Describe the role genetic testing and genetic counselors play in the delivery of health care.

* What is Genetic
Information Nondiscrimination Act? Describe the role genetic testing and
genetic counselors play in the delivery of health care. Also, explain how
genetic testing might lead to genetic discrimination.
–
*What is HIPAA?
Explain one of the four standards of HIPAA. Do you think this law was necessary
and why?
–
*What is OSHA? Who and
what does it cover? In a medical setting, OSHA standards are often influenced
by and/or closely associated with guidelines issued by the Centers for Disease
Control and Prevention CDC). Fully explain two OSHA standards and/or CDC
guidelines that most often affect health care practitioners working in a
medical setting

Instructions for #2
–
response need to be a minimum of 200
words.
–
Proper spelling, punctuation, grammar,
sentence structure, and citations are required for responses to be accepted.
Discussion
Board (2) Question:
Research ONE of the following topics. Please use other
resources besides the Study Unit. (The
Wikipedia website is not an acceptable
reference). Then, write a detailed response explaining the topic. * National Organ Transplant Act of 1984 * Uniform Anatomical Gift Act * National Childhood Vaccine Injury Act of
1986 *
Patient Self-Determination Act

Instructions for #3
You’re required to view the recorded webinar below to
complete the course. After you view the webinar, write a two- to
three-paragraph summary of the webinar in a word-processing document (.doc or
.docx).
I can not
upload the video here so here is a transcript of the video
A word root is the foundation of a medical term. And
it provides us with the general meaning of the word. Usually the word root is
going to tell us the body system or the part of the body that the word is going
to be referring to. And that is going to be the foundation of the word.

Some examples of word roots I have listed here are
neur for nerve, cardi for heart, gastr for stomach, and enter for small
intestine.

By themselves the word roots may not seem to mean
much. But when combined with other elements, then we’re able to add a
significant amount of information to the word.

Our prefixes provide information about the word root.
And prefixes are added to the front of the root word. They can tell us
important information like the location of the organ, the number or frequency.
But not all medical terms have a prefix. Some common prefixes are brady for
slow, dys for difficulty or painful, pre for before, tachy for rapid or fast,
mono for one, and multi for many.

Our suffixes are attached to the end of a word. And
they usually tell us a condition. They’ll tell us about the disease process or
about a procedure. And almost all medical terms do have a suffix.

So some examples of suffixes would be algia, which
means pain, logy, which is the study of, lysis is destruction, rrhage will be
excessive or abnormal flow. So if you came across the word hemorrhage and you
weren’t sure what it meant, you could look at the suffix, rrhage. And if you
knew that meant excessive or abnormal flow, then you could move on and look at
the word root, hemo, which would be blood. It would be excessive or abnormal
flow of blood, and that is exactly what a hemorrhage is.

Some examples of surgical procedures. Any time you see
a word ending in ectomy, it means surgical removal. So whether it’s an
appendectomy, cholecystectomy, splenectomy, it all means surgical removal. And
then you look at the word root to see what part of the body has been removed.

Plasty means surgical repair. A centesis means to
puncture to withdraw fluid. So the word amniocentesis, just for an example, if
you look at that word, and you wanted to figure out the meaning, you start with
the suffix “centisis,” which means to puncture to withdraw fluid. And
then you’d look at the word root, “amnio,” which is for amniotic
fluid. And the word means to puncture to withdraw amniotic fluid.

So by using these word parts and breaking the words
down, you’re be able to figure out the basic meaning of medical terms. And
anything that ends in “gram” means to record or take a picture. And a
“scope” would be an instrument used for viewing.

Now, our combining forms are used between a word root
and suffix or between two root words to connect the parts together to make one
word. Now, the vowel O is the one that is used, and the combining form, let’s
say, for cardio. Let’s say you had cardio, and you wanted to add therapy to it.
We wouldn’t say cardi-therapy. It is cardiotherapy. We use that O to help to
blend the word parts together to make one word.

So when do we use this combining vowel? We’re going to
talk about the rule for the combining vowel. And first we take a look at the
suffix. If the suffix begins with a vowel, then we’re not going to use a
combining form. If the suffix begins with a consonant, then we are going to use
a combining vowel. And the combining vowel is typically kept between two word
roots.

So in the examples that I have here, we have
“aden” plus “carcen” plus “oma.” So we start by
looking at the suffix, and, in this case, it does begin with a vowel, so we’re
not going to need a combining vowel between this word root and this suffix. Now
we move over, and we look between our two word roots. And in this case, this
word root begins with a consonant, so we would definitely need the combining
vowel to help us to put the word parts together.

But following what rule that the combining vowel is
typically kept between two word roots, you’ll see that 99.9% of the time that
is the case. And we’re definitely going to need it in this situation because
this word root begins with a constant. So now when we put these word parts
together, we form the word adenocarcinoma.

