonance imaging (MRI) is.
4. List the contraindications for a MRI.
5. Describe ultrasound and state the purpose of it.
6. Explain the patient preparation for ultrasound procedures.
7. Describe patient education concerning the Procedures in this unit.
Psychomotor
8. Instruct a patient about the spirometer and perform a spirometry test.
Initial Questions and Activities
 Discuss the various types of sonographic students. Ask the students how many of
them or their family members have had such studies
13
Key Concepts
References & Activities
Slides
Spirometry
Pages 858-859
33-34
Procedure 16-5
(HW) Terminology
Notebook
(ICA)(HW) Patient
education brochure
(ICA) Competency
evaluation, Procedure
16-5
Sonographic studies
Page 859
36
MRI
Page 860
35
(ICA)(HW) MRI Project
(HW) Chapter 16, Unit 3
Workbook Assignment
Sheet
(ICA) In-Class Activities
1. Patient education brochure. Have students research and prepare a brief pamphlet
of instructions for patients scheduled for spirometry testing. (Could also be
assigned as Homework.)
2. Competency evaluation, Procedure 16-5. Explain the facility’s spirometer
operation and demonstrate the proper procedure for perform a spirometry test.
Have the students to return the demonstration for evaluation of competency of
Procedure 16-5. If the instrument provides a print-out of results, attach it as the
work product for evidence of achievement of the procedure.
3. MRI Project. Have the students research the open MRI that is now available and
write a synopsis of their findings. (Could also be assigned as Homework.)
(ICD) In-Class Discussion
1. What is the definition of vital capacity?
Vital capacity is the greatest volume of air that can be expelled during a complete, slow,
and unforced exhalation (expiration) following a maximum inhalation (inspiration).
2. What is ultrasonography and how does it work?
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Ultrasonography is a technique in which internal structures are made visible by
recording the reflections or echoes of the ultrasonic sound waves directed into the tissue.
A transducer is held against the body are to be imaged; the transducer sends sound
waves through the skin to the organs. As the echoes are sent back, the transducer picks
them up and converts them into electric energy. This energy converts to an image that
can visualized on a monitor.
3. When is the MRI contraindicated?
MRI’s should not be performed on patients with pacemakers, those with metallic
implants, females in their first trimester of pregnancy, those with severe claustrophobia,
and the extremely obese.
(HW) Homework Assignments
1. Terminology Notebook. Assign the unit for reading and have students define key
terms and retain in a key term notebook for future reference.
2. Patient education brochure. Have students research and prepare a brief pamphlet
of instructions for patients scheduled for spirometry testing. (Could also be an InClass Activity.)
3. MRI Project. Have the students research the open MRI that is now available and
write a synopsis of their findings. (Could also be an In-Class Activity.)
4. Chapter 16, Unit 3 Workbook Assignment Sheet.
Presentation Tools
Note to Instructors: If you change Objectives or Assignments, don’t forget to change the
slides accordingly.
Introduce the unit.
Chapter
16, Unit 3,
Slide 32
Slides 3334
Spirometry testing
Slide 35
MRI testing
Slide 36
Ultrasound
Slide 37
Have students answer the checkpoint questions on the slide to review
the content in the unit.
15
Part D: Diagnostic Radiologic Examinations
Learning Objectives
Cognitive
1. Spell and define the Words to Know in the unit.
2. Instruct patients in preparation for their radiologic studies.
3. Explain the importance of diet in preparation for x-rays.
4. Explain why pregnant women should have x-rays.
5. Describe x-rays that require no preparation.
6. Explain the importance of patient education in scheduling a mammography.
Key Concepts
References & Activities
Slides
Radiology and radiographic students
Page 862
39-40
(HW) Terminology
Notebook
(ICA)(HW) Radiologic
procedures patient
education brochure
X rays
Page 863
Gallbladder imaging
Page 864
41-42
Patient education box,
page 864
Barium swallow
Page 865
Patient education box,
page 865
Barium enema
Page 865
Patient education box,
page 865
IVP
Page 866
KUB
Page 867
Mammography
Page 867
43-44
Patient education box,
16
page 867
Body scans
Page 868
Patient education box,
page 868
(HW) Chapter 16, Unit 4
Workbook Assignment
Sheet
(HW) The Critical
Thinking Challenge,
page 869.
(HW) The StudyWare
Challenge, Chapter 16
(ICA) Quiz on chapter
material
(ICA) In-Class Activities
1. Radiologic procedures patient education brochure. Have students research and
prepare a comprehensive informational brochure outlining patient preparation for
each of the listed radiologic procedures presented in the text. (Can be assigned as
Homework.)
2. Following review of the chapter and homework assignments, give a quiz on this
chapter that includes the content and competencies listed for CAAHEP and
ABHES.
(ICD) In-Class Discussion
1. Why are x-rays considered dangerous in the first trimester of pregnancy?
The actual x-ray beam can be damaging to the unborn child.
2. What is the difference in a PA and AP view?
The posteroanterior (PA) view has the x-rays to pass from the back to the front where the
patient faces the plate; in the anteroposterior (AP) view, the patient’s back is against the
plate and the x-ray passes from the front through the back.
3. What structures are examined in the upper gastrointestinal and lower
gastrointestinal series?
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In the upper gastrointestinal series (UGI), the esophagus, stomach, and small intestine
are viewed; for the lower gastrointestinal series (LGI), the segments of the large intestine
– or colon as it is commonly called – are examined.
4. An allergy to what substance may cause problems with an IVP?
Iodine
5. At what age does the American Cancer Society recommend for a female’s
baseline mammogram?
The ACS recommends that all females have this study performs at age 35 at the latest.
(HW) Homework Assignments
1. Terminology Notebook. Assign the unit for reading and have students define key
terms and retain in a key term notebook for future reference.
2. Radiologic procedures patient education brochure. Have students research and
prepare a comprehensive informational brochure outlining patient preparation for
each of the listed radiologic procedures presented in the text. (Can be used as an
In-Class Activity.)
3. Chapter 16, Unit 4 Workbook Assignment Sheet
4. The Critical Thinking Challenge, page 869.
5. The StudyWare Challenge, Chapter 16. Have students take the Quiz in “Quiz
Mode” and either email their scores to the instructor, or print the scores to turn in.
Presentation Tools
Note to Instructors: If you change Objectives or Assignments, don’t forget to change the
slides accordingly.
Introduce the unit.
Chapter
16, Unit 4,
Slide 38
Slides 3940
Patient preparation and instructions
Slides 4142
X rays and patient preparation
Slides 4344
Patient education and mammography
Slide 45
Have students answer the checkpoint questions on the slide to review
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the content in the unit.
Slides 4647
The Keys to Career Success slides emphasize the relationship of the
material learned in the classroom to on-the-job success.
19