All right, looks like we have 42 people that have logged into quizzes out of 68. Okay, week six. All right, what did we learn about in this week? Patient preparation, assisting with reproductive and urinary specialties.
Yes, we assist with all different types of exams, guys. Not just physical exams, okay? If you work in general practice or family practice or gynecology, a female come in, need a pap smear. We take care of that. We're the ones that set everything up and then help assist the doctor.
We assist them with the physical exams. If you work in pediatrics, we assist with pediatrics. We do all of that, okay? All right, and then also infant measurements and assisting in pediatrics.
Yes, we're gonna discuss pediatrics, immunizations, and then infant measurements will populate as a slack prompt. You can use a teddy bear. You can use a doll. If you have a tape measure, I have one. OK, this was like plasticky.
You can wipe it off with alcohol, clean it before you actually touch the baby's head. In pediatrics and some family practice offices, we use the bigger paper tape measures like the ones that you can throw away to do head circumference and chest circumference of our infants. And we normally only do head and chest circumference up to about one years old. And then they stop. They stop doing it.
And basically, why do you think we're doing head and chest circumference on infants? Why do you think that is, guys? Why are we doing their head circumference, chest circumference, and their length?
To monitor their growth? Yeah, to monitor the growth of the head, the brain, right? To monitor their chest growth, to monitor their length, to see if they're thriving according to other children in their age percentile.
That's very important, okay? A doctor can tell if a child's not thriving as fast or driving too fast, right? So they can tell by the measurements of the head circumference, chest circumference, and the infant's length.
And remember, it's length if you have to measure with the tape measure. That means they can't stand up on an upright scale to get their height. If they're over two feet, they can stand up on an upright scale.
Then we call it height. If they're under two feet. and we have to lay them down to get their measurement is called length, okay? To see how long they are, okay?
Length. And that could be a question on your certification exam. I kid you not. That did populate for a couple of students.
All right, and then we'll discuss geriatrics. All right, let's move on. All right, so I'm going to actually try to demonstrate here. Hopefully my camera, this camera is acting okay.
So for your Slack prompt, you will have to upload a video of you taking... Head circumference, chest circumference, and length of either a baby doll or a teddy bear. Whatever you have, right?
And if you don't have a tape measure, all right, then you can use, I think he's going to say a necktie or a scarf or anything to mimic it. But I'm going to show you in real time how to do it and go over some things about this tape measure real quick. Let me make sure I got my alcohol pad. Where's my alcohol? Where's my alcohol pad?
All right. But for this tape measure, just so that you can see it, you have the numbers closer together is the centimeter side, right? If I flip it over, the numbers are further apart.
This is the inches side. Normally, that's how it is on a tape measure, okay? Whether it's the paper one or this plasticky one, okay? Inches on one side, centimeters on the other side, okay?
Again, this one I can take and clean it off with alcohol right before. before I use it. Okay. If it's the paper one, those are disposable. Most of the time they give it to the parents.
You can take this home or otherwise they're going to throw it away. How many of you guys have went to the pediatric or pediatrician with your child and they gave you that paper tape measure? Anybody?
Nobody's ever gotten one from their pediatric office? The MA didn't give it to you? Nobody?
What'd you say, Dean? No, not for me either. Oh, I heard somebody saying yes in the chat. Okay. Yeah.
Because otherwise it's going to throw it away. Okay. Most of my students that are working at PISA say, yeah, we just give it to the parent or whoever brought the child in, the caregiver. Or if they don't want it, we just throw it away. Because sometimes they'll say, well, I already have one.
You gave me one last time. So you just pitch it in the garbage. But with this one, it's plasticky. You can clean this off with an alcohol pad.
Okay. All right. So.
You always want to, um... have the parent or guardian partake in the physical exam of the baby. So you can have them place them on the examination table. Most examination tables will have like table paper that you can tear off and throw away after each person has sat up on that table.
You tear it off, wipe down that table real good first, and then let it dry. And then you bring a clean piece of table paper down. Now for an infant, if they don't already have an infant examination table with the built-in scale and it also has a built-in um length measurement do you guys know what i'm talking about have you seen those in a pediatric office where it looks like an examination table but when you sit your baby on it it's actually a scale there and they'll weigh your baby on top of it and everything yes i love those my uh grandkids pediatric office has that and then for their length that the the length measurement is already built into the table. You just pull out this little lever.
The baby's head is up to the top part of the cushion and you bring the lever up to their foot, right? And you can see what their measurement is right there on that table. But not every doctor's office has a pediatric examination table with the built-in scale and all of that. So if they don't, then you'll probably have to do their measurements for length manually, okay?
So table paper comes in handy. If you don't have that type of examination table. for a pediatric patient. And then ink pen, use an ink pen, right?
To write down what the measurements are on that table paper for their head circumference, for the child's chest circumference, and for their length. That way you don't forget it. And of course, you know you have to document. You have to document everything that you're doing. So writing it down on that table paper keeps you from not remembering what their head circumference or chest circumference is.
Again, ink pen, clean it off with alcohol. tape measure, clean it off with alcohol if it's one like this. Okay.
All right. So mom, dad, guardian, whoever brought the baby in, of course they can lay the child on a table paper and then we'll do measurements. And let me try to switch my camera.
I hope this camera is in focus now. Give me a minute here. Let me switch the camera real quick. Oh, let me see if it's actually going to switch. All right.
Is it in focus? Can y'all see it a little bit better? Yeah. Okay.
It's in focus a little bit better. Okay. All right. So here's the baby.
I'm just going to turn myself around. I have the tape measure. I already cleaned it off with alcohol.
Most head circumference and chest circumference on infants is done in centimeters. Okay. So with the tape measure, the centimeter side, remember that's the numbers closest together.
If you're doing head circumference and chest circumference, and the doctor wants it read in centimeters, you put the centimeter side. of the tape measure down on the table, okay? Because you gotta pull this around the baby's head. If you had this part up, then you would be measuring in inches when it comes around.
So again, the centimeter side of the tape measure, which is the numbers close together, lay that part down flat on the table, okay? Have it stretched out. Already have it stretched out.
And then have mommy, daddy, whoever has the baby, place the baby's head. Can y'all see it? Is it too far? Let me try to move this back.
You want to place the baby's head right on top of the tape measure. Can y'all see it? On my end, I don't look like you can see it.
Can you guys see the tape measure? Yes. Okay. All right.
So at the brow line, this is the baby's brow line. You want to carefully bring this around at the brow line where the zero is. Okay.
Hold it still. And then bring the other side around. And the number on the other side that meets up with that zero, that's the baby's head circumference.
Okay? And I see 34. So they're HC, head circumference. So I'll take my ink pen and on the table paper, I would put HC 34CM. Write that right on the table paper. Okay?
All right? Then have mommy or daddy kind of just hold the baby up a little bit, and you're going to slide the tape measure down to where their chest is at. Remember, the centimeter size should be facing down on the table paper, okay?
So you'll slide the tape measure down where the child's chest is. I'll bring the baby up so y'all can see. I put some fake little nipples on here with an ink pen because it don't.
Is it out of focus? I think it's blurry. Hold on.
Let me try to fix that. Hold on. Yeah, a little. Yeah, let me change it. It gets blurry.
I have to keep doing this to make it unblurried. All right. Is it better? A little bit better? Yes.
Yes. All right. So now that it's down by the baby's chest, have mommy or daddy or whoever brought the child in.
It's like a scooted up sociopathy. Have them hold the baby's arms or hands above their head. You know, not too much force, not too much pressure.
Hold their arms up away from the chest because now you're going to do chest circumference, right? Again, we have it on the centimeter side. Around the nipple line this time.
Around the nipples. You're going to bring the tape measure where the zero is at, centimeter side. Bring it around. Where the other side meets with that zero, that's their chest circumference measurement. And I see 32, okay?
