Download Clinical Procedures

Clinical Procedures
INFECTION CONTROL
Objectives
1. Define, spell, and pronounce the key terms related to infection control.
2. Define and state the critical importance of infection control in the ambulatory care setting.
3. Outline the six stages in the infection cycle.
4. Define the five classifications of infectious microorganisms.
5. Recall and elaborate on the four phases the immune system uses to defend against infectious
disease.
6. State the four stages of infectious diseases.
7. Recall at least five infectious diseases, their agents of transmission, and their symptoms.
8. Compare the routes of transmission of AIDS and hepatitis B and C and discuss the risk for infection
from needlestick.
9. Describe the purpose of Standard Precautions and give six examples of ways health care providers
should practice Standard Precautions.
10. Differentiate among the three types of Transmission-Based Precautions, defining what they are and
how they are applied.
11. List eight types of body fluids and give an example of each.
12. Identify appropriate personal protective equipment for potentially infectious situations.
13. Recognize five situations in which exposure to a patient’s blood can occur, and discuss why Standard
Precautions are important.
14. Describe proper disposal of infectious waste.
15. Identify the role of the Centers for Disease Control regulations in health care settings.
16. List human fluids that may contain HIV, HBV, and HCV.
17. Define medical asepsis.
18. Define bioterrorism and describe five agents that could be used in a bioterrorism attack.
19. Define surgical asepsis and differentiate between surgical asepsis and medical asepsis.
20. List eight basic rules to follow to protect sterile areas.
21. State four methods of sterilization.
22. List supplies and equipment necessary to achieve surgical asepsis when using an autoclave.
23. Explain competent wrapping and operation of the autoclave.
24. State storage measures and expiration periods for autoclaved materials.
25. Demonstrate applying sterile gloves.
Activity Checklist
Completed Activity
Complete the Infection Control Pre-test. You will only complete this pre-
Required
Yes
test once.
Read in your textbook or e-book
Not graded- use
to prepare for
Chapters____
competency
demonstration

pages ___
View the following skills videos :
Not graded- use
to prepare for

Universal Precautions
competency

Everyday Handwashing
demonstration

Removing Gloves

Cold Chemical Sterilization of Instruments


Wrapping Instruments for Autoclave
Steam Sterilization using the Autoclave
Complete the following study quiz as many times as needed to prepare for Not gradedthe content competency evaluation.
use to prepare
for competency

Infection Control
demonstration
Complete the following Competency Theory Exam to demonstrate mastery Yes
of theoretical competencies”

Infection Control
Demonstrate competency of the following skills found in your Competency Yes
Manual to your skills evaluator:
Medical Asepsis Hand Wash

Removing Contaminated Gloves

Transmission-Based Precautions: Donning a Gown, Mask, Gloves,
and Cap

Sanitation of Instruments

Chemical “Cold” Sterilization of Endoscopes


Preparing Instruments for Sterilization in an Autoclave
Sterilization of Instruments (Autoclave)
Real World Application Activities
The following list of activities contains suggestions to assist you to evaluate how the material learned in
this module is applied in the clinic where you work. These are ungraded activities designed to help the
student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills
to evaluate the experiences.

Using observation, evaluate your patient interactions at the clinic. Are standard precautions used
appropriately in every instance? Why or why not? Is it ever acceptable to fail to adhere to standard
precautions?

Identify the clinic’s policy for the steps to be taken by a medical assistant in regard to transmissionbased precautions.

Evaluate your own proficiency in selecting the correct PPE for different situations. Here are some
practice examples. What PPE should be selected for the following:
Performing vital signs on a patient who has tested positive for tuberculosis and who
has not yet initiated antimicrobial treatment.
2. Changing a dressing on a patient with second degree burns.
3. Performing venipuncture to obtain blood for a CBC and fasting glucose.
4. Obtaining sample of wound exudate for microbiology
1.

Observe other MA staff throughout the day- is the policy upheld in every instance? Evaluate why
adherence to the policy may vary.

Evaluate your own handwashing technique throughout the day. How does it compare to the
procedure you have learned in this module? Do you need to change your habitual procedure?

Respond appropriately to a patient who asks why you are wearing PPE.

