Prior to allergy testing the medical assistant should inform the patient to Quizlet

Social Psychology

10th EditionElliot Aronson, Robin M. Akert, Samuel R. Sommers, Timothy D. Wilson

525 solutions

HDEV5

6th EditionSpencer A. Rathus

380 solutions

Myers' Psychology for the AP Course

3rd EditionC. Nathan DeWall, David G Myers

955 solutions

Social Psychology

10th EditionElliot Aronson, Robin M. Akert, Timothy D. Wilson

525 solutions

Temas: AP Spanish Language and Culture

1st EditionCole Conlin, Elizabeth Millan, Max Ehrsam, Parthena Draggett

829 solutions

Points de Départ

2nd EditionAlbert Valdman, Cathy Pons, Mary Ellen Scullen

376 solutions

Deux mondes

8th EditionBetsy Kerr, Guy Spielmann, Mary Rogers, Tracy D.Terrell

469 solutions

Liaisons: An Introduction to French

3rd EditionBill VanPatten, Stacey Weber-Feve, Wynne Wong

266 solutions

The Human Body in Health and Disease

7th EditionGary A. Thibodeau, Kevin T. Patton

1,505 solutions

Clinical Reasoning Cases in Nursing

7th EditionJulie S Snyder, Mariann M Harding

2,512 solutions

Pharmacology and the Nursing Process

7th EditionJulie S Snyder, Linda Lilley, Shelly Collins

388 solutions

Essentials of Modern Neuroscience

1st EditionDavid Standaert, Erik Roberson, Franklin Amthor, W. Anne Burton Theibert

182 solutions

Various radiography techniques are used in cardiology. Chest X-rays can reveal conditions like cardiac enlargement. In radionuclide studies, the patient ingests or is injected with a radioactive contrast medium, often referred to as a dye. X-rays are then taken. For example, fluoroscopy studies are X-ray exams in which a contrast medium is injected and pictures of the heart in motion are projected onto a closed-circuit television screen. A venogram allows evaluation of the deep veins of the legs. Angiography is an X-ray examination of a blood vessel after the injection of a contrast medium. The test, performed in a hospital, evaluates the function and structure of one or more arteries.
Page 819

Ultrasound, a noninvasive diagnostic method, is also used in cardiology. Doppler ultrasonography tests the body's main blood vessels for conditions such as weaknesses in vessel walls or blocked arteries. With the use of a handheld probe, sound waves are transmitted through the skin and are reflected by the blood cells moving through the blood vessels.

Echocardiography tests the structure and function of the heart through the use of reflected sound waves, or echoes. Sound waves of an extremely high frequency are projected through the chest wall into the heart and are reflected back through a mechanical device. The echoes, recorded on paper or video, can indicate conditions like structural defects and fluid accumulation.

Heart magnetic resonance imaging (MRI) is a diagnostic procedure that uses strong magnets and radio waves to produce images of the heart. This procedure is noninvasive and does not use ionizing radiation, so it is safer than other imaging techniques. Detailed pictures of the heart and heart vessels can be obtained using heart MRI.

Cardiac catheterization is an invasive diagnostic method in which a catheter (a slender, hollow tube) is inserted into a vein or artery in the right or left arm or leg and passed through the blood vessels into the heart. The cardiologist can use this method to take blood samples for analysis, measure the pressure in the heart's chambers, and view the heart's motions with the aid of fluoroscopy. During cardiac catheterization, the physician may choose to perform a balloon angioplasty to open partially blocked coronary arteries. This procedure involves passing a slender, hollow tube through the artery at the blockage site. The balloon at the end of the tube is then inflated, compressing the blockage and widening the artery. A metal mesh tube known as a stent may be placed in the artery in order to keep it open. These stents are usually coated with medications that prevent the reclosure of the blood vessel.

If the blockage is extensive, the patient may need surgery known as coronary artery bypass graft (CABG), which involves bypassing the blockage with a vessel taken from another area. All of these procedures are performed in the hospital.
Dermatology Exams

During a whole-body skin examination, the dermatologist examines the visible top layer of the entire surface of the skin, including the scalp, the genital area, and the areas between the toes. The physician uses a magnifying lens and a bright light to look for lesions, especially suspicious moles or precancerous growths. Your role in this exam includes preparing patients and helping them into the proper position before examining each skin area. During the exam, drape patients to protect their privacy as much as possible while exposing the area to be examined. The physician also may ask you to take photographs or make sketches of lesions to aid in detecting future changes.