32 CMs, all right? Now that you know what the measurement is for their chest, have mommy or daddy raise the baby up some. You can remove the tape measure carefully.
You don't want to just zip it from under them if they're laying on top of it, because if it's paper, it could cut them, okay? You carefully remove it as they hold the baby up some. All right. And then on the table paper, CC for chest circumference, 32 CMs.
Right there, right on that table paper. OK, now for the length of the child. Hopefully you guys can see.
I hope you can see. Is it blurry again? Can you guys see?
Is it blurry? I don't know how big this is, if you guys can see it or not. I'm not sure. Hopefully you guys can see a little bit blurry.
OK, let me switch it out again. Hold on. I got to keep switching it or else it'll. And I know you probably got a video in your stepbook. That's what I just want to make sure I'm showing it.
All right. So now for length of the baby, remember this baby cannot step up on an upright scale. They're not over two feet tall, right? So therefore we have to lay them down and get their length.
It's called length when you have to do a tape measure for that particular measurement. All right. So now what do we do? We have the ink pen, clean it off with alcohol. We already did that, right?
So at the very top of the baby's head, I'll bring it down so y'all can see what I'm doing. At the very top of the baby head, while they're laying on that table paper, this is the manual way of taking their length. Take the ink pen that you cleaned off with alcohol. Touch the top of their head, but bring it down to the table paper. Make a mark.
You're making a mark, right? Then where the foot is, and I know you probably can't. I don't know if you can see the baby's foot. Can y'all see it? Okay.
Then where their foot is, you're going to stretch out that little kneecap, kind of gentle. Right? And where the heel of their foot is, not their toes, where the heel is, you make another mark on the table paper where the heel is.
Have mommy or daddy raise the baby up. Okay? And then the two marks that you made.
There's going to be this baby doll over here somewhere. The two marks that you made on the table paper, now you're going to turn the tape measure on the inches side this time. Inches.
And where the first mark is, put the zero. Okay? Zeros at the first mark and bring the other end down to what a second mark is.
And whatever that number is, what that second mark is, that's their length. All right. And we got 18, 18 inches.
And this is what you document. You document their head circumference, chest circumference, and their length. Head and chest circumference is normally in centimeters. And then the length is normally done in inches. Okay.
All right. I hope that helped y'all better understand how to properly do it. And I know you may not, some of you guys may not have a tape measure at home.
But again, you can use a scarf instead. So you can use a necktie if you have that to mimic. But if you do have a tape measure at home, make sure you're doing head and chest circumference in centimeters and then the length in inches. It will vary per doctor's office. Maybe the doctor might want all of it done in inches.
Maybe your doctor might want all three measurements done in centimeters. I don't know. But normally, head and chest circumference is in centimeters, and the length of the child is in inches, okay?
This is going to be your slack prompt, all right? You can use a teddy bear if you have a baby doll, or you might have a baby of your, a real baby of your own with a tape measure. However you want to do it, just be real gentle with your child, of course. And I just want to make sure I showed you guys that method with marking on the table paper, because that keeps you... from having to try to remember all these numbers.
Just mark it right on that table paper. Now, again, if your doctor's office already has a pediatric examination table where the length measurement is already built in and it's a scale and all of that, great. Most pediatric offices do have those, okay?
All right, and don't forget, this will populate for you to have uploaded your video on Thursday, okay? Make sure you get your video uploaded on Thursday before the end of the day, okay? Any questions about your Slack prompts? Any questions, guys? We're good.
Yes. You guys are good. Y'all okay?
Yes. Okay. All right.
So we're going to talk about general physical exam. Yes. We're the ones that get everything together, guys.
We do all of that. We get all the supplies together for the physical exams, whether it's on a female patient, male patient, kid, we get everything together. Whatever your doctor normally likes to have when they do their physicals, we get those items together.
Make sure nothing's expired. Make sure all instruments used are not expired because those can expire too. All right. We position and drape the patient for certain exams. We have to know about different examination methods.
And then, of course, we do educate patients on a lot of different things. All right. So let's start with our role in the general physical exam. Basically, this examination is the first step of the diagnosis or treatment process. And yes, it is based off of signs and symptoms.
All right. We're the ones that do the first interview with a patient asking them about their chief complaint. So what brings you to the doctor's office today? When we ask that question, we need to get some feedback from our patient to let us know why they are really there. Sometimes patients make appointments for certain things.
And then when they get there for the appointment, they've totally changed why they're there for the visit. Have you guys done that before at your doctor's office? Be truthful.
And it's OK. I know I have. You made the appointment. For one thing, yeah, what'd you say?
Yes, I've done that. I just recently did that. Yeah, and they shouldn't seem upset about it because it happens all the time, right?
Hopefully they weren't upset. They see on the appointment log why you're there, but patients can change their mind. I know I scheduled my appointment for a pap smear, but I'm having some other concerns I would like addressed before I have this pap smear done. That's totally fine, right?
So again, signs and symptoms. Signs are objective information detected by the physician, okay? Objective, that means when we take their vitals, we can feel what their pulse is. We can hear their heartbeat with a stethoscope. We can physically examine them, okay?
And look for signs and stuff. These are objective information detected by the physician and by the medical system. When we take vitals, We're feeling for their pulse.
We're taking their blood pressure. It gives us a number, right? We're watching them breathe.
We're counting when they breathe. So this is objective information. Their symptoms is subjective information.
We don't know what their symptoms are. We don't know how the patient feels. So we have to rely on them supplying this information to us. So that's called subjective information.
So the minute you say, good morning, Ms. Johnson, I'm your medical assistant today. Can you state your name and date of birth? and they state their name at birth.
So what brings you to the doctor's office today? When that patient starts to talk to you and give you the reason why they're there, that is subjective information. It is supplied to us by the patient, okay?
Once we start taking their vital signs, and this is the medical assistance role, right? Once we start taking their vital signs, touching them for the pulse, watching them breathe, taking their blood pressure, This is objective information. We can actually hear it, see it, feel it, and know for a fact what it is. Objective information. Okay?
So our role as a clinical medical assistant, yes, we do the interviewing. We get the chief complaint. Again, that is subjective. We have to rely on the patient letting us know the reason for the visit. We obtain their histories, whether it's their past medical history, family medical history, current history.
Whatever it is, that is subjective information. They also have to give us that information. We don't know this, right? Determining their vital signs, objective. Measuring their weight and height, objective.
We can see what their height and weight is. We can feel for their pulse. Ensuring instruments and supplies are available.
We always have to be prepared for the next day, okay? So by the end of the day, you're already looking at the next day's appointment logs, right? You're trying to see who all's coming in. And what are they coming in for? And then that way we make sure we have proper supplies available for the next day's appointments.
Okay. Next two days, next three days. We always have to make sure we have everything in stock for when our patients come in.
Okay. The doctors get upset if a patient's there for a certain thing that we knew they were coming in for, and we don't have what's needed for the examination. The doctors will be upset. That is our responsibility.
to make sure we have everything ready to go when patients come in, okay, for their scheduled appointments, even though their appointments... the reasons for their visits can change. We still have to make sure we have everything ready for whatever they made those appointments for, okay?
For instance, you're looking at the log to say, oh, tomorrow we're going to have three pap smears, we're going to have two physicals, and we're going to have a suture removal come in. That means we need to go to the cabinets and make sure we have everything ready to go for these appointments tomorrow, right? All right, we help put patients into positions or help, you know, assume in positions, ensuring that the patient is comfortable.
So we're going to go over those different positions so to make sure you know them. Observe for signs of distress or need for assistance always. Anytime you walk up to the front desk area, let's say you're a clinical medical assistant, but you walk up to the front, you want to look out into the lobby and surveillance the lobby. Okay, you're looking down at the sign-in sheet, but look up out into the lobby.