Ask to job shadow the person who performs instrument autoclaving at your clinic, observing for:
 Sanitization procedures, including the solution used.
 How the appropriate wrapping material is selected.
 Strip indicator used? What type? Where is it placed?
 Autoclave tape – how is it used?
 Labeling- how is the wrapped package labeled?
 Loading of the autoclave.
 Operation of the autoclave- where are the instructions for time, temperature and pressure
appropriate for the items being sterilized maintained?
 Storage practices- what is the policy in your clinic for place and length of time for the storage of
sterile items.
 Does your clinic maintain a log sheet for the operation of the autoclave? How is the log
maintained?
MINOR OFFICE SURGERY
Objectives
1. Define, spell, and pronounce the key terms as presented in the glossary.
2. Define surgical asepsis and differentiate between surgical asepsis and medical asepsis.
3. List eight basic rules to follow to protect sterile areas.
4. State four methods of sterilization.
5. List supplies and equipment necessary to achieve surgical asepsis when using an autoclave.
6. Explain competent wrapping and operation of the autoclave.
7. State storage measures and expiration periods for autoclaved materials.
8. Explain the sizing standards of suture material and the criteria used to select the most appropriate
type and size.
9. Given a variety of surgical instruments, be able to identify each and describe its intended use.
10. Demonstrate the ability to select the most appropriate type of dressings for a given situation.
11. State advantages and disadvantages of Betadine®, Hibiclens®, isopropyl alcohol, and hydrogen
peroxide when each is used as a skin antiseptic.
12. Define anesthesia, and explain the advantages and disadvantages of epinephrine as an additive to
injectable anesthetics.
13. List five preoperative concerns to be addressed in patient preparation and education.
14. List five postoperative concerns to be addressed with the patient and the caregiver.
15. Demonstrate applying sterile gloves.
16. Demonstrate setting up a surgical tray, including laying the field, applying supplies and instruments,
pouring a sterile solution, using transfer forceps, and covering the sterile tray.
17. Explain what is meant by alternative surgical methods.
Activity checklist
Completed Activity
Complete the Minor Office Surgery Pre-test. You will only complete this
Required
Yes
pre-test once.
Read in your textbook or e-book
Not graded- use
to prepare for
Chapters_____:
competency
demonstration

Pages_____
View the following skills videos
Not graded- use
to prepare for

Draping a Sterile Field
competency

Applying a scalpel blade
demonstration

Sterile gloves

Set up and assist with surgery

Removing sutures, staples, applying steri-strips


Dressing change, suture removal
Preparation of skin before surgery
Complete the following study quiz as many times as needed to prepare for Not gradedthe content competency evaluation.
use to prepare
for competency

Minor Office Surgery
demonstration
Complete the following Competency Theory Exam to demonstrate mastery Yes
of theoretical competencies”

Minor Office Surgery
Demonstrate competency of the following skills to your skills evaluator:
 Applying Sterile Gloves

Setting up and covering a sterile field

Opening sterile packages of instruments and supplies and
applying then to a sterile field

Pouring a sterile solution into a cup on a sterile field

Assiting with office/ambulatory surgery

Dressing change

Wound irrigation

Preparation of a patients skin before surgery

Suturing of laceration or incision repair

Sebaceous cyst excision

Incision and drainage of localized infection

Aspiration of joint fluid

Hemorrhoid thrombectomy

Suture/Staple removal

Application of sterile adhesive skin closure strips
Yes
Real World Application Activities
The following list of activities contains suggestions to assist you to learn how the material learned in this
module is applied in the clinic where you work. These are ungraded activities designed to help the
student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills
to evaluate the experiences.
Who assists the physician with office surgeries in your clinic:
o
Prepare the surgical area/ exam room.
o
Evaluate the chart for appropriate consent.
o
o
Provide patient pre and post-surgical education and information.
Prepare the patient; positioning, surgical site preparation, any medications.
Observe and evaluate the preparation for a sterile procedure. Watch and evaluate to yourself whether
the following procedures were performed according to the standards you have learned in this module:
o
Sterile gloving and gowning
o
Set up of the sterile field or tray
o
Opening of sterile packages
o
Adding items to the sterile field
o
Pouring sterile solutions
o
o
Assisting with suturing
Application of the wound dressing
Where is the information written, or is it written, identifying the instruments and other items needed for
various sterile procedures commonly performed in your clinic?
Who removes sutures or staples in your clinic? What is the appropriate PPE to be worn during the
procedure? Are appropriate PPE consistently worn by all staff when performing this procedures?
Evaluate to yourself why or why not. When might a medical assistant need to ask a physician to evaluate
a surgical wound either prior to or after sutures or staples are removed?
MEDICATION ADMINISTRATION
Objectives
1. Define, spell, and pronounce the key terms related to medication administration.
2. Discuss the legal and ethical implications of medication administration.
3. Describe the medication order.
4. Identify abbreviations and symbols used in calculating medication dosage.
5. Describe the parts of a prescription.
6. Define drug dosage.
7. State what information is found on a medication label.
8. Understand ratio and proportion.
9. Use the metric, household, and apothecary systems of measurement and convert between the metric
and apothecary systems.
10. Understand units of medication dosage.
11. Correctly calculate dosages for adults and children.
12. List the guidelines to follow when preparing and administering medications.
13. Administer oral medications.
14. Select proper sites for administering parenteral medication.
15. Describe safe disposal of syringes, needles, and biohazard materials.
16. Describe site selection for administration of injections.
17. Administer intramuscular, subcutaneous and intradermal injections.
18. Understand intravenous therapy.
19. Understand allergenic extracts.
20. Describe inhalation medication and its administration.
Activity Checklist
Completed Activity
Complete the Medication Administration Pre-test. You will only complete
Required
Yes
this pre-test once.
Read in your textbook or e-book,
Not graded- use
to prepare for
Chapters: ____
competency
demonstration