Now in the second example, we have the word parts
“hepat” plus “splen” plus “megaly.” So we start
by looking at the suffix, and our “megaly” does begin with a
constant, so we’re going to be our combining vowel. And then we move over, and
the rule is that we typically use the combining vowel between two word roots.
And in this case, we definitely would again because this word root begins with
a consonant so we are going to use the combining vowel. So now we can take
these word parts, and we are going to combine them and make the word
hepatosplenomegaly.

Now if you didn’t know what the word meant, you could
use your word attack skills to help to break down the word into the word parts
to decode the meeting. Now when you do that, you start with the suffix first,
and we have “megaly,” which means enlarged, “splen,” which
is word root for the spleen, and “hepat,” which is the word root for
liver. So reading it right to left, we have an enlarged spleen and liver, and
that is exactly what hepatosplenomegaly is.

So using that idea of breaking the words down will
help you to get the basic meaning, enough so that you have the basic concept of
what that word is about. When you do break the words apart, you start with the
suffix. So we would be breaking the word down and reading it from right to
left, as opposed to when you read a book, and you read from the left to the
right.

There was one student that was having issues with
audio. Eric, did that resolve? Are you able to hear now? Now, spelling is so
important in medical terminology because one wrong letter can change the whole
entire meaning of the word. I have two examples here. We have ileum that’s
spelled with an E, and we have ilium that’s spelled with an I. Now, depending
on how you spell word, it refers then to different parts of the body.

So with an E, ilium, we’d be referring to the small
intestine, and ilium with an I would be referring to part of the hip bone in
pelvis area. So if you’re the transcriptionist and you were listening to the
doctor’s dictation and you were transcribing the work, you need to know what
part of the body the doctor is referring to in the report to know which way to
spell the word.

Even using spell check, it’s not that they’re spelled
incorrectly, so it would not necessarily even be picked up on spell check. For
medical assistants, if you’re documenting in the record, you just need to make
sure that you’re careful. Because, as you could see, one change in that letter
can change the whole meaning of the word. Same thing with coders. If you’re
coding a record and you are coding something to do with the ilium, you need to
make sure you’re spelling it correctly so that you are arriving at the correct
code.

And in the second example, I have prostate and then
prostrate. And by accidentally adding an R, again, we can change the meaning of
the word. So if you’re not sure, always stop and look it up quickly. Most of us
have online access, even in the workplace, these days, so it’s quick and easy
to double check to make sure you’re spelling everything correctly.

Now, another part of medical terminology is the basic
understanding of the human body. And some of you may be going to take an anatomy
and physiology class in your coming courses. But for medical terminology we
have to have a basic understanding in how our body is organized in order to
understand the terms that we’re seeing.

So the cell is the smallest unit of all living things.
And all of the tissues in body are made up of cells. Now, there are very
specialized cells that carry out some very special functions, and these
specialized cells then go one to form our tissues. And then the different types
of tissues are what make up our organs. And then our organs work together to
make our systems, and our systems are what make up the human body.

So the cells are the fundamental unit of all living
things. And the study of cells and their functions is called cytology. Now, all
of the cells in our bodies have a nucleus, a cytoplasm, and a cell membrane.

And there are some very specialized tissues that are
in our bodies. The muscle tissue helps our bodies to move by contracting and
relaxing. And there are three types of muscle tissue. We have our skeletal
muscle, and that is attached to our bones, and it helps us to move our bodies.
We have our smooth muscle, and this is found in our internal organs and our
digestive system. And then we have our cardiac muscle, which is only found in
the heart.

Now, out of those three muscles types, the only one
that we can voluntarily contract is our skeletal muscle. Our smooth muscle and
our cardiac muscle, they contract and relax every day without us ever having to
think about that. They’re involuntary. So skeletal muscle is our muscle that is
voluntary that we can contract and relax in order to help us to move our
bodies.

The epithelial tissue is found throughout our bodies,
and it is made up of closely packed cells. And this tissue forms the covering for
and the lining up our body structures. Our connective tissue supports and
protects the body structures, and they can perform different functions,
depending on its location, and it can appear in different forms, depending on
the job that needs to do. So examples would be bone, tendon, and cartilage.

And the nervous tissue is made up of cells called
neurons. And this is the tissue that forms our brain and spinal cord. And our
nervous tissue forms a network of nerves that run throughout our bodies called our
peripheral nervous system. Now, our organs are made of those tissues that work
together. And then our body systems are made up of several organs working
together and performing complex functions.

Now, the systems in our bodies, they each have very special
jobs and functions, and they all work together to help keep us functioning at
our best. And if one body system becomes diseased and is not able to work and
actively, the other body systems will try to compensate for that diseased
system the best that they can. So I’m just going to quickly touch upon the body
systems.