Why are we surveillancing the lobby when we look up and look out? Why do you think that is? Why are we doing it as MAs?
To keep track of any patients that are in distress or upset or maybe their condition is declining quickly or something like that. Absolutely. Absolutely. You nailed that. Absolutely, guys.
We don't just walk up to the front and only look down at the sand and then walk back. You need to look up. It's real quick. Look up and look out. You might see a patient grabbing their chest or looking very upset or frustrated or looking like they're going to pass out.
or can't sit, they're very antsy. Something's wrong, right? So we need to get that patient back and assess them and see, do we need to call them back next instead of the other four people ahead of them, right?
That's called triaging, right? Also educate patients on self-examinations like the BSE breast self-exam, TSE testicular self-exam. Maybe we need to train them on how to do a capillary puncture to test their blood for glucose.
and then show them how to use a glucometer. We educate. We do a lot of educating with our patients, okay? And remember that you guys are educators. Once you're out there working in the field, you are now an educator.
We perform injections. We do EKGs, phlebotomy, and so much more. A medical assistant is a very important healthcare team member, okay?
Everyone at office is very important. But most doctors rely on MAs. We're like their right-hand person, okay? All right, so these are different positions. Is it blurry or is it me?
Does it look blurry? Oh, wow. It's a little blurry.
Yeah, it's a little blurry. Yeah, it's a little blurry, right? I don't know why. What's going on?
I don't know if it's my other camera. I got connected. I don't know.
But these are the different positions in which we can put patients in for certain procedures, guys. We have the sitting position. You're just sitting up on the table.
This is like the main position when patients come in and we have them sit up. Maybe they're dressed or maybe they are undressed, but covered up with a gown and a drape sheet, but just sitting, waiting on a doctor to come into the room, right? But the doctor can still perform examination, inspection.
They can look into the eyes and the nose, down the throat and ears in this position, listen to their heart sounds with the stethoscope, listen to their lung sounds. Where would the doctor place the stethoscope to listen to their lungs? Where would they place the stethoscope?
They're auscultating, listening. Where would they place that stethoscope to listen to their lungs? On their chest and then they might go to the back.
On their chest for the lungs? And then they go to the back too? Yeah, it's on their back for the lungs.
So when they place it on their chest, what do they listen to? What organ is that? The heart.
The heart, yes. So when they place it on the chest, they listen to the heart, right? Listen to their heartbeat. It says a lot.
If the heart beats too fast, too slow, irregular. And then when they place it on the back, they're listening to their lungs. They tell you to take a deep breath, breathe it out. They're listening to your lung sounds.
A doctor is highly trained to know what healthy lungs should sound like. And then what it sounds like when there's something going on wrong, like pneumonia or rails or something like that. And then when they're listening to your heart, irregularities.
They know what it sounds like. Or maybe the heart's normal, right? So inspection, they're looking. Inspection means to look.
They can take the pen light, shatter it in your eyes. They can also have you open your mouth, place a tongue to press on your tongue, look down the back of the throat. This is inspection. They can take the otoscope and look into your ears.
Take the ophthalmoscope and look into your eyes. Inspection, right? So this position is supine.
They're laying flat on their back. Most examination tables in... a doctor's office don't quite look like this okay this looks more like a massage therapy table to me Most of the examination tables have drawers on the sides and in the front and have a leg extender that you can pull out and push it back.
So with that type of table, if they're going to be in a supine position, which means they're on their back, you would pull out that leg extender. You want their legs to be relaxed on the extension, not draped down in the front dangling. Okay.
All right. So supine, flat on their back, the doctor can examine the anterior. Anterior means front, the anterior of the body. Front of the face, front of the neck, the chest, the stomach, front of the legs, the thighs, the legs, the knees, and the top of the feet.
Okay. Picture C is dorsal recumbent. So they're on their back, but their knees are bent and slightly apart. This is called dorsal recumbent position. Okay.
It can also be for abdominal examination, but also rectal, vaginal. Okay. Dorsal recumbent, laying flat on their back, but the knees are bent, feet on the table.
Right. And of course, we're going to cover it up. This picture D is lithotomy.
Ladies, I know y'all hate this position, right? Childbearing position, pap smear position, right? Lithotomy.
Please remember that term lithotomy. That means you're on your back, but the buttocks is at the very edge of the table and the feet are in the stirrups. Remember how to describe these positions.
Your certification exam may have a paragraph with a description of a position, and then you have to pick the right term for that position. So make sure you know how to describe these positions, okay? So again, the thotomy, buttocks is at the edge of the table.
Feet are in the stirrups, knees apart. Again, pap smear, vaginal exam, rectal exam, the thotomy. Semi-fowlers.
The other picture they don't have on this one is the fowlers. The fowlers and the semi-fowlers, okay? So fowlers is when the back of the table is raised up at a 90 degree angle. And this one that you see here is the semi-fowlers.
That means half a fowlers. So that means the back of the table is raised at a 45 degree angle because that is... half of Fowler's, okay?
Fowler's is 90 degree. Semi-Fowler's is the back of the table is raised up at a 45 degree angle. Anytime a patient is complaining of chest pain or difficulty breathing, you will never ever lay them down flat. Don't ever do that.
If they're having difficulty breathing and chest pain, you need to put them either in a Fowler's position, which is raising the back of the table up at a 90 degree angle, or a semi-Fowler's position, okay? We can also put them in these positions for positions for other examinations, ear irrigation, eye irrigation, just a regular inspection. If a doctor needs to inspect, but again, foulers and semi foulers. Okay.
Next we have prone position. It's the opposite of supine. So if supine is on your back, line on your back, then prone is line on your stomach.
Okay. Prone is the opposite of supine. So with prone position, line on your stomach, face turned to the side, arms can be above the head, kind of bent like this, maybe with your head turned to the side or straight out like he has it. And this is to examine posterior. Posterior means the back of the body, the back of the head, back of the neck, the upper back, lower back, back of the buttocks, here of the back of the legs, back of the feet.
Again, posterior back. Okay. Sims position is the next one.
Sim's position, patient's kind of on their left side with the left leg slightly bent, but the right leg is bent at a 90 degree. That left arm is to the back of the body, but the right arm is kind of flexed like this, okay, with the head turned toward it. This position, Sim's position can be for sigmoidoscopy, colonoscopy, rectal exam, maybe vaginal, but most of the time rectal type of exams, colonoscopy, sigmoidoscopy, rectal exam. Sims position.
On the left side, left leg slightly bent. The right leg is bent at a 90 degree angle, left arm toward the back, right arm flexed. Knee, elbow, or knee chest. With this position, the patient is up on knees. Chest is kind of touching the table.
Arms are kind of like toward the face area, head turned to the side, but the buttocks is up in the air. This can be for rectal examination. vaginal examination, certain surgical procedures, right?
They might put you in this position. But again, if it's a surgical procedure, normally you're going to be on a special procedures table. in this position called proctologic, okay?
Sometimes they call this the jackknife position. Jackknife is the same as proctologic. What does the word proctologic mean?
Anybody? The proctologic position. What is proctologic? Procto, what does that mean? Nobody knows?
Procto, proctologic? Procto is related to rectum, okay? So in this position, remember, it has to be a special procedures table where the head part goes down toward the floor and the leg and feet part can be slanted toward the floor. Most of these special procedures tables have foot pedals where you can raise the table up.
You can lower it. You can make it go this way, like how you see it on the picture, proctologic. Again, this could be for rectal, vaginal, surgical procedures. Right. Don't forget, proctologic is also called jackknife.
And then there's another picture that they don't have. They'll have it on Thursday slides. I mean, Friday slides, I do believe. But it's called the Trendelenburg position.
That's when the head is down toward the floor, but the feet and legs are elevated. That particular position, Trendelenburg, is to help relieve shock. And for some surgical procedures, they put you in that position. Again, there's no picture. There's no term, but you'll see it on Friday's slides.
