Medical Office Pharmacology: Review For Medical Assistant Students and Professionals
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Patient Assessment
For medical assistants who need to brush up on certain areas in pharmacology as it applies to a medical office.
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The need for well trained medical assistants remains high. At any given moment there are over 100,000 job offers for medical assistants and other healthcare professionals available across the nation, hundreds in every state! Most disciplines require knowledge of medical office procedures and some pharmacology....
medication dosage calculations  

Patient Assessment
Factors Affecting Medication Response
Age
Weight
Gender
Ethnic background
Physical health
Psychological status
Environmental temperature
Amount of food in stomach
Dosage form


Proper Patient Assessment before any treatment and medication administration is vitally important!
Vital signs traditionally consist of blood pressure, temperature, pulse (heart) rate and respiratory rate. In a medical office it is an important component to monitor every patient before and after a medication is administered. This task is usually assigned to the medical assistant and includes neonatal, pediatric, and adult patients. The equipment needed is a thermometer, a sphygmomanometer, and a watch. Though a pulse can often be taken by hand, a stethoscope may be required for a patient with a very weak pulse.

Attention!  When observing a patient accuracy should not be taken for granted.
Any degree of inaccuracy resulting from incorrect technique leads to:
False readings
Unnecessary treatment
Inappropriate treatment and follow up

Remember: Only a medical assistant who is aware of the factors that lead to false readings should measure blood pressure. Inaccurate readings obtained through failure to use the proper technique lead to the wrong diagnosis, which may result in unnecessary or inappropriate treatment and follow up.


Blood Pressure Screening
National Heart, Lung, and Blood Institute (NHLBI) guidelines defines normal blood pressure as follows:
- Less than 120 mm Hg systolic pressure
and
- Less than 80 mm Hg diastolic pressure

Obtaining a Blood Pressure Reading
Instruct patients not to use tobacco or caffeine for 30 minutes before the measurement is performed.
Seat the patient in a quiet environment, free from temperature extremes, for at least 5 minutes before the measurement is performed.
Perform the measurement with a mercury sphygmomanometer, if available. An aneroid manometer may be used if it is periodically calibrated according to manufacturer's recommendations. A validated electronic device meeting the requirements of the American National Standard for Electronic or Automated Sphygmomanometers set forth by the Association for the Advancement of Medical Instruments may also be used.
Position the manometer at eye level, if possible, to assure accuracy in reading the measurement.
Use an appropriately sized cuff. The bladder of the cuff should encircle 80% to 100% of the arm. The cuff width should be 40% of the circumference of the upper arm. Use of narrow cuffs leads to falsely elevated readings. Use of wide cuffs may falsely lower the reading.
The patient's arm should be bare; avoid constricting the upper arm with a rolled shirt sleeve. Support the arm horizontally so the cuff is positioned at heart level (the fourth intercostal space).
Apply the stethoscope lightly to the antecubital fossa. Excess pressure results in falsely low diastolic blood pressure readings.
Rapidly increase cuff pressure to about 30 mm Hg beyond the point at which the radial pulse is no longer palpable. Decrease pressure at a rate of no more than 2 to 3 mm Hg per second.
In adults, the measured systolic blood pressure (SBP) and the diastolic blood pressure (DBP) readings are the pressures corresponding to the first of two consecutive sounds and the disappearance of sound (not muffling), respectively. Confirm the disappearance of sound by continuing to listen while decreasing pressure 10 to 20 mm Hg below the last sound heard.
Use the average of at least two readings unless the first two differ by more than 5 mm Hg, in which case obtain additional readings. To permit blood to be released from arm veins, allow an interval of 1 to 2 minutes before repeating pressure measurements in the same arm.
Measure blood pressure in both arms initially; at subsequent visits, remeasure using the arm with the higher initial pressures.
Confirming the diagnosis of hypertension requires high blood pressure readings during at least two subsequent visits (unless SBP is 210 mm Hg or higher, DBP is 120 mm Hg or higher, or both).
Because blood pressure readings obtained in a medical setting may not be typical of a patient's usual blood pressure, monitoring at home or work by the patient, family, or friends may be valuable. Measurement devices must be calibrated initially and rechecked at least yearly. Instruct the person taking the blood pressure in proper technique, and recheck the technique periodically.

Source: Clinician's Handbook of Preventive Services, 2nd Edition, produced by the U.S. Department of Health and Human Services, is a practical and comprehensive guide to clinical preventive services including screening tests for early detection of disease, immunizations and prophylaxis to prevent disease, and counseling to modify risk factors that lead to disease.

A comprehensive physical examination and clinical education site by UCA, San Diego
View proper blood pressure reading technique tutorial by the Faculty of
Medicine & Medical Sciences Medi-CAL Unit at the University of Aberdeen.
View blood pressure measurement technique instructional video!
(Warning, this file is 44MB in size and may take a while to download!)

                                                                                                                                                                                                                                                                                                           

To report illegal prescription drug sales and/or rogue pharmacies operating on the Internet call the anonymous Pharmaceutical Drug Abuse Hotline: 1-877-RxAbuse (1-877-792-2873).
More info at: DEA Website
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Buying controlled substances online without a valid prescription may be punishable by imprisonment under Federal law and it is a felony to import drugs into the United States and ship to a non-DEA registrant.


This Website is protected by applicable copyright laws. No part may be reproduced, transmitted, or used in any way other than its intended purpose without prior written permission. Inquiries, contact Website owner:  Danni R.

About the Author:
Danni R. has created this extensive resource in her capacity as certified medical assistant and medical assisting instructor at Porter & Chester Institute, Ultrasound Diagnostic School, and Branford Hall in 2003.  You may also visit her other websites at Advanced Medical Assistant of America, Medical Assistant Net, Medical Billing and Coding Net, Medical Coding and Billing Home Page, and Phlebotomy Pages to get better acquainted with her work.