Pages: _____
View the following skills videos:
Not graded- use
to prepare for

How to Handle a Needlestick
competency

Withdrawing From A Vial
demonstration

Withdrawing Medication From An Ampule

Administering SQ & IM Injections

Administering ID & Z-Track IM Injections

Mixing Diluent & Changing Needles

Medication Administration Terms

Positioning Babies and Children for Injections

Immunization Techniques

Mantoux Test

Tips for Childhood Vaccinations


Immunizations
Child Profile and Pain Management
Complete the following study quiz as many times as needed to prepare for Not graded-
the content competency evaluation.
use to prepare
for competency

Medication Administration
demonstration
Complete the following Competency Theory Exam to demonstrate mastery Yes
of theoretical competencies”

Medication Administration
Demonstrate competency of the following skills found in your Competency Yes
Manual to your skills evaluator:

Withdrawing medication from a vial

Withdrawing medical from a ampule

Administering a subcutaneous injection

Administering an intramuscular injection

Administering an intradermal injection of purified protein derivative
(PPD)


Reconstituting a powder medication for administration
Z-track intramuscular injection technique
Real World Application Activities
The following list of activities contains suggestions to assist you to evaluate how the material learned in
this module is applied in the clinic where you work. These are ungraded activities designed to help the
student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills
to evaluate the experiences.

Find and read your clinic’s policy for the personnel that can administer medications in your clinic.
What will be your role in the administration of medication?

What drug references are available to obtain information on medications to be administered?

What are the medications most commonly administered in your clinic. Using one of your clinic’s drug
references, prepare a drug reference card for the medications/ vaccines you are most likely to
administer, for use as quick review prior to medication administration.

Find the medication preparation area in your clinic. How is it organized?

Are sample medications available for dispensing at your clinic? Where and how are they stored?

Following your clinic’s HIPAA guidelines, read and evaluate various health care provider’s medication
orders.

Practice reading the labels on various medication vials/ ampules in your clinic.

Job shadow clinic personnel as they administer injections:
o
How is the medication selected? How many times was the label read?
o
Evaluate the preparation of the medication. Was ii the same as you learned in this module? Why
or why not?
o
Was the medication explained to the patient? Would you have said anything additional?
o
Was paperwork (i.e. a VIS form) required prior to administration of the medication or vaccine?
How was that obtained?
o
Observe the administration of the medication? Was it administered as you learned in this
o
module? Evaluate why the procedure was performed as you observed.
How was the medication administration documented?
ELECTROCARDIOGRAPHY
Objectives
1. Define, spell, and pronounce the key terms related to electrocardiography.
2. Follow the circulation of blood through the heart starting at the vena cavae.
3. Describe the electrical conduction system of the heart.
4. State three reasons why patients may need an electrocardiogram (ECG).
5. Identify the various positive and negative deflections and describe what each represents in the
cardiac cycle.
6. Explain the purpose of standardization of the ECG.
7. Identify the 12 leads of an ECG and describe what area of the heart each lead represents.
8. State the function of ECG graph paper, electrodes (sensors), and electrolyte.
9. Describe various types of ECGs and their capabilities.
10. Explain each type of artifact and how each can be eliminated.
11. Name and describe the purposes of the various cardiac diagnostic tests and procedures as outlined
in this chapter.
12. Identify the placement of Holter monitor electrodes.
13. Describe the reason for a patient activity diary during ambulatory electrocardiography.
14. Identify six arrhythmias and explain the cause of each.
15. Explain how to calculate heart rates from an ECG tracing.
16. Identify a common coding system used to code each lead on an ECG tracing.
17. Describe the procedure for mounting an ECG tracing.
18. Perform an ECG.
Activity Checklist
Completed Activity
Required
Complete the ECG Pre-test. You will only complete this pre-test once.
Yes
Read in your textbook or e-book
Chapter:____
Not graded- use
to prepare for
competency

Pages ____
demonstration
View the following skills videos:
Not graded- use
to prepare for

EKG and Holter Monitor
competency
demonstration
Complete the following study quiz as many times as needed to prepare for Not gradedthe content competency evaluation.
use to prepare
for competency

ECG
demonstration
Complete the following Competency Theory Exam to demonstrate mastery Yes
of theoretical competencies”

ECG
Demonstrate competency of the following skills found in your Competency Yes
Manual to your skills evaluator:

Perform a multi-channel electorcardiogram
Real World Application Activities
The following list of activities contains suggestions to assist you to evaluate how the material learned in
this module is applied in the clinic where you work. These are ungraded activities designed to help the
student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills
to evaluate the experiences.