And you might see it in your classroom lessons as well. But it's called Trendelenburg, Trendelenburg position, where the head is down toward the floor, but your legs and feet are elevated. You got to slant, again, to help alleviate shock or for some surgical, abdominal surgical procedures.
So how does that Trendelenburg position where you slant it like this, where the head is down toward the floor, but your feet is elevated, how do you think that helps to alleviate shock? What's happening? What you think, guys?
It forces organs. Like, it forces circulation to, like, your organs. Yes. Yes.
It is forcing circulation of blood to rush to the what? The head. Yes, absolutely.
Very good, everybody. That answer. Very good.
All right, moving on, guys. Here we go. All right, here are the different examination methods. So we have inspection. That's to visually examine.
I'm sorry, inspection is to visually exam, I was about to say examination. All right, and right here, she is visually examining his ear using an otoscope. Oto means ear.
Scope means lighted instrument to visually examine. Put it together, otoscope. These are normally mounted on the wall. You'll see them when they're pulled off from the wall, look into your ear, or they will use the ophthalmoscope to look into your eyes, right?
Okay. Inspection means to visually examine. Auscultation means listening to body sounds.
And right here, the doctor is auscultating. He's listening to his lung sounds, right? If he places this on the chest area, then he'll be listening to the heart sounds.
Auscultation. You can take that stethoscope and listen to the abdomen sounds, the stomach sounds, or the sounds of the bowels. Doctors are highly trained to know what they sound like when they're normal. And if something's wrong, okay? Palpation means to touch.
Right here, when we take our patient's pulse manually, we're touching them. That's called palpation. To touch is palpation. You're palpating an area.
The doctors will take their fingers and feel over the body as well. Certain organs, they'll feel, okay? They might massage in a certain area. When they're doing this, feeling in behind your ears, down under your jaw area.
In the neck, on top of your shoulders, that's palpation, touching. They're feeling your glands to see if they're swollen. All right? Percussion is tapping or striking the body to hear sounds or feel certain vibrations.
Okay? So right here, where is it? Right here.
This picture. They are percussing or percussion. What instrument is this?
Who knows the name of this instrument? Anybody? What is this called? Who knows?
It's used for the percussion method of an exam. It's a hammer. Reflex hammer.
Very good. They call it percussion hammer, reflex hammer. Yes, it's checking reflexes of the joints.
You can tap at the knee, at the wrist to see how the joints are at the wrist, the elbow. Yes, this is a percussion hammer, also known as reflex hammer. Very good. and it's for percussing tapping or striking the doctor can use their fingers to do percussion They'll place their fingers over an organ and do this, and they'll move it around and do this, go to another organ, and they can feel vibrations on their fingers. They're highly trained to know what that feels like if there's a buildup of fluid in that organ, right?
That's the purpose of them doing this on top of your certain organs, okay? Percussion, tapping. Menstruation, not menstruation, because menstruation is when you have your menstrual cycle. This is mensuration. Mensuration is the process of measuring.
Just like when we take this tape measure and do the head and chest circumference and the length of an infant, that is mensuration, we're measuring. The doctor can take a tape measure and measure maybe a mole or a growth or take it and measure the person, the length of their limbs or something, okay? And then the last one is manipulation, moving of a patient's body part. to assess range of motion of joints.
And here's a picture of probably in physical therapy where they are doing range of motion exercises. And so they'll take the limb and they'll take it outward, pull it back in, rotate at the joint. That's called manipulation. You're manipulating at the joints.
All right. Know your different examination methods and a description of each, please. You have to know them.
Create flashcards, whatever you got to do. Which exam method is the physician using when observing the range of motion of a joint? Just said it.
Okay, let's see. 32 people answered out of 47. 24 got it right. Manipulation. Okay, let's see, leaderboard. Okay, Melanie.
Number one, Spadia, Kayla, Emma, and Abby, right? I gotta say Abby. Here we go. All right, next question. Here we go.
Which position has the patient lying on the left side, left leg slightly flexed, with the right leg flexed at a 90 degree angle? Okay. 34 out of 47 answered, 23 got it correct.
Sims position. Very good. Okay. All right, Kayla, you moved up to number one spot. Melanie, Emma, Dia, and Brissa.
All right, guys. Next, assisting in reproductive and urinary specialties. All right, here we go.
gynecologic and obstetrical exams. If you want to work in gyne or OBGYN, because OBGYN is obstetrics and gynecology, or maybe you just want to work in gynecology, okay? We also can work in urology, right? Well, in urology, different types of urine exams, testicular exams for the male. Females can see a urologist as well, but most males go to a urologist for problems with the...
male reproductive system as well. And then a review of common urinary and reproductive disorders and diseases. We'll talk about all of this coming up next.
All right. So assisting with gynecological patients include us, the medical assistant, making sure we have everything needed for that particular type of an examination. Okay.
As you see here, this is a picture of a vaginal speculum. There are different types of speculums, but this one is a vaginal speculum. The word speculum means to open a body orifice. Okay. The word speculum by itself means to open a body orifice.
So a vaginal speculum opens the vaginal canal. A nasal speculum opens the nasal passageway. A rectal speculum will open up. the rectum okay this one happens to be a vaginal speculum this one's plastic it is disposable one-time use throw it away okay i prefer these at my doctor's office sometimes they do pinch um i don't know what do you guys prefer when you go to your doctor for your pap smears the metal vaginal speculum or the plastic disposable one i think i've only had the metal ones metal one okay yeah every doctor should have both because i know some patients have preferences with this and me and it's just for me working in the medical field for so long and seeing how lazy people can be with the metal one it has to be sanitized disinfected And then sterilized before it can be used again.
So the metal ones are reusable. And I'm just going off experience with lazy people. And even working as an office manager, sometimes I'll have to fire people because they're just too lazy.
They don't want to do their jobs correctly. But when there's the metal ones, they have to be broken down. I mean taken apart. And use different brushes and bristles to get all in between the grooves when you're sanitizing and disinfecting. And then you have to put the metal ones in an autoclave.
like an oven to basically, you could say bake them, but you're using steam, high steam under pressure, high pressure to sterilize them. And then they're used again, the metal ones. These are one-time use, plastic, throw them away, okay?
You can request this if you'd like, if your doctor, I'm sure your doctor should carry plastic and metal vaginal spectrums. But gynecologic exams, overview of a woman's health and cancer screening exams and tests. So how do a doctor... uh examine what type of exam is it for to check for breast abnormalities what exam is that that the doctor performs i kind of just said it what is it i said mammogram but i think i'm wrong yeah that is one way yeah that's one way in the doctor's office the doctor will physically examine the breast with a breast exam right as medical yeah as medical assistants we will actually train and teach our female patients, if they don't already know how to do what's known as a BSE. Anybody know what a BSE is?
BSE. Breast self-exam. Yes.
Breast self-exam. How many of you ladies actually perform this once a month on yourself? Anyone performs BSEs on yourself once a month? I do.
Yay. I'm so glad to hear that. Yeah. Because that's the only way you're going to know if you have an abnormal growth or something wrong with the breast. I've had a biopsy done before.
Yeah, me too. Yep. Absolutely.
Yep. And when you're in the shower is the best way to do BSC because the water is lubricating the skin. And when you glide your fingers around, you're kind of rotating around the breast circular motion that you walk, you're walking, you're feeling massage a little bit.
And you do this all the way around the breast. You get the nipple. that you squeeze the nipple to see if there's any discharge.
Hopefully not. Now, if you're breastfeeding, yeah, you're probably gonna have some discharge, right? But if you're not breastfeeding, you didn't just stop breastfeeding, okay? But there's a discharge. You have to let your doctor know there's something coming out of your breast.
Make sure you know the color. Is it tinged with blood? Is there an odor to it?