Another type of dermatologic exam is the Wood's light examination, in which the physician inspects the patient's skin under an ultraviolet lamp in a darkened room. This examination highlights certain abnormal skin characteristics and aids in diagnosis. The dermatologist also may perform more limited, focused exams to evaluate specific skin conditions or disorders.
Endocrine Exams and Tests

Before an exam, you will take a thorough medical history. The physician will assess the patient's skin condition, weight, and cardiac functioning for clues about illness. An endocrinologist will perform a complete physical exam, including palpation of glands. Most of the endocrine glands are located deep within the body; only the thyroid, the testes, and, to some extent, the ovaries can be examined with palpation or auscultation. Therefore, you may need to collect essential diagnostic urine and blood tests.

Other diagnostic tools used in endocrinology include radiologic tests like X-rays and iodine scans. In a thyroid scan, the patient receives an oral or intravenous (IV) dose of radioactive iodine, and the thyroid is X-rayed as the material is absorbed. Ultrasound also can be employed to view glands or detect tumors. Urine and blood may be tested for the presence of glucose or hormones.
Gastrointestinal Exams

The gastroenterologist's examination of the patient's GI tract covers the mouth (lips, oral cavity, and tongue), the abdomen and lower thorax, the lower sigmoid colon, the rectum, and the anus. Depending on the patient's symptoms, the physician may perform an invasive exam procedure during the patient's first visit. Formerly, such procedures were performed only in hospitals or special medical facilities. Now, many GI specialists' offices are equipped for these procedures and the management of possible resulting emergencies.

You must prepare the patient and provide reassurance during exams and help patients be as comfortable as possible. Your duties during the procedures will vary according to your state's scope of practice and the physician for whom you work. Instruct patients in advance to arrange for someone to drive them to and from the exam. After a procedure in which patients have had a local anesthetic at the back of the throat, caution them to avoid eating until the drug has been eliminated from the body. Otherwise, they could choke or aspirate food particles into the trachea.

Endoscopy Endoscopy generally refers to any procedure in which a scope is used to visually inspect a canal or cavity within the body. Most endoscopic exams are performed with a flexible fiber-optic tube that has a lighted instrument on the end. These exams provide direct visualization of a body cavity and a means for collecting tissue biopsies and removing polyps, as in the colon. Endoscopy helps diagnose tumors, ulcers, structural abnormalities, and other problems. It is particularly useful in performing procedures that formerly would have required an incision, like removing stones from the bile duct.
Page 820

Peroral EndoscopyPeroral endoscopy involves inserting the scope by way of the mouth (Figure 42-9). The patient is sedated and the gag reflex is inhibited with a local anesthetic. The peroral endoscopic procedures include esophagoscopy (esophagus only), gastroscopy (stomach only), duodenoscopy (duodenum only), and panendoscopy (esophagus, stomach, and duodenum) also referred to as an EGD (esophagogastroduodenoscopy).
To perform a peroral endoscopy, the physician inserts a scope through the patient's mouth.

ColonoscopyColonoscopy—performed by inserting a colonoscope through the anus—can provide direct visualization of the large intestine. The gastroenterologist uses this procedure to determine the cause of diarrhea, constipation, bleeding, or lower abdominal pain. A colonoscopy also is performed on patients over 50 to screen for abnormal growths called polyps that can lead to colon cancer.

Patient preparation is designed to clear the colon of fecal material so the colon can be seen clearly. The type of preparation varies depending upon the practice where you are working. For example, one regimen requires the patient to follow a liquid diet for 24 to 48 hours before the procedure, then take a cathartic on the two evenings prior to the colonoscopy. Patients may also need to use one or more prepackaged enema preparations the night before and the day of the procedure. Teach the patient the colon cleansing regimen and then tell him to expect diarrhea and possibly mild cramps.

Immediately before the procedure, instruct patients to empty the bladder. Patients should be given a sedative or an analgesic before undergoing the procedure. Patients lie in the Sims' position as the scope is guided through the large intestine. The doctor may manipulate the abdomen to facilitate passage of the scope.