Ask to job shadow the person who performs ECG’s at your clinic, observing for:
o
Where to obtain the supplies and equipment needed and what needs to be gathered. Is it all on
one cart, or must additional supplies be obtained?
o
How is the procedure explained to the patient? Would you add or delete anything you heard? Did
the explanation put the patient at ease with the procedure?
o
Does your clinic have a policy for shaving the chest for males with an abundance of hair? If
shaving is necessary, is the necessity explained? Is the patient required to sign a consent form
agreeing to be shaved?
o
In your observation, were the leads places as you learned in the module? If not, why not?
o
Did the person placing the leads palpate for landmarks, or just place the leads in a general
area? Was the patient’s modesty protected?
o
Was the ECG tracing examined for artifacts upon completion? Were any artifacts noted? If
artifacts were present, what may have caused the failed recording?
o
Look at the ECG tracings obtained at your clinic in a given day, making sure to abide by any
HIPAA regulations at your clinic. Can you identify the difference between normal and abnormal
tracings?
PHLEBOTOMY
Objectives
1. Define, spell and pronounce the key terms for phlebotomy procedures.
2. Explain the medical assistant’s responsibility to the patient in terms of quality of care and respect for
the patient as a human being.
3. Explain the supplies and equipment used in blood collections and demonstrate the ability to use them
safely and comfortably.
4. Explain the importance of correct patient identification; complete specimen labeling; and proper
handling, storage, and delivery.
5. Summarize the step-by-step procedure for drawing blood with a syringe, vacuum tube system,
butterfly, or capillary puncture.
6. Explain how to handle the various reactions a patient might have to venipuncture.
7. Perform a capillary puncture to obtain a blood sample.
8. Perform venipuncture to obtain a blood sample.
Activity Checklist
Completed Activity
Complete the Phlebotomy Pre-test. You will only complete this pre-test
Required
Yes
once.
Read in your textbook or e-book
Not graded- use
to prepare for
Chapter:____
competency
demonstration

Pages:____
View the following skills videos:
Not graded- use
to prepare for

1-D Syringes and Needles
competency

1-E Evacuated Tubes & Vacutainer Equipment
demonstration

1-G Finding Veins in the Anticubital Area

2 Syringe Method of Blood Collection


3 Evacuated Tube Method of Blood Collection
4 Butterfly Method of Blood Collection
Complete the following study quiz as many times as needed to prepare for Not gradedthe content competency evaluation.
use to prepare
for competency

Phlebotomy
demonstration
Complete the following Competency Theory Exam to demonstrate mastery Yes
of theoretical competencies”

Phlebotomy
Demonstrate competency of the following skills found in your Competency Yes
Manual to your skills evaluator:

Palpating a vein and preparing a patient for venipuncture

Venipuncture by vacuum tube system


Venipuncture by butterfly needle system
Capillary puncture
Real World Application Activities
The following list of activities contains suggestions to assist you to evaluate how the material learned in
this module is applied in the clinic where you work. These are ungraded activities designed to help the
student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills
to evaluate the experiences.