Also, make sure you examine the areola. We know what the areola is, right, ladies? What is the areola? Around your nipple?
Like the dark spot around the nipple? Yes. Yes, ma'am.
Absolutely. The darkened area around the nipple is called the areola. When you're in front of that mirror, standing up straight, look at your breast, look at the areola, look at the nipples.
Does one breast look like it's bigger or longer than the other one? Let your doctor know. And they normally say one breast is normally a little bit bigger than the other one. Okay.
Now, I'm not talking about folks that want to have their breasts done, you know, and all that stuff. Now they're perfect. The normal breast, one is normally a slightly larger than the other one. But I'm talking about if you see a drastic change, like one is hanging. It's the same thing with the male's testicles.
They have to perform TSE, testicular self-exam. And we do BSE, breast self-exam. They got to do the same thing. If they see one, normally one is already hanging a little bit lower testicle for the male, but now it's way.
Yes. That means you need to let the doctor know like ASAP. Don't wait on that.
Okay. But... Again, gynecological exams is to check for cancer screening for the breasts and also to check for uterine cancer, cervical cancer, vaginal cancer, because yes, you can get cancer in the vaginal canal even.
Cancer can pop up anywhere on your body. It can pop up on your earlobe, your baby toe. Cancer does not discriminate. It will populate anywhere in your body, okay? The breast exam, examination of breast and underarm areas to check for abnormal lumps.
So when you're doing a BSE, you also need to run your fingers, massage under the underarm area, and then around. the breasts, right? And you got three different hand methods you can use when you examine the breasts. And that'll take all day if I go through all of that.
All right. But our role when it comes to gynecological exams, I'll send you guys the BSE video. So that way you know exactly how to do a BSE.
Okay. We have patients enter their bladder and obtain a urine specimen if needed. Most of the time you worked in gyne, they're going to want to check that urine.
Okay. So we always get a urine sample. And in some doctor's offices, you have a protocol. You do certain tests before the doctor even comes into the doctor's office. And it could be to run a UA, right?
We provide a gown and interview the patient, discuss gynecologic and general health. We review of factors that may indicate cancer or sexually transmitted infections, STIs. We ask questions about the patient's menstrual cycle. Absolutely.
We check vital signs, determine the first day of her last. menstrual period again i said it one more time the first day of the last menstrual period what happens if your patient doesn't remember the first day of their last menstrual period do we just chart patient doesn't remember first day of their last menstrual period or what do we do if they can't remember do we just chart what they said what do you think what you think you said what now If you could ask them like for an estimation about when they thought they had it or. Yeah. And go get a calendar. There's always calendars.
Gyne loves to have calendars because we know we're going to have to ask that question, right? If your patient does not remember her last first day of her last menstrual period, pull out a calendar. OK, would you say you had one in this month or last month? Oh, I think it was last month.
Flip that calendar to last month. OK, was it the first week, second week, third week or the fourth week? Oh, it was definitely the third week because it was right after we went to a birthday party, third week. Okay, would you say it was Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, or Saturday?
You have to make them give you a date, basically. Everybody got it? You got what I'm saying? You can't just go empty-handed on that. Why do you think it's so important for us to get the first day of their last menstrual period?
Why is that so important for every doctor to have this information from female patients? Why do you think, guys? That's like the start of the cycle. And what other reasons?
Come on, give me some more. You're right. But give me something else. Why is that so important?
It can let you know about population, pregnancy. They may be pregnant. Yes.
And doctors do what? They prescribe medications. Absolutely.
Very good, everybody. Yes, because of pregnancy and the prescribing of meds. We have to know. Now, if that patient, female patient says, oh, girl, I haven't had a period in seven years. Do we just write down patient states within their chart that haven't had a menstrual cycle in seven years?
Is that all we need to know? Say what, dear? What'd you say? Get more information about what they experienced during that time.
Yeah. Why is it Ms. Johnson hasn't had a menstrual cycle in seven years? We need to dig further. Okay, Ms. Johnson, you haven't had a menstrual cycle in seven years?
Have you had a hysterectomy or? Oh yes, I had a partial hysterectomy seven years ago. Now you can type that in or write that out in your notes before you type it into their EHR.
Get a doctor's name. Who did your surgery for this? What year was that? You need to get that info. Or it's a younger female patient said, oh, I haven't had a period in two years.
And clearly you see she's of childbearing age. Do we just put down patient's days hasn't had a menstrual cycle in two years? She's of childbearing age. What do we need to do with this one? Ask if they're sexually active?
Yeah, same questions, right? Is there a reason why you haven't had a menstrual cycle in two years? Oh, I'm on the Depo-Provera shot.
It kind of messed around with my menstrual cycle. At first, I was having it every month, and now it's gone. I don't have it for two years. You got to type that in their chart.
Patient states she's on the Depo-Provera injection and has not had a menstrual cycle for two years. Boom. Doctor needs to know that. She should not.
be without a menstrual cycle because she's on Depo-Provera, right? Depo-Provera has messed up a lot of females' bodies, just being honest, okay? All right, moving on. And I'm going to end it on that note with that.
All right, different tests for OBGYN. Pregnancy test, it detects the presence of the hormone HCG. HCG stands for human chorionic gonadotropin. That's the name of that hormone. STI test, sexually transmitted infections may require bacterial intercourse.
and tissue cultures, examining lesions, blood tests, and patient histories. Ultrasound, it assesses organs and structures and also can produce pictures of a fetus if it's there right hysterosalpingography oh i love these long medical terms beautiful hysterosalpingography graphene means an x-ray image of an x-ray image of something hyster anybody know what hyster means it's a root word these are both two root words what does hyster mean anybody remember from medical terms uterine you Uterus. Very good.
Salping means, what does salping mean? Fallopian tube. Fallopian tube. Very good.
So basically this is an x-ray image of the uterus and the fallopian tube. It says the x-ray procedure used to view the inside of the uterus and fallopian tubes. Hysterosalpingography.
This one says hysterosalping oophorectomy. This is a procedure. We know that because we see ectomy as a suffix. What does ectomy by itself mean? Ectomy means what?
Removal. Removal. Removal.
Yeah, so they're removing something. We know hyster is uterus. We know salping is fallopian tube. And what is oophore?
Ovaries. Ovary. So basically, this is like they had a total hysterectomy.
Removal of the uterus, fallopian tubes, and ovaries, right? All right. Moving on. All right.
Assisting a urology. Patient chief complaining history check for any changes in urination for the physical examination, palpation of the kidneys and bladder and visually examine the external genitalia. So, yes, females can see a urologist.
Most males go to a urologist, especially if they have any like what is it? Oh, my God. What am I trying to say? Reproductive organ problems.
Right. Um, also in urology, I have helped to assist with a lot of vasectomies. Anybody want to help with vasectomies? Would you like to work in urology? Anybody?
No one? No. Nope.
You guys know what vasectomies are, right? A vasectomy. Everybody's heard of that. My husband had one.
Yeah. Very simple procedure for the male patient. Takes but a hot second.
I have helped to assist with lots of vasectomies when I worked in urology as a medical assistant and then an office manager. Very simple procedure, guys. It takes a few minutes and they're a little bit sore, but they can be back at work the very next day.
Okay. All right. Inspection and palpation of the penis and scrotum. The groin is examined for a hernia. In men over 40, the prostate gland is examined by digital insertion to the rectum.
So that is how the doctor is able to feel the prostate gland by way of a gloved, lubricated finger inserted into the rectum. And then they can touch the prostate gland. Why are they touching the prostate gland? Because it feels a certain way when it's healthy and that it feels a certain way if it's too hard or too soft.
That lets the doctor know a lot about the prostate gland. They can tell if it's enlarged even by touching it. All right. We're responsible for teaching the patient to perform regular testicular self-exams, TSEs.