We have our integumentary system, and that provides a
protective barrier and helps us to regulate our body temperature. Our
musculoskeletal system provides our bodies with support and helps to protect
our bodies. The cardiovascular system’s job is to pump blood through the body,
and this is closely tied to the hematic system.

Now, the hematic system is made up of our blood. And
if you think about what’s in our blood, of blood contains plasma, erythrocytes,
which are our red blood cells, leukocytes, which are the white blood cells, and
platelets. And our blood carries nutrients and oxygen and waste from the cells,
through our bodies, to then be filtered out by the kidneys.

Now, the lymphatic system protects the body from
disease and pathogens. Our respiratory a system obtains oxygen and removes
carbon dioxide from of the body. Our digestive system includes the ingestion,
digestion, and absorption of nutrients for the body. The urinary system
provides the filtering of waste products out of the blood and removes them from
the body.

The reproductive system includes the male and female
sex organs. And the endocrine system regulates the metabolic activities of the
body. And the last one is the nervous system, which receives sensory
information and then responds to that stimuli.

Now, the anatomical position, this is used when
describing the positions and relationships of structures in the human body. And
if you open up your textbooks to page 30, you will be able to see Figure 2.3,
which shows you a picture of the anatomical position.

I’ll give everybody a moment just to grab their
textbooks. Now, next to that Figure 2.3 is Figure 2.4, and that goes over the
planes of the body. And what I have up on screen now is a picture showing the
different planes of the body. These are imaginary lines that are drawn to the
body to help us to describe the position and the relationships of structures
within the body.

So the first one we have is the sagittal plane, and
this is a vertical plane that divides the body into left and right sections.
And this is also called the median plane. And then we have our frontal plane,
and this plane divides the body into a front and a back section, and it’s also
called the coronal plane. So these terms are interchangeable.

And then we have the transverse plane, and this is a
horizontal plane, and it divides the body into upper and lower sections. And
this plane is parallel to the ground, and it’s also called the horizontal
plane. So anybody that’s ever worked in radiology would be very familiar with
these terms because they’re used every day in the radiology area, with doing
MRIs and CAT scans and x-rays. So even if you’re reviewing a report from
radiology on a patient’s chart, you would want to be familiar with those terms
so that you will be able to understand what the report is saying.

Now, our body is divided into large regions that can
be easily identified externality. And at the top of page 32, it would be figure
2.5 that shows the body regions. Take your time and just familiarize yourself
with those body regions so that you’d be able to have a frame of reference that
you’d be able to identify the regions if you were to come across them in a
report. For medical assistants, you need to be able to identify those regions
when you are helping with and assisting with procedures.

Now what I have up on my screen does have the body
broken down into very specific regions. But if you take your time and just
learn the ones at the top of page 32, that would be fine. Now, directional and
positional terms assist in discussing and identifying a position or location on
a patient’s body. And when we’re using location or directional terms, it is
assumed that the patient is going to be in that anatomical position.

So the anatomical position is as follows. The body is
erect with the feet slightly apart. The palms are facing forward with the
thumbs pointing away from the body. Now, sometimes we need to document how a
patient is positioned in bed. So we’re going to discuss some important body
positions that you would want to know if you needed to document how a patient
was positioned in bed or if you were somebody that was reviewing a record and
you’re trying to figure out what was going on with the patient, you would be
able to understand the report or the notes that may have been written.

So in the prone position, the patient is laying face
downward. In the supine position, the patient is laying face upward. In the
Trendelenburg position, you will see that the head of the bed is lower than the
patient’s feet. Now, this position is not routinely used, unless it’s been
ordered by the physician in the hospital setting. The reason being is that the
blood flow is going to be increased to the head, and for some patients, they
may have medical issues that will contraindicate this position.

Now, why would a doctor want the patient in this
position? Well, sometimes it helps with stabilizing blood pressure. If the
patient is having difficulty with their blood pressure, sometimes this position
might be used. If the patient maybe was receiving respiratory therapy and they
were using this position to help with drainage off the secretions from the
lungs, that could be another reason why it might be ordered. But, as you can
see, it’s not really the most comfortable position. So that is the called the
Trendelenburg position.

Now the Fowler’s position has the patient sitting up
in bed with the head of the bed elevated between 45 and 65 degrees. So for
patients with respiratory conditions, this position often helps to make their
breathing easier and less labored.

The lateral position is when the patient is laying on
their side, supported by pillows for comfort and also to help with positioning.
This position is often used for sleeping. And then lastly what I have up are
the sims, the dorsal recumbent, and the lithotomy position. And they’re often
used for various medical procedures.

Now this is just a list of some comment directional
and positional terms. And in your textbook on 35 over on to page 36 is also a
list of these terms, and you do want to take your time. You want to have a good
understanding of these terms. You will see them in records. You’re going to be
using them if you’re actually looking at patients and providing patient care.
So you want really a good understanding and be able to see the word and know
what it means.