ProctoscopyProctoscopy is an examination of the lower rectum and anal canal. After an initial digital exam, the proctoscopy is performed with a 3-inch instrument called a proctoscope. This exam can detect hemorrhoids, polyps, fissures, fistulas, and abscesses.

SigmoidoscopySigmoidoscopy is similar to colonoscopy, except that only the sigmoid area of the large intestine (the S-shaped segment between the descending colon and the rectum) is examined. Sigmoidoscopy also aids in diagnosing colon cancer, ulcerations, polyps, tumors, bleeding, and other lower intestinal problems. Patient preparation involves using one or two prepackaged enemas either the night before or the morning of the procedure, depending on the physician's instructions. The method for assisting the physician during a sigmoidoscopy is described in Procedure 42-2, at the end of this chapter.

Diagnostic and Laboratory Testing A GI specialist may order laboratory analysis of stomach contents (obtained by gastric lavage) to determine the presence of bacteria or gastric bleeding. Another important test for GI specialists is the occult blood test, in which the feces are analyzed for occult, or hidden, bleeding from the intestinal tract. This is discussed in the Testing and Processing Urine and Stool Specimens chapter.

Gastroenterologists sometimes use imaging techniques, such as X-rays, ultrasound, radionuclide imaging, computed tomography (CT), and magnetic resonance imaging. Most GI radiologic exams are not performed in an office, but you should know enough about them to answer patients' questions. Generally, these exams are performed in a hospital X-ray laboratory or an outpatient facility. You may be responsible for scheduling tests at such facilities for patients. You also may help prepare the patient for these exams. However, in some cases, the patient should discuss specific preparation with personnel from the other facility.

CholecystographyCholecystography is a gallbladder function test performed by X-ray with a contrast agent. The patient swallows tablets of the contrast agent the night before the test. X-rays taken 12 to 14 hours later should show the contrast agent in the gallbladder. The patient then swallows a substance high in fat, which should make the gallbladder contract and empty the contrast agent into the duodenum. If the contrast agent is not taken up by the gallbladder or if the gallbladder does not contract properly, the physician can determine whether there is bile duct obstruction or gallstones. See the Diagnostic Imaging chapter for further information about cholecystography.

UltrasoundUltrasound is used commonly for diagnosing problems in the gallbladder, pancreas, spleen, and liver. The patient should have nothing to eat or drink after midnight of the night before and on the morning of the exam. Some gastroenterologists may perform ultrasound exams in the office.

Barium SwallowThe barium swallow (also called an upper GI series) is used to detect abnormalities in the esophagus, stomach, and small intestine. The patient swallows a liquid containing barium—an insoluble contrast agent. This material is viewed using fluoroscopy (moving X-ray images) as the liquid is swallowed and passes into the stomach. X-ray films are taken at frequent intervals to record the diagnostic images. The patient is asked to move into various positions while the barium is tracked through the small intestine. To prepare for this test, the patient should have nothing to eat or drink after midnight the night before and on the morning of the procedure. Refer to the Diagnostic Imaging chapter for more information.
Page 821

Barium EnemaA barium enema (also called a lower GI series) is used to detect abnormalities in the large intestine. Barium is given as an enema in this test. A balloon-like tube is inflated in the rectum during the X-ray and the patient is asked to move into various positions to ensure that the barium is distributed completely (Figure 40-10). Patients must eat no meats or vegetables for 1 to 3 days before the test to avoid incorrect indications on the X-ray. For 24 hours before the test, they must also follow a liquid diet, which includes drinking special liquid laxative preparations and more than a quart of water. Specific steps vary depending on the facility, but the intent is to cleanse the colon completely. See the Diagnostic Imaging chapter for more information.

Radionuclide ImagingRadiology subspecialists trained in nuclear medicine perform nuclear medicine studies with radionuclide imaging. The patient is first injected with a radioactive substance, then waits a prescribed length of time for the radioactive substance to be taken up by the body part being imaged. The patient is scanned or photographed with a special gamma camera, which can read the radioactive areas to determine abnormalities in their composition. This technique is commonly used for liver, spleen, thyroid, and bone scans.