Ask to job shadow the person who performs venipuncture or capillary punctures at your clinic,
observing for:
o
Read the order for the type of specimen required.
o
Where to obtain the supplies and equipment needed and what needs to be gathered. What
equipment is needed for each procedure? Find the expiration dates on the supplies and check
the dates.
o
Listen as the procedure is explained to the patient. Listen to patient responses and observe the
patient as the procedure is explained. Is the explanation adequate? Does the patient ask
questions? Is the verbal communication from the patient congruent with their non-verbal
communication? If not, is this addressed with the patient? Example: Does the patient state they
don’t have a problem with blood draws, but turn pale and clammy? Were all patient concerns
addressed adequately or were reassuring cliché’s such as, “you will be fine” used instead of
informative responses?
o
Was the blood sample collected using the techniques you have learned in the module? Did you
observe any variations? What were they? Analyze the variations to yourself and decide if the
procedure was performed in a manner that met strict patient safety guidelines and would lead to
an adequate blood sample.
o
How were the patient samples labeled and prepared for testing or packaged for shipping?
o
Imagine a venipuncture emergency has occurred. List one. What first aid supplies would be
needed for that emergency? Do you know where those supplies are located in your clinic? Who
would you notify in your clinic of the emergency?
SPECIMEN COLLECTION, MICROBIOLOGY, AND QUALITY CONTROL
Objectives
1. Explain the reasons for performing laboratory testing.
2. Describe the main similarities and differences between an independent laboratory and a physicians’
office laboratory (POL).
3. Explain the levels of laboratory personnel in relation to their education, skills, and duties, and where
the medical assistant is placed in the hierarchy.
4. List eight different departments within the medical laboratory and list at least two types of testing
performed within each of those departments.
5. Name nine of the most common laboratory panels and explain the body system or function being
surveyed.
6. Explain the concepts of quality control and quality assurance in the medical laboratory.
7. Describe at least three methods of ensuring quality in the medical laboratory.
8. Demonstrate how to correctly complete a laboratory requisition.
9. Explain the rationale behind proper patient preparation before laboratory testing.
10. Explain where accurate and reliable information might be obtained about proper procurement,
storage, and handling of laboratory specimens.
11. Demonstrate the proper use and care of a compound microscope.
12. Use language/verbal skills that enable a patient’s understanding.
13. Describe basic bacterial cell structure.
14. Discuss quality control issues related to handling microbiology specimens.
15. Explain the types of microbiology specimens collected in the POL and how they are collected.
16. List different types of stains used to microscopically observe microorganisms.
17. Describe the significance of sensitivity testing.
18. List two parasites and two fungi that can be observed in the POL.
19. Obtain specimens for microbiological testing.
20. Perform CLIA waived immunology tests on serum.
21. Distinguish between normal and abnormal test results.
Activity checklist
Completed Activity
Complete the Specimen collection, Microbiology and Quality Control Pre-
Required
Yes
test. You will only complete this pre-test once.
Read in your textbook or e-book,
Not graded- use
to prepare for
Chapters:_____
competency
demonstration

pages ____
View the following skills videos:
Not graded- use
to prepare for

Throat culture and Rapid Strep test
competency
demonstration
Complete the following study quiz as many times as needed to prepare for Not gradedthe content competency evaluation.
use to prepare
for competency

Specimen collection, Microbiology and Quality Control
demonstration
Complete the following Competency Theory Exam to demonstrate mastery Yes
of theoretical competencies”

Specimen Collection, Microbiology and Quality Control
Demonstrate competency of the following skills to your skills evaluator:

Procedure for obtaining a throat specimen for culture


Performing strep throat testing
Instructing a patient on obtaining a fecal specimen
Yes
Real World Application Activities
The following list of activities contains suggestions to assist you to learn how the material learned in this
module is applied in the clinic where you work. These are ungraded activities designed to help the
student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills
to evaluate the experiences.

Identify the policy at your clinic for laboratory quality control measures for microbiology testing.
Review the policy for correct performance of quality control testing.

Identify the procedure manual at your clinic related to CLIA waived microbiology testing. Review the
manual for the steps to perform testing at your clinic.

Observe the performance of CLIA waived microbiology testing in your clinic and evaluate to yourself
whether it was performed in accordance with the written policy.

Complete a sample requisition form.

Practice screening results. Identify the process in your clinic to report values that require follow-up,
including patient notification. How is this documented in the chart?
HEMATOLOGY AND LABORATORY TESTS REQUIRING BLOOD SAMPLES
Objectives
1. Describe the process of hematopoiesis.
2. List the five types of normal white blood cells and give the identifying characteristics and role of each.
3. Explain to a fellow student the role of the red blood cell and the platelets.
4. Discuss how the clinical science of hematology and the complete blood count (CBC) are used in the
diagnosis and treatment of disease.
5. Discuss how the hemoglobin, hematocrit, erythrocyte to indices, and ESR are used to diagnose.
6. Apply mathematical computations to solve the equation of erythrocyte indices (using RBC count,
hemoglobin and hematocrit).
7. Describe CRP and its uses as a screening test for general infection and inflammation.
8. Discuss quality-control issues related to handling laboratory specimens.
9. Explain the types of waived specialty tests performed in the POL and how specimens are collected.
10. Obtain specimens for specialty tests as covered in this chapter.
11. Select appropriate PPE for potentially infectious situations.
12. Perform CLIA waived chemistry tests covered in this chapter.
13. Distinguish between normal and abnormal test results.
Activity checklist
Completed Activity
Complete the Hematology and Laboratory Tests Requiring Blood
Required
Yes
Samples Pre-test. You will only complete this pre-test once.
Read in your textbook or e-book
Not graded- use
to prepare for
Chapters:____
competency
demonstration