Now, medical terminology we have sometimes what’s
called eponyms that you’ll see. And an eponym is basically a name given to a
medical disease, a body part, or procedure, and the name comes from the actual
name of the person who discovered or defined it or maybe had the disease, so,
for example, Parkinson’s disease, Crohn’s disease. Lou Gehrig’s disease,
Alzheimer’s disease. They’re all example of eponyms, and how do we know it’s an
eponym? Well, we can tell because they’re always going to be capitalized, and
they’re always going to end with an apostrophe S. So that makes it easy to be
able to identify them when we’re trying to spell those words or trying to
interpret the words.

We come to the point now where we’re going to do some
questions. They are all multiple choice, and so all you need to do is type in
A, B, C, or D, and then we’ll go over them to see what one is the correct
answer. So what I’ll have everybody do is just we’ll read the questions together.
I allow about 45 seconds for everybody to answer, and then we’ll review the
answers.

Now, this question happens to have two correct
answers, so you have a 50% chance of getting this one correct. The plane of the
body that passes through the center of the body and divides it into a left and
right, what do we call that? You can look back in your books if you need to.

OK, everybody has this one correct. Everybody selected
either C or D, and that would be the correct answer. How about the plane that
divides the body into two parts horizontally, what do we call that?

OK, everybody got that one correct too. That would be
D, transverse. How about the part of a medical word that usually tells what
part of the body is involved, what do we call that?

The overwhelming majority on this one said A, the
root, and that would be the correct answer. When a medical disease, a body part,
an instrument, or procedure includes the name of the person who discovered it
or created it, what do we call that? What is that term?

All right, everybody had that one correct, and it
would B for epoynym. Which of the following is not one of the basic components
of medical terminology? Out of the four choices below, what is one item that
you’re not going to learn at all in medical terminology?

OK, everybody had that one correct– C, for hospital
admission procedures. So we’ve already talked about this morning our roots, our
prefixes, and our suffixes. We talked a little bit about body structure and a
little bit about anatomy. And in a few minutes we’re going to be talking a
little bit about the very basic terms related to diagnostic procedures. But the
one thing we don’t talk about and it’s not covered in medical terminology would
be the hospital admission procedures. Everybody had that one right.

This one can sometimes be a little bit challenging, so
take your time. But select the word root from the following. So remember now,
we’re just looking for the word root.

We had majority that selected a for
“gastri,” and there were a few that thought maybe B, for
“gastro.” The correct answer here would be A, “gastri.”
This would be the word root. B is our combining vowel form because it has the O
added on so that it would be ready to combine then with [INAUDIBLE] another
word group or with a suffix. So “gastr” would be the correct answer.

Now we’re going to move on to what I call Medical
Terminology, Part 2. We’ll going to kind of shift gears for a few moments and
talk about the health record. And basically, AHIMA says that legal health
record is the documentation of the health care services that have been provided
to an individual. And all care, whatever everybody does for that patient, needs
to be documented.

Within the health care facilities, and as we’re going
to be working in health care, you’re going to need to maintain confidentiality.
So you just want to be aware of where you are when you’re talking about
patients. Elevators, cafeterias, hallways are not the best places to be
discussing patients’ conditions or the status of a patient because many times
it can be accidentally overheard, even at the nurse’s station in the hospital,
where you would think nurses are working and they’re talking about patients
with the doctors. They still have to be aware because family members of other
patients, other patients could be walking by, and they can overhear
confidential information.

Now, depending on what part of the medical field
you’re going to be entering, you might be somebody who might be responsible for
releasing information. And if you’re going to be giving out any information
from a patient’s chart, you want to know exactly what are you going to be
releasing, who are you giving that information to, why are we sending that
information. And then the request needs to be signed and dated by the patient,
and then that request for release of information will then be kept in the
patient’s medical record.

In the patient’s medical record, especially in the
inpatient record, you’ll see that the there will be a medical history and
physical completed after the patient’s been admitted. And in that medical
history and physical, there’s going to be two types of information. You will
see subjective information, and that’s information that’s being reported by the
patient. It’s going to be their symptoms and their feelings. I had a headache.
I have a belly ache– how they feel.

Now, objective information, on the other hand, is what
is observed by the medical team. It can be heard. It might be able to be seen.
It might be able to be felt. And many times it’s measurable. So objective
information, many times, is measurable and it has a numbers. We can quantify
it. Think of blood pressures, pulse rates, respirations. So whenever a medial
assistant is obtaining vital signs, that is objective information.

Now, when the doctor goes in, to do the physical exam,
when they’re performing the exam, there’s different ways that the doctor can
assess the patient. One of them is auscultation. Auscultation means listening.
So the doctor can use their stethoscope to listen to the patient’s lungs, to
listen to their heart, and to listen for bowel sounds, so that is auscultation.

