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Preface
Health care is constantly evolving and expanding,
developing improved, more efcient ways to deliver
patient care. Science and research are nding new ways
to prevent and treat disease and improve a person’s
well-being. The health care system depends on knowledgeable health care professionals to provide this health
care. Physicians, hospitals, and other health care providers rely on versatile, multiskilled medical assistants to
assist with the management of their patients.
Medical assistants need to be educated in the entrylevel knowledge necessary to meet the expectation of the
health care providers and to ensure patient safety during
the delivery of procedures and treatments. Just as the
medical eld has expanded knowledge and technology,
the medical assistant needs to adopt an attitude of lifelong learning in order to keep pace with the anticipated
changes to the future medical eld landscape.
The Complete Medical Assistant textbook serves as a
comprehensive collection of entry-level knowledge and
skills necessary for the medical assistant to be condent
to practice medical assisting under the supervision of a
licensed health care provider. This rst edition textbook
includes the 2015 curriculum requirements set forth
by the Commission on Accreditation of Allied Health
Education Programs (CAAHEP). It also includes the
content and skills required by the Accrediting Bureau of
Health Education Schools (ABHES).
The textbook was designed with the student in mind
as the primary reader and user. The level of presentation takes into account the typical entry-level medical
assistant student, using a writing style that will make it
easy to read and comprehend for long-term retention of
information. As medical assistant students use this textbook to learn and understand the theory and concepts
of the health care environment, we hope that they will
appreciate and fully understand their responsibility as
a health care professional to provide quality service to
their health care practitioners and patients. As students
progress from the classroom, to the externship experience, and then to their employment, we encourage them
to adopt an attitude of lifelong learning and continuing education in health care. In their future experiences,
they will encounter diversity in the workplace, with their
employers, coworkers as well as their patients. With
the higher incidence of global travel and relocation, it
is more likely for medical assistants to participate in
the treatment of conditions such as the Zika virus and
victims of natural disasters. Medical assistants serve to
protect us by educating, immunizing, practicing sound
aseptic technique throughout the medical ofce, keeping
up with standards, supporting certication and other
indicators of competency, and remaining vigilant to the
health risks of our populations.
We believe that this textbook will challenge the student but at the same time introduce the student to the
essentials of becoming a complete medical assistant.
ORGANIZATION OF THE TEXT
The textbook design is a sequential progression of
information divided into ve sections. The chapters
are intended to stand alone in content so the medical
assistant program can implement them in the sequence
desired. This textbook will fulll the requirements of a
certicate or diploma program and satisfy the clinical
and administrative components of the associate level
program. The main areas presented in each chapter are
as follows.
● Section I General Skills for the Medical Assistant
Chapter 1 introduces essential communication techniques the medical assistant need for effective and appropriate interaction with patients, staff, and supervisors in
the workplace. Chapter 2 provides information regarding the basic legal and ethical principles for the safe and
lawful practice of medical assisting. Chapter 3 information includes the medical ofce operations involving the
computer operation of the ofce and the function of the
intranet and Internet to support the business practice.
● Section II Anatomy and Physiology
This section includes six (6) chapters that introduce the
medical assistant to the anatomy of the human body
and the functions of the major body systems. The information includes an overview of the organization of the
body, the integumentary, skeletal, muscular, nervous,
endocrine, digestive, cardiac, respiratory, urinary, and
reproductive systems.
ix
x Preface
● Section III Administrative Medical Assistant
Skills
Chapter 10 presents the concepts of scheduling appointments in the health care facility used to maximize the provider’s effectiveness in meeting the needs of thepatients.
Chapter 11 provides information about the appropriate
methods to document the patient’s medical record and
maintain HIPAA requirements. Chapters 12, 13, and
14 introduce the concepts of medical insurance coding, medical ofce nances, and health insurance claims
processing. These chapters explore the practice methods
used in medical facilities to support nancial activities in
the medical business and comply with policies set forth
by insurance reimbursement requirements.