Pages____
View the following skills videos:
Not graded- use
to prepare for

Protime or INR
competency

Microhematocrit
demonstration

Measurement of blood glucose using an automated analyzer
Complete the following study quiz as many times as needed to prepare for Not gradedthe content competency evaluation.
use to prepare
for competency

Hematology and Laboratory Tests Requiring Blood Samples
demonstration
Complete the following Competency Theory Exam to demonstrate mastery Yes
of theoretical competencies”

Hematology and Laboratory Tests Requiring Blood Samples
Demonstrate competency of the following skills to your mentor / skills
Yes
evaluator:

Hemoglobin determination using a CLIA waived hemoglobin analyzer

Microhematocrit determination

Erythrocyte sedimentation rate

Prothrombin time (using a CLIA waived ProTime analyzer)


Measurement of blood glucose using an automated analyzer
Cholesterol testing
Real World Application Activities
The following list of activities contains suggestions to assist you to learn how the material learned in this
module is applied in the clinic where you work. These are ungraded activities designed to help the
student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills
to evaluate the experiences.

Identify the policy at your clinic for laboratory quality control measures for hematologic testing.
Review the policy for correct performance of quality control testing.

Perform the routine maintenance of any equipment used in hematologic testing, such as a
glucometer.

Identify the procedure manual at your clinic related to CLIA waived hematologic testing. Review the
manual for the steps to perform testing at your clinic.

Observe the performance of CLIA waived hematologic testing in your clinic and evaluate to yourself
whether it was performed in accordance with the written policy.

Complete a sample requisition form.

Observe how blood samples are labeled in your clinic.

Practice screening laboratory results and begin to memorize normal levels for common hematologic
tests. How are results outside of normal “flagged” for the provider to evaluate? What is the medical
assistant’s role in reviewing lab results in your clinic?
PHYSICAL AND SPECIALTY EXAMINATIONS
Objectives
1. Define, spell, and pronounce the key terms as presented in the glossary.
2. Describe the six methods used in physical examinations.
3. Name and describe seven positions used for physical examinations.
4. Discuss the purpose of draping and demonstrate appropriate draping for each position.
5. Identify at least 10 instruments and supplies used for examination of various parts of the body.
6. Identify eight basic components of a physical examination.
7. Describe the sequence followed during a physical examination.
8. Recall method of examination, instrument used, and position for examination of at least eight body
parts.
9. Explain the importance of prenatal care, and discuss what examinations will be performed as part of
the initial visit.
10. Explain why the initial prenatal visit is important.
11. List 12 conditions or diseases that can cause a pregnant woman and her fetus to be at greater risk for
problems during the pregnancy.
12. List signs and symptoms and their possible corresponding conditions that the provider searches for
during the prenatal history and physical examination.
13. Calculate an expected date of confinement (EDC) or expected date of birth (EDB) using Nagele’s
Rule.
14. Calculate an EDC (EDB) using a gestation wheel.
15. Explain the purpose of ultrasonography and amniocentesis.
16. List and describe six types of abortion.
17. Explain what occurs in each of the three stages of labor.
18. Describe what takes place during the postpartum examination.
19. List and describe the diseases and disorders that can affect the female patient.
20. Describe the laboratory tests and procedures that can help diagnose the diseases and disorders that
can affect the female patient.
21. Describe seven sexually transmitted diseases.
22. Explain the medical assistant’s responsibilities with a gynecologic examination.
23. Describe breast self-examination and the method of teaching patient breast self-examination.
24. Discuss menopause.
25. Describe the findings and concerns surrounding hormone replacement therapy.
26. Describe several methods of contraception.
27. Explain reasons for impaired fertility.
28. Describe three therapies that assist in reproduction.
29. Explain testicular self-examination to a male patient.
30. List major organs in each body system.
31. Describe the normal function of each body system.
32. List basic integumentary assessment keys.
33. Define components of neurological examination.
34. List essentials of a sensory system examination.
35. Explain the value of each chart utilized in the eye exam.
36. Describe the proper use of a metered dose inhaler.
37. Briefly discuss the role of the medical assistant during spirometry and pulse oximetry.
38. Explain oxygen administration using a nasal cannula.
39. Identify patient education information for sputum collections.
40. Describe patient preparation for occult blood testing.
41. List items required by a provider for a neurologic examination and explain the medical assistant’s role
in the examination.
42. Discuss the different types of visual acuity charts and how to use them appropriately.
43. Differentiate between an instillation and irrigation.
44. Describe how to perform a nasal irrigation.
45. Explain the medical assistant’s role when assisting with audiometry.
46. Describe how to perform a urinary catheterization.
Activity checklist
Completed Activity
Complete the Physical and Specialty Examinations Pre-test. You will only
Required
Yes
complete this pre-test once.
Read in your textbook or e-book
Not graded- use
to prepare for
Chapters:_____
competency
demonstration