The second type of assessment is palpation, which
means feeling. When the doctor palpates area, they can palpate to see if
there’s any lumps or bumps or masses, or does the patient have pain on
palpation when they’re touching an area? So palpation means feeling.

And the third type is percussion, which is tapping.
And the doctor can tap over areas of the body that are typically more hollow or
air-filled. And as they’re tapping across– there’s a way to do it, a
technique– they can listen to the sounds. And in an area that is air-filled
it’s going to have more of a tympanic sound. But if there’s fluid or density in
that area, then the sound is going to change, and it’s going to be more dense.

So if the doctor was percussing across the lung
fields, they should hear nice, tympanic sound, provided the patient’s lungs are
clear. But if the patient maybe has some fluid accumulating in the bases, when
the doctor percusses across that area, it’s going to have more of a dull sounds
to it. So that’s another type of assessment.

And the last one is visualization or inspection, and
it’s when they look with their eyes. And a lot of times the doctors can get a
lot of information just by looking, from the overall general appearance of the
patient from the time they walk into the room, to maybe if the patient has a
wound, and they’re looking to see is it red? Is there drainage? What does the
wound [INAUDIBLE] look like? Is it healing? How are the edges of the wound? Was
is the size of the wound approximately? So they can get a lot of information
just by looking.

Now, once the doctor has seen the patient and
completed the physical exam, then they’re go on and form their impression or
diagnosis. And they’ll review all of the information that’s been obtained. So
they’re going to look at the vital signs that the medical assistant has
obtained. If there’s a height and a weight or a pain scale that’s been used,
they’re going to evaluate that information as well,

They’ll look at the symptoms, the history, any lab
testing or procedures that have been done. And then once they have their
impression or their diagnosis formed, they’re then going to move on and create
a plan. What is the plan? What are we going to do for the patient? And that
might include more testing or maybe reports with specialists. There might be
specific patient education that needs to be done with the patient.

Well, as far as diagnostic testing, sometimes tests
are done initially, and sometimes doctors will do more tests to rule out or to
verify a disease or illness. So these are just some very common diagnostic
tests that are routine. And for some patients, they might be part of their
routine physicals when they go to the doctor. A complete blood count– a lot of
times you will see that abbreviated as a CBC. Urinalysis, which looks at the
composition of the urine, and a lot of times that’s abbreviated as a UA.

Chest x-rays– we can use chest x-rays to look at the
overall lungs and within the chest area itself. And many times you will see
that abbreviated as a CXR. And then the last one is an electrocardiogram, which
you could see abbreviated as an ECG or an EKG.

Stool specimens can be obtained for a variety of
reasons. We can obtain a stool specimen for occult blood, which is blood that
we’re not able to see with our eyes. We can obtain stool specimens for ovum and
parasites to see if maybe the patient has an infectious process going on. We
can obtain a stool specimen for C. difficile. C. difficile is an anaerobic
bacteria that when given the opportunity, can sometimes flourish in the
intestinal tract and cause the patient to have some very distinct symptoms,
such as persistent diarrhea, foul smelling. And that’s treated with medication.
So a stool sample is obtained to confirm that type of diagnosis.

Blood chemistry profile– that looks at the overall
electrolytes of the patient, and we can use it to determine if there’s any
electrolyte imbalances. Lipid profiles– some of you may have had a lipid
profile yourself drawn to see what are your cholesterol and triglyceride levels
to look at your overall lipids.

Now, sometimes doctors will need to work
consultations. If a patient has been to the hospital and they’re newly
diagnosed with atrial fibrillation, the family doctor might say, I think you
need to seen at cardiology. I’m going to consult cardiology to come in and see
you. When cardiology comes into the hospital to see the patient, they’re going
to focus on that particular problem, and then they’re going to review and
examine the patient and come up with a plan and a treatment, ideally, for that
specific diagnosis. And then they’d dictate it.

The transcriptionist would transcribe it. It would be
placed on the chart for health care professionals to review as needed. And
eventually, it would make its way down to the coders and billers, who then
would be working on coding the patient’s record. So in health care, no matter
what part of it that you’re going into, this information you’re going to see
because, at some point in time, these reports and these records will pass by
you. Depending on where you’re working, then what you’re dealing with them is
going to be different. But you still need to have that basic foundation of
being able to understand the words that you see.

Now progress notes are a collection notes made after
the initial examination and history and physical. That history and physical is
a very intense report. It’s very comprehensive. Now, a lot of that information
doesn’t change from day to day. The patient’s past medical history is still
going to be the same. So the doctor, when they come in on subsequent visits,
you’re going to document short, concise notes about the patient today. And they
call them progress notes.

Now, sometimes you’ll see different abbreviations in
the charts, and these are just a couple of abbreviations that I’ve selected. I
know in the textbook at the ends of the chapters they do have a lot of
abbreviations, and, actually, the back of the textbook, I know there’s a whole
list of abbreviations as well. You don’t need to know all of them, but you do
want to just be a little bit more familiar with the common ones that are more
frequently used.