● Section IV Clinical Medical Assistant Skills
Chapter 15 provides critical information on practicing
quality medical asepsis in the medical ofce. Infection
control is a primary focus throughout this chapter. Chapter 16 examines the techniques of obtaining a medical
history and the basic elements involved in patient assessment procedures. Chapter 17 provides essential information for the medical assistant to prepare the patient
and assist the physician with a physical examination.
Chapter 18 includes concepts of maintaining a surgical environment, setting up sterile trays, and assisting
the physician throughout minor ofce surgical procedures. Chapter 19 introduces basic pharmacology math
required to determine accurate dosages ordered by the
physician. Injection techniques presented include intradermal, subcutaneous, and intramuscular methods of
administration. Chapter 20 discusses various diagnostic
tests the medical assistant will encounter in the ambulatory medical setting. Chapter 21 gives information
about developing patient education materials based on
the patient needs. Chapter 22 presents the key elements
for recognizing and managing medical ofce emergencies. First aid procedures are included in the chapter as
well as how to prepare for catastrophic emergencies in
the community.
● Section V Clinical Laboratory
Chapter 23 describes the role of the medical assistant in
the clinical laboratory. Information includes CLIA and
OSHA requirements to work legally and safely within
the clinical laboratory. Chapter 24 explores the components and function of the blood. The elements of the
complete blood count and normal values are included.
Also discussed are various types of anemia and their
causes. Chapter 25 presents the practice of phlebotomy
including the equipment used, patient techniques, and
safety measures required. Capillary puncture techniques
are introduced. Chapter 26 examines the different types
of immunity and immunological testing. The antigen–
antibody reaction is examined focusing on the major
blood types and the importance of blood type testing.
Chapter 27 presents the purpose of the urinalysis,
performance of the test including the methods of proper
specimen collection. Urine drug testing and specimen
chain of command are discussed. Chapter 28 discusses
the purpose of performing clinical chemistry tests and
the common chemistry panels ordered by the physician.
The information includes how the chemicals in the body
affect the function of the various systems and how the
physician uses the test results to diagnose metabolic
problems. Chapter 29 presents information including the
use of microbiological cultures and the different types of
bacteria, fungus, and viruses found in the human body.
Various specimen collection methods are discussed.
FEATURES
The textbook design is user friendly and student centered. Essential elements of medical assisting presented
are easy to implement into a medical assisting program.
The key chapter features, where applicable, are designed
to stimulate the student’s learning and retention and
include the following:
Chapter objectives
r
CAAHEP and ABHES competencies
r
Chapter terms
r
Medical abbreviations
r
Icons to indicate content that is part of the cognitive,
r
psychomotor, and affective learning domains
Case scenarios emphasizing critical thinking
r
Cultural connections to introduce students to differ-
r
ent customs and beliefs
Study skills for students
r
Patient education
r
Detailed procedures
r
Externship preparation
r
National certication examination preparation
r
questions
Electronic medical records exercises
r
User’s Guide
This User’s Guide introduces the helpful features of The Complete Medical Assistant that
enable you to master new concepts and put your new skills into practice.
CHAPTER OPENING ELEMENTS
Each chapter begins with the following elements, to help orient you to the material:
Chapter Objectives help
you focus on the most
important information to
glean from the chapter.
Chapter-specic CAAHEP
& ABHES Competencies
are listed at the start of
the chapter.
Chapter Terms and
Abbreviations
dened in the chapter are
listed for quick reference.
that are
xi
xii User’s Guide
SPECIAL FEATURES
Unique chapter features will aid your comprehension and retention of information:
Case Studies challenge you to think
through real-world situations and are
tied to
critical thinking throughout the chapter.
Case Questions emphasizing
Cultural Connections
introduce you to different
customs and beliefs.
Study Skills offer helpful
tips for studying.
Ethics boxes help you
learn how to respond
to ethical dilemmas that
might be encountered on
the job.
Patient Education boxes
contain information on topics
you need to know in order to
help educate patients.
Domain Icons indicate content that
is part of the cognitive, psychomotor,
and affective learning domains.