pages_____
View the following skills videos:
Not graded- use
to prepare for

How to use the power exam table
competency

Positions
demonstration

Female pelvic exam

Assisting with pelvic exam

Welch Allyn Ear Wash system

Elephan ear wash system

Performing ear irrigation & ear instillation

Assisting a physician with a Neurological screening examination

Assisting with a Flex Sig

Visual acuity testing using a snellen chart

Eye patch


Administer Oxygen by Nasal Cannula for Minor Respiratory Distress
Spirometry
Complete the following study quiz as many times as needed to prepare for Not gradedthe content competency evaluation.
use to prepare
for competency

Physical and Specialty Examinations
demonstration
Complete the following Competency Theory Exam to demonstrate mastery Yes
of theoretical competencies”

Physical and Specialty Examinations
Demonstrate competency of the following skills to your skills evaluator:

Assisting with a complete physical examination

Assisting with pelvic examination and pap test (conventional and
ThinPrep method)

Assisting with insertion of an intrauterine device (IUD)

Assisting with Insertion of a Hormonal Contraceptive (Implanon)

Wet prep/wet mount and potassium hydroxide (KOH) prep

Amplified DNA probe test for Chlamydia and Gonorrhea

Instructing patient in testicular self-examination

Assisting the physician during a lumbar puncture or cerebrospinal
fluid aspiration

Assisting the provider with a neurologic screening examination

Performing visual acuity testing using a Snellen chart

Measuring near visual acuity

Testing color vision using the Ishihara plates

Performing eye instillation

Performing eye patch dressing application

Performing eye irrigation

Performing ear irrigation

Assisting with audiometry

Performing ear instillation

Assisting with nasal examination

Cautery treatment of epistaxis

Performing nasal instillation


Assisting with plaster cast application
Assisting with cast removal
Yes
Real World Application Activities
The following list of activities contains suggestions to assist you to evaluate how the material learned in
this module is applied in the clinic where you work. These are ungraded activities designed to help the
student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills
to evaluate the experiences.
Evaluate your clinic: How many types of different examinations are performed at your clinic?

What are they called?

Who assists with each type of examination? Who explains the procedure to the patients?

Who is responsible to perform each component of the various exams? Can you list the examination
procedures that are the responsibility of medical assistants at your clinic?

Who is responsible for the maintenance and quality assurance of any equipment used during
examinations?

Does you clinic maintain a policy and procedure manual listing the equipment and supplies to be
gathered for various examinations? Does this vary from doctor to doctor?

Try to observe as many specialty exams as you can and list the equipment/ supplies needed for
each.
URINALYSIS AND LABORATORY TESTS REQUIREING URINE SAMPLES
Objectives
1. Define, spell, and pronounce the key terms as presented in the glossary.
2. Use language/verbal skills that enable the patient’s understanding.
3. Display sensitivity to the patient’s rights and feelings in collecting specimens.
4. Explain the rationale for performing a proper clean catch collection to a patient.
5. Explain the process of urine formation.
6. Discuss the importance of safety procedures and quality control when working with urine.
7. Describe the importance of proper collection and preservation of 24-hour urine specimens.
8. Identify the proper technique for examining the physical characteristics of a urine specimen.
9. Perform urinalysis (excluding microscopy).
10. Identify the proper method of preparing urine sediment for microscopic examination.
11. Identify normal and abnormal structures found during the microscopic examination of urine sediment.
12. Perform urine pregnancy testing.
Activity checklist
Completed Activity
Complete the Urinalysis and Laboratory Tests Requiring Urine Samples
Required
Yes
Pre-test. You will only complete this pre-test once.
Read in your textbook or e-book
Not graded- use
to prepare for
Chapters:_____
competency
demonstration

pages_____
View the following skills videos :
Not graded- use
to prepare for

US (Urinalysis)
competency
demonstration
Complete the following study quiz as many times as needed to prepare for Not gradedthe content competency evaluation.
use to prepare
for competency

Urinalysis and Laboratory Tests Requiring Urine Samples
demonstration
Complete the following Competency Theory Exam to demonstrate mastery Yes
of theoretical competencies”

Urinalysis and Laboratory Tests Requiring Urine Samples
Demonstrate competency of the following skills to your skills evaluator:

Assessing urine volume, color, and clarity (physical urinalysis)

Using the refractometer to measure specific gravity (physical
Yes
urinalysis, continued)

Performing a chemical urinalysis

Preparing slide for microscope examination of urine sediment

Performing a complete urinalysis

Utilizing a urine transport system for C&S

Instructing a patient in the collection of clean-catch, midstream

urine specimen
Pregnancy test
Real World Application Activities
The following list of activities contains suggestions to assist you to learn how the material learned in this
module is applied in the clinic where you work. These are ungraded activities designed to help the
student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills
to evaluate the experiences.