In the physical exam section, sometimes doctors will
use A&P to mean Auscultation and Percussion. So if you were listening to
dictation and the doctor said, physical examination, lungs clear to A&P, it
would mean lungs clear to auscultation and percussion. So sometimes you’ll see
that in the exam section.

BP would be for blood pressure. CBC would be For a
complete Blood Count. The capital CC is fr the Chief Complaint, and it’s
typically listed at the very beginning of the history and physical. And there
will be exactly what the patient is complaining of, why they’re there. I have
had a belly ache. I have a tummy ache. I have a headache. Whatever words
they’re saying will usually be in quotes, and that would be the patient’s chief
complaint.

H&P then would be for history and physical. Now,
in the exam section, HEENT is often used, and it stands for the Head, Eyes,
Ears, Nose, and Throat, and it’s a quicker way for the doctor to say all of
those words without having to actually say them all. So HEENT within normal
limits would be one way that the doctor could cover all of those body areas in
an abbreviated format.

LDL would be for Low Density Lipoprotein. And that’s a
lipoprotein that would be evaluated on a lipid profile. So that would have a
result, and then doctor would be able to review that. PERRLA– P-E-R-R-L-A,
that’s another one from the physical exam section. And if the doctor is
assessing the patient’s pupils, they will look to see if they’re equal, if
they’re round, if they react to light.

So if they use the pen light, the eyes should
constrict and dilate appropriately, and then accommodation is the last thing
they’ll look for. So if everything is normal, a lot of times the doctor’s going
to say, eyes PERRLA. And it just means that the eyes then, when they examined
them, that they were equal, round, and reactive to light and accommodation. And
the last abbreviation there is Pt for Patient.

So that brings us to a few more multiple choice
questions. We’ll do them the same way we did before. But if the doctor is
feeling with fingers or hands to determine the physical characteristics of
organs or tissues, what do we call that?

OK, we’ve had some mixed answers. Let’s see, I’m just
going through them quick. OK, the majority did select B, for palpation. But
they was a fair amount that thought maybe C, for percussion. The correct answer
here would be B, for palpation. When the doctor is feeling with their fingers
or hands to determine the characteristics of organs and tissues, so if they’re
pressing on an area, and they’re looking to see maybe if there’s any lumps or
bumps or it’s hard and firm in an area, or if the patient has pain in an area
when they’re pushing, that’s called palpation, so B would be the correct
answer.

Using the fingertips to tap the body, what do we call
that?

OK, everybody had that one correct. It would be C,
percussion. Using a stethoscope to listen to sounds in the body, what do we
call that? OK, just about everybody had that one correct. We had a couple
answers, here that– some that thought maybe percussion, and we had some that
thought observation. But the correct answer would be D, auscultation. So when
the doctor is using a stethoscope to listen to sounds within the body, that’s
called auscultation. And the transcriptionists that are listening today and
medical assistant students, you do need to know how to spell that word because
it is used frequently in the history and physicals.

OK we’re just going to do a few of these. Let’s do the
first one. What is the abbreviation for a complete blood count? All right,
everybody had that one correct– CBC. How about the next one? The head, eyes,
ears, nose, and throat, what is that abbreviation? OK, just about everybody had
that one correct too, very good. It was H-E-E-N-T.

We’re going to skip down. We’re going to the last one.
Pupils are equal, round, reactive to light and accommodation. If you came into
the webinar late, and you do not have a textbook, so could, at this point, just
exit the webinar. Without a textbook, you’re really not going to be able to get
much out of the webinar. So I would wait until you receive your textbook, and
then you can view another webinar in the future. All right, so just about
everybody got that one correct too. It would be P-E-R-R-L-A, and that would be
for Pupils are Equal, Round, and Reactive to Light and accommodation.

That brings us then to our last section of the
webinar. And we’re going to talk about pharmacology a little bit. This comes
from one year earlier reading assignments. In the textbook it starts on page
465. And I selected pharmacology because some of the terms that are sometimes
associated with medicines and medication administration, we might not all be
familiar with all of them. So I figured this is probably a good area to focus
on for the last few minutes.

So the study of the origin and the characteristics and
the effects of drugs, we call that pharmacology. And it is important to
remember that all drugs are chemicals and that these channels can come from a
variety of sources. We have our vitamins that are found in our foods. We have
hormones that can be derived from animals, and some of our antibiotics are
actually derived from molds. A lot of plants– we use a lot of plant substances
in our medicines. So some plants substances, when they’re used in concentrated
formulas, they can be used in medications to help with treating disease and
illness.

Now, drugs can have different names. And as you gain
experience in the health care field, you will see, and you’re going to become
more familiar with many of the common medications. All drugs have a chemical
name, and the chemical name is going to tell us exactly what the chemical
formula and the molecular structure is for a particular truck.