Again, just like we do our BSEs, the male patient should also perform a TSE, testicular self-exam. So I'll be sending you guys the video for BSE and TSE, okay? That way you guys have that to look at as many times as you'd like.
All right, urological tests and procedures, urinalysis, they're most so common. to perform a UA in different doctor's offices, not just urology, family practice, general practice. Any doctor's office can actually do a urinalysis.
So that's the most commonly ordered test is a UA. Here's a picture of a dipstick method for a urinalysis exam. That's the dipstick with the 10 different chemicals that we're checking for in someone's urine.
There's that cup of urine. You have to make sure you dip the dipstick in that urine and saturate. each color-coded pad to make sure you get an accurate result.
And we'll talk about that and go over that procedure later. Semen analysis, determining fertility and to evaluate the success of a vasectomy. The reason for a vasectomy, of course, is to prevent sperm cells from leaving the epididymis that's coiled up on top of the testicle. So the lesser amount of sperm cells that are released, the less chance of... impregnation.
Okay. Fertilization. Okay. smears to diagnose infections, and then cystometry measures the bladder capacity and pressure.
Of course, blood tests is to monitor for dysfunctions of the prostate gland and certain sexually transmitted infections. Okay. Nobody wants to work in urology?
Nobody. Let me see if anybody in the chat is saying they want to work in urology. Let's see. No, nobody. Aesthetic MA.
Okay. Somebody said, I don't know what I want to work yet. Okay. And you know what?
You're early. It's week six. But again, start thinking about it. Where do you see yourself working as a medical assistant? What specialty practice?
Okay. Start thinking about that, guys. All right. Ectopic pregnancy.
You know, they call this also a tubal pregnancy. Again, the actual embryo cannot grow in the fallopian tube. So if the woman has an ectopic pregnancy, surgery has to be done to remove that.
So it's a fertilized egg unable to move out of the fallopian tube into the uterus for implantation. So again, a fertilized egg has to move to the uterus and implant itself in the uterine wall so that it can expand. If it's in the fallopian tube, which is very narrow tube, it cannot expand. And if it ruptures, the patient may die.
OK, so that has to be removed surgically. fibrocystic breast disease, benign fluid-filled cysts or nodules in the breast. This is why it's so important to perform a BSE once a month, not once a year, once a month.
And you should do a BSE roughly around seven days after your menstrual cycle. Because if you perform it while you're on your menstrual cycle, you may have little knots that come because of the cycle and you might mistake that for something wrong, right? And freak out.
So always wait about seven days, seven to 10 days after your menstrual cycle before you perform your BSE. Ovarian cysts, sacs of fluid or semi-solid materials that form on the ovaries, they're usually benign. If left untreated, they might get turned into cancer.
So it's best, and a lot of times you don't even know you have cysts on your ovaries. I didn't know I had a cyst, a couple of cysts on my ovaries until one day one ruptured and I almost passed. out and had to be rushed to the hospital. Found out I had cysts on my ovaries that ruptured and I was bleeding internally. Menstrual disturbances.
We have amenorrhea. A is the prefix that means absence of. Men means menstruation, right? Mencies. And then rhea is flow.
So amenorrhea, absence of menstruation. Dysmenorrhea. This is the prefix that means painful.
Again, men, it's menses, reaflo, painful menstrual periods. Menorrhagia, heavy or prolonged menstrual bleeding. Metrorrhagia, abnormal bleeding.
Kidney stones. Kidney stones can be called renal calculi, nephrolithiasis, or urolithiasis. Three different names.
Three different medical terms for kidney stones. These are chemical substances in the urine. that form crystals in the kidneys, the ureter, or the bladder. Has any one of you guys ever had to try to pass a kidney stone or know someone that had to pass a couple? Anybody?
Kidney stones, anybody had to pass that before? I know someone. How painful was it for them? It was like excruciating or maybe not that bad. I don't know.
Yeah, it was excruciating. She was describing it to me like, cause she had to go to the ER and she was saying how she was hunched over and she couldn't find a comfortable position, kept flip-flopping. Had to wait in the ER for a while with all that pain.
Wow. And it's worse for males. Why do you think trying to pass kidney stones is worse for males? Why do you think that is? The longer urethra.
The longer urethra. Mm-mm-mm. I remember working in urology. This man came in almost screaming in pain, pushing out a lot of blood and bucus.
He was trying to pass the largest kidney stone. Guys, I was crying for him because he came into the office. We had to call the ambulance and we had to go to the hospital like right away ASAP. And not only that, but his kidneys were failing on top of that.
It was just really sad. And he stayed in the hospital, I think, for about a month. That's how bad his situation was with his kidneys and the stones.
So yeah, I cried that day. I've never seen a man holler out like that in the sheer agony. And I remember a couple of family members, males, that had to push out kidney stones. They said, I guess we could say that's the equivalent to y'all having a baby, like that type of pain.
I was like, okay, you're probably right. All right, here are common STDs. We got chlamydia, gonorrhea, syphilis, trichomoniasis, HSV, which is herpes simplex.
HPV is the virus, the human papillomavirus that causes genital warts. Okay. I remember somebody has skin tags hanging off of their private parts, guys.
That's H. Those are genital warts caused by the human papillomavirus. Don't let anybody tell you I was born with that. That happened to a student of mine once. I was working up north in the classroom, of course.
And we were going over the reproductive system and I was showing videos and everything, talking about it. And she just got up and bust out the classroom, ran out crying. And I went out there, what is going on?
What is wrong? It's like, oh, my God, he told me he was born with all that stuff on him. I was like, oh, my God. And she had to go get checked out. She had, you know, he was passing all kinds of stuff to her.
But again, no sexual harassment diseases and educate your teenagers about it. Please be graphic with your teens. Show pictures, okay? That's how you scare them. But educate them to know better, okay?
You got to educate them. Yes? I know there's two type of HPVs. It's a little confusing.
When they do a vaginal exam, you have cancerous cells. So that's also HPV? I would have to look into that, dear, because I'm sure it's probably a totally different name than HPV. I'll look into that for you. Okay.
There's so many different types of tests for cancer, whether they're collecting the cells off of the cervix, they can collect the cells off of the vaginal wall and test for cancer. So yeah, I'll check into that for you. Okay.
A lot of different tests for that. All right. Unless you already know the name, did you get, did you get checked for that or know someone and you have a name for me? Well, when I was, when I was younger, they told me I had HPV, but it was like a cervical. Like I had cancerous cells in my cervix.
Okay. So I don't know. That's why I'm like, wait. Are you sure they said that this was cancers or benign cells? Have you been checked since then?
Yeah, I have to get it every year. All right. Yeah, I'll look into that. But yes, HPV can turn into cancer if left untreated. Okay, absolutely.
Chlamydia is bacterial. Gonorrhea is bacterial. Syphilis is bacterial.
Guess what? These can be cured. There's medication for these.
If I'm gonna have anything STD, I'd rather have something that could be cured than something that cannot be cured, okay? Now look at herpes simplex. These are viral, HPV viral, okay?
These cannot. be cured. There's no cure for them. Yes, they have medication for symptoms, but any type of virus, there is no cure for viruses.
I don't care if it's a cold virus. There's no cure for viruses. Okay.
Now trichomoniasis is a protozoa. It also though has medication in which you can cure trichomonas. We call it on the street, they call it trich, trichomonas.
Okay. All right. Now cannot be cured, but can manage.
Yes. Those are your virals like herpes, simplex viruses, and HPV. Transmission, fluid transmission versus skin to skin transmission. So chlamydia, gonorrhea, and trichomoniasis, these are all transmitted with fluids and skin to skin STDs are syphilis, HSV, which is the herpes simplex virus and HPV. Okay.
All right, here we go. Questions guys. The MA is asked to give a patient education on a procedure for nephrolithiasis. What will the MA explain to the patient about this diagnosis?