User’s Guide xiii
C
O
G
P
S
Y
A
F
F
Detailed, step-by-step
Procedures show you
how to perform essential
medical assisting tasks
properly.
xiv User’s Guide
Preparing for Externship
sections offer helpful information
and tips to help you prepare for
your externship experience.
Chapter Recap reinforces
learning by reviewing key
pointsfrom the chapter.
At the end of each chapter, an
OnlineResources for Students
section lists available ancillary
resources on thePoint.
Certication Preparation Questions
atthe end of each chapter allow for
exam practice.
Electronic medical records exercises,
CareTracker Connection, help you
master content as you learn to use
the Harris CareTracker software for
patient scheduling, charting, coding,
and billing.
ADDITIONAL LEARNING RESOURCES
Valuable ancillary resources for both students and instructors are available on thePoint
companion site. See the inside front cover for details on how to access these resources.
Students Resources include review activities and games, certication preparation
r
question bank, competency evaluation forms, an audio glossary, animations, and videos.
Instructor Resources include lesson plans, image bank, test generator, PowerPoint
r
lecture slides, answer keys, CAAHEP and ABHES competencies mapping spreadsheets,
and more.
Available for purchase separately:
Study Guide for The Complete Medical
r
Assistant comes with procedure skill sheets
and a variety of question types to meet the
needs of different learning styles and to
reinforce content and knowledge.
Acknowledgments
We would like to rst of all thank Wolters Kluwer for
recognizing the vision of this publication and approving
the development. This adventure would not have been
possible without the initial encouragement from Michael
Nobel, WK Acquisitions Editor. He supported the concept
of this textbook to provide the need to know information
in a format that is easy to read, comprehend, and retain
format. From start to nish of this project, Amy Millholen, Senior Product Development Editor, was there for
support, encouragement, and expert advice. Her positive
attitude and constant oversight kept the momentum
going. Without her ability to manage and direct the production, the end resulting product would not be possible.
A huge thank you to both Michael and Amy.
Also, thank you to C. Lynn Phillips Karvanek, RN, DC,
for her contribution writing the test bank that accompanies this book. Her experience and knowledge teaching
medical assistants and understanding of the practice of
medical assisting allows her to relate to the entry-level
expectations of the new graduate medical assistant.
xv
Contents
Reviewers vi
About the Authors viii
Preface ix
User’s Guide xi
Acknowledgments xv
Section I GENERAL SKILLS FOR THE MEDICAL ASSISTANT
1 Communication Skills for Medical Assistants 2
2 Law and Ethics 30
3 Medical Ofce Procedures 55
Section II ANATOMY AND PHYSIOLOGY
4 Organization of the Body and Integumentary System 70
5 Skeletal and Muscular Systems 87
6 Nervous System, Special Senses, and Endocrine System 112
7 Digestive System and Nutrition 133
8 Cardiovascular and Respiratory Systems 151
9 Urinary and Reproductive Systems 173
Section III ADMINISTRATIVE MEDICAL ASSISTANT SKILLS
10 Appointments and Schedules 193
11 Medical Documentation 214
12 Medical Insurance Coding 227
13 Managing Medical Ofce Finances 241
14 Health Insurance and Processing Claims 262
Section IV CLINICAL MEDICAL ASSISTANT SKILLS
15 Medical Asepsis and Infection Control 278
16 Medical History and Patient Assessment 301
xvii
xviii Contents
17 Assisting with the Physical Examination 339
18 Assisting with Minor Ofce Surgery 371
19 Pharmacology and Drug Administration 422
20 Diagnostic Testing 468
21 Patient Education 499
22 Medical Ofce Emergencies and Emergency Preparedness 524
Section V CLINICAL LABORATORY
23 Medical Assistant Role in the Clinical Laboratory 553
24 Hematology 573
25 Phlebotomy 590
26 Immunology and Immunohematology 610
27 Urinalysis 624
28 Clinical Chemistry 645
29 Microbiology 663
Appendix A Abbreviations 683
Appendix B Key English-to-Spanish Health Care Phrases 687
Appendix C Valuable Internet Resources 692
Glossary 693
Index 707