So in the example I have on the screen, the chemical
name for Tylenol is N-acetyl-p-aminophenol. Now, all medications also have a
generic name, and the generic name, you can always recognize it because it will
always be in lowercase letters. And in this case, the generic for Tylenol is
acetaminophen.

And then drugs also have brand names, and the brand
name is from the company that researched and developed the medication, and they
brought it to the market and they had it patented. They have a trademark on it,
and they use the brand name. So, in this case, the brand name or proprietary
name would be Tylenol.

Now. Each drug can only have one generic name. So it
doesn’t matter what bottle of Tylenol or generic acetaminophen you were to pick
up. They’re all going to contain the exact same ingredient, active ingredient,
acetaminophen. Now, the dosages will vary some from regular strength to extra
strength. But the active ingredient itself has to be the same.

Now, the pharmaceutical company that develops the
medication, they hold a patent on that medication for 17 years, which means
during that time period, no other company can produce, manufacturer, or sell
that active ingredients in that drug for that purpose. So they hold that
patent, and they are exclusively the only company that can sell that
medication.

Now, once that patent expires, then any drug manufacturing
company can come along and use that recipe to then make the medication and sell
it as the generic. So generic drugs are usually priced lower than the brand
name medications. And one of the reasons is that those companies that are
making generics, they did not have to invest all of that money into research
and developing that medication to bring it to market. They just use the recipe
to mass produce the generic formula.

Now, many times the generic maybe substituted for
brand name when a prescription is being filled, unless it’s been otherwise
specified by the physician. Our generic drugs, they have to have consistent
labeling. They still have to have assured quality. They have to meet the
rigorous manufacturing standards. They have to have the same, identical active
ingredient. So they are essentially the same.

The only thing that can be different is maybe the
color of the tablet or the shape of the tablet. Some of the nonactive
ingredients might be different, what they call the fillers. So some of those
can be different. But the active ingredient must be identical.

Now, if we think about what is a prescription,
basically a prescription is the written explanation to the pharmacist regarding
the name of the medication, the dosage, and the times of administration. Now,
there are medications that do not require prescription, and we call them
over-the-counter medications. And examples of that would be acetaminophen and
antacids.

Now, all over-the-counter medications can have adverse
reactions and side effects, and a patient needs to read and follow all of the
directions on the label. Patients should always be asked if they take any
over-the-counter medications or supplements because some over-the-counter
medications can interact with prescription meds, and it is important for the
physician to know everything that the patients is taking.

One example is the antibiotic family the
tetracycline’s. They should not be taken with antacids or magnesium-,
calcium-containing products. So if you have a patient that is going to be
ordered on a tetracycline antibiotic, and they maybe forget to tell you that
they take antacids that contain calcium or magnesium, they just might not think
it’s important. Who cares if it’s a Tums? Tums doesn’t matter. But it can
potentially decrease the effectiveness of their antibiotic.

So that’s why when medical assistants maybe aren’t
getting a medication list to specifically ask, do you take anything over-the
counter? Do you take any herbs or any vitamin supplements? And be specific to
make sure that the patient might not have disregarded as being that important
or it doesn’t matter because everything matters when it comes to the doctor
prescribing medicines to make sure that there are no drug-to-drug interactions.

Now controlled substances are drugs that have a
potential for being addictive or habit forming. And a schedule for controlled
substances is classified by the drug’s potential for abuse. The Drug
Enforcement Agency, which is the DEA, they are the federal agency that enforces
the control of these drugs. And we have our Schedule 1s, and any drugs that are
in this schedule are not accepted medical use in the United States. These drugs
do have the highest potential for addiction, and many times just one exposure
can cause addiction. So some examples would be heroin, LSD, and
methamphetamines.

Now medications in this schedule, in Schedule 2, are
drugs that have a high potential for addiction and abuse. But they do have
accepted uses in the United States. So examples would be cocaine and morphine.
Now, with cocaine, a doctor is not going to write a prescription to go have a
patient get filled at the local pharmacy. But there’s restricted accepted use
some nasal and sinus surgeries, where it is used in quantities to assist with the
procedure. So that’s a restricted use.

There’s morphine. We use morphine post-operatively to
help the pain control. We use morphine in patients with advanced cancer, who
are suffering and have issues with pain control because morphine is basically
the gold standard for pain medication, and it will help to bring relief to
patients that maybe are not obtaining with the other medication. So, again,
it’s an accepted, but restricted use. Another example of Schedule 2 medications
is the stimulant medications used to treat Attention Deficit Hyperactivity
Disorder, like you Ritalin and Concerta out Adderall. They are all under that
Schedule 2 classification.