All right, 32 students answered 25, got it correct. Kidney stones. Yeah, all right, guys. Let's look at this leaderboard. Let's see what happens.
All right, we have Kayla. You said number one spot. Emma, Dia, Anna, and Brissa. All right, next question, guys. Which STI is not caused by a bacteria?
Not caused by bacteria. Which one of these guys? All right, 35 students answered, 25 got it correct. Herpes, simplex. All right, guys, let's see.
Lead the board now. Okay, Emma, you moved up. Rissa, Megan, Stephanie, Anna. All right, guys. Next is assisting in pediatrics.
How many of you guys want to work with the babies, with the kids? Kids are strong, and they will beat you up. I worked in pediatrics for years.
Anybody want to work with the kids? Nobody. I did. Thanks, my mom. What'd you say?
No? Okay. I heard you guys.
Okay. Thanks. All right.
Good. Yeah, I worked in pediatrics for quite some time, managed a pediatric office. And when children are scared, I kid y'all not, they are very strong.
And you don't want to put your adult weight on them or strength on them. Try your best to get the parents to help assist. If you know you got to give immunizations and stuff, please get those parents involved, right? Sometimes parents will flee from the scene because they don't want to see their child crying or whatever.
You have to get other inmates to help you out because children, bigger size kids, oh, they can be very strong. They're scared. So, of course, they're going to have a little bit more strength when that epinephrine gets to flowing and stuff, you know.
All right. Developmental stages, pediatric exams, pediatric immunizations and common diseases and disorders of children. Pediatrician.
Yes, they specialize in children ages. 18 to 21. My daughter, who's 21 now, her pediatrician sees up to 21 years old. They monitor the development of children. They monitor immunizations.
Yes, we educate guys on immunizations, the different schedules. We need to know at what age a child has what series of shots, all of that. We give out parent education and developmental milestones for each stage. is also discussed and managed. So the developmental stages encompasses changes in physiological, emotional, mental, social, interactive, spiritual, and physical.
Okay. Erickson's eight, for some reason, on the certification exams for MA, for medical assisting, they like to throw in questions related to Erickson's eight stages of psychosocial development. I don't know what it is, but they like to throw that on there. Okay. And I think it's because it relates to pediatrics.
They're trying to give you more pediatric questions on that exam. So again, Erickson's eight stages of psychosocial development. These are guidelines for identifying psychosocial challenges and can have a positive or negative outcome for personality development. And here they're showing you the early childhood, preschool, school age, adolescence, young adulthood, middle adulthood.
and maturity. I forgot infancy to start it out. But again, this is just like the ring of Erickson's eight.
And again, they will throw some questions on that exam related to that. So for the pediatric examination, height and length, we talked about the difference between those two. They may throw a question on the exam related to what's the difference between the height and the length. Now you guys know the difference.
I broke it down, explained it to you. The weight, head and chest circumference up to about 36 months depending on your pediatrician about how long they'll be taking the head and chest circumference okay um temperature use a tympanic temporal rectal or axillary no oral thermometer should be used right in children less than five years old why would we stay away from the oral thermometer and i think i have mine right here why do you think we'll try we'll mainly stay away from this one if we're doing the temperature under five years old. Why? They probably won't know how to hold it under their tongue properly. Yeah.
And then they're going to do what? Start biting on it. It's the baby, you know, them kids, they're going to start biting on it.
They could, they could break a tooth. Right. And they're not going to keep it still underneath the tongue, even.
Right. So it's best to, you know, if you're going to use one, try to use this one. And I know you guys probably have this one at home, right? I think everybody probably got one of these at home, right?
So I get this from Walmart, CVS, Walgreens. Yeah. But this one, yeah, this one is for the ear.
Okay. You can use this for the ear. Now, if we use the probe thermometer, well, guess what? Instead of oral, where would we place this?
If we don't put it in our mouth. Under their arm. Rectal.
Under their arm and rectal. Very good. So again, rectal, we already know would be red.
We see red here. instead of blue. Blue means oral. You might can change this out depending on which model or yeah, device you have with Welch Allen. This one that I have is not compatible for rectal.
It's only axillary, oral, and yeah, adult axillary, pediatric axillary. Now you might get the one, or your doctor's office might have one where you can change it out to the red one, okay? Mine is a cheaper, these things are expensive, y'all. I had to get what I could for. And again, I use those when I'm going out into the field.
But this one, of course, is only for the ear, tympanic, right? For temperature on our smaller patients, right? All right, for the pulse, apical for infants. What does that mean, apical pulse?
What type of pulse is that? What do we need to take this type of pulse, apical? and where are we at where are we listening for their their pulse with a stethoscope where on this child on the chest on the chest yes yay yes the aphids in the heart very good um ear exams for pediatric examination blood pressure over age three we normally don't take blood pressure under three years old now if that child um has some type of heart problem or something like that, then yeah, we'll use a little tiny little pediatric cuff.
But over age three, especially school-aged children, you know they have to have a physical in order to start kindergarten, get into school. But under age three, normally we don't do blood pressure. Use the correct cuff size. Some children are bigger than other kids, okay?
But you would never use an adult size cuff though, okay? smaller children as they get bigger preteens and teenagers then yeah you may have to use an adult size cuff because they're bigger now do not use the palpatory method on smaller children review family health histories existing conditions current health concerns observe the child for any abnormalities that may indicate an underlying health concern monitor their growth charts and record their measurements their height and their weight now growth charting you EHRs, these are electronic charts. Most of the time in EHR systems, when you put in the child's weight and their height, it will automatically chart the growth chart if the doctor has it set up like that. Otherwise, you'd have to do it a manual way with growth charting. And that means you're going off of, hold on, let me see down here.
It says their age down here. And then it has kilograms on this side. Normally on the opposite side, it'd be pounds. So basically, you just simply go off of what their age is. Let's say this child is six months.
And then whatever their weight is in kilograms. And then you mark a dot. And then this color coding will let you know what percentile they're in for their age group.
And whether they're thriving or not, the doctor will determine that by what we chart on here. Okay. But again, if they have EHR systems and it's all built into their EHR, as soon as you input that child's... weight, you already got the age in there, it will automatically populate what their percentile is. Okay.
Love those. All right. But again, it's monitoring the child for thriving.
Are they thriving according to other children in their age percentile bracket? Pediatric immunizations. Right here, here is a vaccine information statement sheet.
This one is DTAP, diphtheria tetanus, acellular pertussis. All right. There's a sheet for every immunization that's out there on the market. There is a vaccine information statement sheet. These have to be given to the parent of the child, the caregiver, before we give immunizations.
Even if it's an adult, you're supposed to give that vaccination information statement. Why do you think that's important to give them this statement first before we give immunizations? Why do you think, guys?
So the parent knows if they still want to go through with the vaccine after having all the information about it? Absolutely. It's called informed consent, right? We're informing them of what this vaccine is. They can read about it.
What are the pros and cons of it? Okay, what happens if they get it? What happens if they don't get the immunization done?
What to do when they get home if the child gets a little bit of a fever, they're a little bit lethargic? Sometimes we tell them to take a warm washcloth and rub the area that we gave them the immunization in a circular motion to help the medication dissipate, to move, right? So all of this is on there, okay?
What to do if they get a fever? What to do if they seem a little bit sick, right? What is DTaP?
What is MMR? What is IPV, right? These are all different immunizations.
And then these are updated, updated ever so often through CDC. CDC stands for what? Who knows? What is CDC, guys? The Centers for Disease Control.
Centers for Disease Control. CDC.gov is going to be your best friend, especially if you work in pediatrics, right? That's where you go to get all the most updated information about immunizations. All immunizations, not just for P's, right? These vaccination information statement sheets have to be the most current ones.