Identify who performs urinalysis in your clinic.

Identify the correct urinalysis requisition form. Practice completing it.

What instructions are provided to a patient who is sent to collect a specimen for urinalysis? Who
provides the instructions?

What PPE is required to collect a urine sample?

Where is the urine tested? Is a quality control log of the testing supplies maintained?

Identify where results are entered. Is there a policy for informing the practitioner immediately for
certain urine component levels? What are those? How are these levels to be communicated to the
appropriate person?

Who conducts urine pregnancy testing in your clinic? Who provides the patient with the results? Is
there any education and/ or counseling provided, regardless of the results? Who provides this
information?

Following your facility’s HIPAA policy, job shadow as urinalysis and/ or pregnancy results are
provided to a patient. Evaluate for yourself the communication used to provide results. Was it
therapeutic?
VITAL SIGNS
Objectives
1. Define, spell, and pronounce the key terms as presented in the glossary.
2. Discuss normal and abnormal temperatures, including factors affecting temperature.
3. Identify and explain the procedures for using, caring for, and storing the various types of
thermometers.
4. Discuss the Environmental Protection Agency’s initiative to phase out mercury thermometers and
other mercury-containing equipment.
5. Describe the locations and procedure for obtaining pulse rates.
6. Explain the procedure for obtaining respiration rates.
7. Identify and describe normal and abnormal pulse and respiratory rates and the factors affecting each.
8. Describe the appropriate equipment and procedure for obtaining a blood pressure measurement.
9. Identify normal and abnormal blood pressure, including factors affecting blood pressure.
10. Describe the procedures for obtaining height, weight, and chest measurements of adults.
11. Accurately record measurements on the patient’s chart or electronic medical record.
12. Explain two reasons why a professional individual shows responsibility by learning about the dangers
of mercury.
13. Describe the various theories of human development.
14. Describe pediatric care including measuring height, weight, head circumference, chest
circumference, and vital signs.
15. Maintain growth charts.
16. Explain the process of screening for hearing and visual impairments in pediatrics.
17. Describe common pediatric diseases and disorders.
18. Describe infant holds for injections and procedures.
Activity Checklist
Completed Activity
Complete the Vital Signs Pre-test. You will only complete this pre-test
Required
Yes
once.
Read in your textbook or e-book
Not graded- use
to prepare for
Chapters:_____
competency
demonstration

pages_____
View the following skills videos :
Not graded- use
to prepare for

Well Baby check
competency

Reading measurements
demonstration

Blood pressure by palpation method

Ascultatory Gap

Induction


Induction Scenario
Axillary Temperature and 24-7 Apical pulse
Complete the following study quiz as many times as needed to prepare for Not gradedthe content competency evaluation.
use to prepare
for competency

Vital Signs
demonstration
Complete the following Competency Theory Exam to demonstrate mastery Yes
of theoretical competencies”

Vital Signs
Demonstrate competency of the following skills to your mentor / skills
evaluator:

Measuring an oral temperature using an electronic thermometer

Measuring an aural temperature using an electronic thermometer

Measuring a temperature using a temporal artery (TA) thermometer

Measuring a rectal temperature using a digital thermometer

Measuring an axillary temperature

Measuring an oral temperature using a disposable oral
strip thermometer

Measuring a radial pulse

Taking an apical pulse

Measuring the respiration rate

Measuring blood pressure

Measuring height

Measuring adult weight

Measuring the infant: weight, length, and head and chest
circumference

Taking an infant's rectal temperature with a digital thermometer


Take an apical pulse on an infant
Measuring infant's respiratory rate
Real World Application Activities
The following list of activities contains suggestions to assist you to evaluate how the material learned in
this module is applied in the clinic where you work. These are ungraded activities designed to help the
student learn from daily experiences, using a guided, purposeful approach, then use critical thinking skills
to evaluate the experiences.

Ask to job shadow the person who performs vital signs at your clinic, observing for:
o
Where to obtain the supplies and equipment needed and what needs to be gathered. Is it all on
one cart, or must additional supplies be obtained?
o
How are the procedure explained to the patient? Would you add or delete anything you heard?
o
Which vital signs are routinely obtained during patient inductions? Who makes the decision to
obtain additional vital signs? How is that decision made?
o
Where are vital signs recorded?
o
What is the procedure for cleaning and caring for equipment, such as blood pressure cuffs and
thermometers?