Now, the Schedule 3s are drugs that have a moderate to
low potential for addiction and abuse, and examples would be the anabolic
steroids or acetaminophen with codeine. And then this Schedule 4s are drugs
that have even a lower potential for addiction an abuse. And then the Schedule
4 examples would be phenobarbital, which is used often times to treat seizures,
and diazapam, which is a sedative.

And then Schedule 5, these drugs have usually very
limited quantities of narcotic in them. They have a low potential for any
addiction or abuse. And examples of would be cough suppressants with codeine,
which now during cold and flu season, are more likely to be ordered, as well as
lomotil, which is a medication that can be used to treat diarrhea.

Now, the method by which a drug is introduced into the
body is called the route of administration. And for a medication to be
effective, it does needs to be administered via the correct route. Sometimes
there may be more than one route for a medication to be delivered, and the
doctor’s going to nee to decide then which route is the most appropriate for
the patient.

So we’re at the oral routes, and this includes all
medications that are given by mouth, both liquids and in pill form. And the
advantages of this route are that it’s easier to administer. Patients generally
don’t normally have a lot of problem with taking medications orally, and there
is a slower rate of absorption. So medications can be made to be long-acting,
sustained release, controlled release, and that way they don’t need to be dosed
as frequently.

But there’s disadvantages to the oral, and one of them
is that sometimes that slower rate of absorption is not a good thing. And if a
patient needs to get a medication into their system immediately, then the oral
route is probably not going to be the best. And the second disadvantage is that
there are certain medications that when they’re taken orally, they’re
destructed by our gastric juices.

In our stomachs we have some very strong, powerful
hydrochloric acid, and there are certain medications that, as they go through
our digestive system, are broken down and rendered useless. An example would be
insulin, and this is why insulin needs to be given subcutaneously, or it can be
given intravenously in the hospital setting, if needed. But generally, the
diabetic patients that are on insulin would give themselves their insulin
medication subcutaneously. Or they might have an insulin pump that would
deliver it for them. But the idea is that they cannot take it orally because
insulin is a very delicate protein, and when it is consumed orally, it is
broken down by our stomach acids, and it’s not able to do its job.

Sublingual is very similar to– sublingual’s here, and
buccal is over here, and these are both very similar routes in the sense that
the sublingual, the medication is administered under the tongue, and it’s not
swallowed. And with buccal, the medication is placed between the lip and the
gum or between the cheek and the gum. And, again, it’s not swallowed, but as it
dissolves, the medication then is absorbed through the blood vessels in the
mucosa.

And nitroglycerin is one example of a medication that
can be delivered via the sublingual route. Patients that have angina pectoris
many times will carry nitroglycerin tablets with them. And if they begin to
experience chest pain, they can put and place one of those nitrates tablets
under their tongue, where it will dissolve and be absorbed then by the blood
vessels that are under the tongue, and it works to dilate the vessels to
relieve the chest pain.

Inhalation is another route, and this includes drugs
that are inhaled directly into the nose and mouth. So the inhalers used for
asthma, the nose sprays uses for allergies would all be examples of medications
delivered through the inhalation route. Parenteral is an invasive method
because it does require that the skin be punctured by a needle. So with
parenteral it’s going to include all of our injections, subcutaneous,
intradermal, intramuscular, as well as intravenous.

And then we have transdermal route, and this is
basically a route where medication is in a patch, and the patch is applied to
the skin. And then that medication is absorbed through the skin. Some examples
of transdermal medications are nicotine patches, sea sickness patches. There’s
patches for contraception, patches for treatment of low testosterone. There’s
patches for pain control. It’s called duragesic, fentanyl patch.

And the nice thing with these patches is that they do
provide a prolonged period of medication delivery, and so patch many times will
last more than one day. And in the case of the duragesic or the fentanyl patch,
it actually lasts 72 hours. So the patient, when they apply the patch, would
receive, from that point on then, 72 hours of continuous medication delivery,
which will help to keep them more comfortable.

The rectal route includes medications that are
introduced directly into the rectal cavity in the form of suppositories and
solutions. If you have a patient that maybe is suffering from a severe case of
nausea and vomiting, a Tigan suppository can start to work within 15 to 20
minutes to help to bring relief for the patient.

Topical medications or any medications that are
applied directly to the skin. Examples would be ointments and creams. And the
vaginal route includes medications that are inserted into the vagina. And it’s
a common route for the treatment of vaginal yeast infections. Some hormone
replacement therapies are also delivered through that route.

Eye drops can be administered during eye examinations
to dilate the pupil. We use eye drops that help to treat diseases of the eye,
like glaucoma and also to help to treat eye infections, like conjunctivitis.
Ear drops are placed in the ear canal, and they can help to relieve pain if the
patient has maybe an outer ear infection. They can use ear drops to help soften
ear wax, and we can also use them to treat ear infections. Again, if a patient
has an external ear infection, like swimmer’s ear, it can be treated very
effectively with ear drops.

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