We cannot give out old vaccination information statements. Okay? And we have to give it to them first before we give them the vaccine. Right here is showing you at what age a child gets what vaccines at birth. It's their very first vaccine before they leave the hospital, hepatitis B, right?
When do they get their second hepatitis B? Well, as you can see, it's yellow here from one to two months. So that means they can get their second hepatitis B anywhere between one and two months of age, right?
When that baby come in for their first well baby visit, it's going to be at two months when they see the pediatrician. That two month well baby visit includes immunizations. Well, look at all of these. At two months, your child, if they're not sick, don't have a fever, right? This child is going to get possibly that second hepatitis B.
If they didn't get the second one at one month, they'll get it at two months, along with the rotavirus vaccine, the DTa, the Hib, the PCV13, and the IPV. This is the inactivated polio. PCV is the pneumococcal conjugate.
HIV is the haemophilus influenza type B, okay? RV rotavirus. So they're getting all of these.
and one well baby visit okay some of these are combination vaccines have you guys heard combos combination vaccines anybody anybody heard of those combination vaccines all right so thank goodness for combos so that means it might be three of these in one shot okay depending on what the combination pediurettes uh trihibit i can't think of the other names of combination vaccines But it lessens the amount of times you have to stick that child when it's a combo. Then they come back in at four months, another series. Six months, another set of vaccines.
Okay? That third hepatitis B can be given from what month to what month can they get that third hepatitis B? What does this tell you? Six to 18 months.
Between six to 18 months, it's up to the doctor when they want us, the MA, to give them that third hepatitis B vaccine. Okay? All right. Look at IPV.
The inactivated polio virus vaccine can be given between what months? What months, guys, for the IPV? Six through 18. From six to 18 months. Again, the doctor determines when the child gets these vaccines. We don't determine that, but the doctor will let us know what to actually give the child.
Okay. All right, immunizations. Check published immunization schedules found at the cdc.gov.
Check for contraindications. Ensure the scope of practice when administering immunizations. That means stay within your scope of practice. Do not act as a doctor or a nurse.
Informed consent. We talked about the reason for this vaccination information statement. It has to be the most updated version.
We do not give out old ones, okay? We document everything about the administration of vaccines. What we gave, how much we gave. Where did we give it? Company that made it, lot number, expiration date.
Okay, how well did the child or the patient tolerate? This is for any injections. That's how much information you document for one shot.
Document, document, document. There's no way around not documenting what you do every day on every patient in that doctor's office, okay? We write down everything. Common diseases and disorders for children, common cold and influenza.
Ear infections, otitis media is very common in kids as well, middle ear infection. That's what otitis media is. Bronchitis, airways in the lungs swell. and produce mucus in the lungs. This is mainly a viral thing.
Again, it'll go away when it's on. You can get medications to treat the symptoms. Remember, viruses, that's what it is. Viruses, there are no cures for it.
There are medications to help treat symptoms and keep it suppressed somewhat. Yes, thank goodness for that. RSV, respiratory syncytial virus, RSV doesn't just affect children.
Adults can get RSV as well. But RSV is more common in kids. Mild cold-like symptoms, including fever, coughing, and sneezing. Hand, foot, and mouth disease. Very contagious.
Symptoms include skin rash, fever, amongst other symptoms. Conjunctivitis, also known as pink eye. Redness, discharge, itchiness, swelling in both, one or both eyes. When you go to sleep, sometimes you try to wake up.
You can't get your eyes open when you have conjunctivitis. Because that crusty buildup overnight has your eyes stuck together, right? Gastroenteritis, stomach flu, viral. Symptoms include nausea, vomiting, and diarrhea.
Again, if it's viral in nature, there's medications to treat those symptoms, right? Sinusitis, sinus infection. These are all common diseases and disorders in children. I know we're looking over time, but I'll say the last part, though. What are the following types of patients would be measured in length?
Length. Length. Alright guys. 31 students answered 23 got it correct neonates yep okay because all these other children they're able to stand on the upright scale to get their height very good anna you moved up isha emma you still holding on to the number one spot looks like all right next question guys which is not taken on a child until the age of three All right, 32 people answered, 28 got it correct. Blood pressure, very good.
All right, I know we're a little over time, but assisting in geriatrics, guys, if you're not able to stay on, I get it. developmental changes in geriatric patients special considerations and assisting older patients is there anyone on here that wants to work in geriatrics or internal medicine see a lot of older patients as well anybody are you interested in that like in louisiana we have like a osher's that's 65 plus would that be would that be that um is this uh i don't know is there a physician that's on staff i'm sure geriatric doctor maybe yeah You work there as a medical assistant? Yep.
Okay. You work there now? No, I'm just trying to see would that fall into the category?
Oh, okay. Now, if it's a nursing home, then no, medical assistants don't work at nursing homes or assisted living facilities, CNAs work there. But if this is actual like a doctor's clinic, then yeah.
Okay. All right. Select physical changes of aging.
Of course, the older you get, guys, the body starts to change. Integumentary system, you have... thinning and wrinkling skin, decreased collagen.
The musculoskeletal system, osteoporosis, that's a breakdown of bone, bone mass. And they say the older you get, you start to shrink. I'm already short.
So what am I going to get down to four feet, nine or something? But anyway, the nervous system, decreased blood flow to the brain due to arteriosclerosis. What is arteriosclerosis, guys?
What's that? Arteriosclerosis. We only have four more slides to go.
What is arteriosclerosis? What does that mean? Sclerosis is the suffix. Artery is the root word. What does this mean?
Hardening of the arterioles. Hardening of arteries. So we have decreased blood flow because the arteries begin to harden.
In the special senses as we get older, impaired vision like presbyopia, the respiratory system increased shortness of breath. And then for the cardiovascular system, atherosclerosis. A lot of students get atherosclerosis confused with arterio. Sclerosis after means.
like a plaque buildup. Okay. And it is in the arteries, but it's like a flaky type of buildup. Hypertension, hypotension, both are bad.
Hypotension of course means what? What is hypotension guys? What is that?
Hypotension. Low blood pressure. Low blood pressure.
Yeah. How did you know hypo means? Yeah. Cause hypo means low, right below.
hypertension, of course, is a high blood pressure. All right, we only have a couple more slides to go. Cystic and geriatrics, we need to observe for physical limitations, communicate effectively with our elderly population of patients. We can write down some instructions, speak clearly, maybe a little bit slower, make sure we use low tones so they can understand. If a patient is hard of hearing, kind of place yourself kind of in front of them so they can read your lips.
A lot of elderly patients read lips. It's because their hearing is not that great anymore. The patient may have denial or confusion.
Educate the patient on the importance of preventative measures. If there's a caregiver that comes in with the elderly patient, family member maybe, make sure we're educating the family members or the caregiver as well. Ensure that the patient is compliant with medications.
Make sure they, this right here is key. I mean, anybody can use this and stay on target with their medications. for each day of the week.
There's nothing wrong with you being a younger person to have one of these if you take a lot of medications. It will help you keep your medications in order, right? This is a very good thing to use. All right, here we go.
Which physical change happens in the elderly patient's special senses? Special senses. All right, 34 people answered.
14 people that said got it right. Presbyopia. Presby means older age, right? Opioid, vision. Okay, let's see.
Isha. Kayla, Elizabeth, you moved up. Emma holding on to that number one spot. I think this is the one last question.
At which age is a patient considered geriatric? Okay, 33 people answered. 22 got it correct.
65 years of age is considered geriatric. Okay, leaderboard, final leaderboard. Emma, you held on to the number one spot. Isha, you moved up second.
Megan, Kayla, and Elizabeth. Very good, everyone. You guys did a great job.
And again, we have our bigger review on Friday to get ready for this midterm. Make sure you're on there now. It's recorded just in case you have an emergency or something. Yes, how are you guys feeling so far about all of your classes?