Lesson 1, Topic 1
In Progress

The Medical Assistant’s Role in Examinations, Diagnostic Procedures, and Treatments

April 11, 2024

Learning Objective: Examine the medical assistant’s role in examinations, diagnostic procedures, and treatments for gastrointestinal diseases and disorders.
      Many times, the medical assistant may get calls from patients or parents of patients who are experiencing gastrointestinal problems. It is important for the medical assistant to be able to screen these phone calls and gather information for the provider. TABLE 19.1 provides possible screening questions for common signs and symptoms (Procedure 19.1).


19.10 Critical Thinking Application
List three screening questions for each of these symptoms a patient has vomiting, abdominal pain, and diarrhea.


Assisting with the Examination
Learning Objective: Describe the medical assistant’s role in examinations for gastrointestinal diseases and disorders.
      When a patient describes and points to the location of the pain, the medical assistant must know the underlying organs that may be involved. Record the abdominal quadrant or region in which the pain is located so the provider can immediately assess this area when the examination begins. (See Chapter 6 for a discussion on the abdominopelvic quadrants and regions.)
      The provider’s inspection of the abdomen begins with noting any change in skin color, such as jaundice. Striae (silver stretch marks), petechiae (small, purple hemorrhagic spots), scars, and visible masses may be seen. The contour of the abdomen may be flat, rounded, or bulging in localized areas.
      The provider uses palpation and percussion to evaluate the entire abdominal area. If present for the examination, the medical assistant should remove the drape from the area to be examined and redrape the patient once this segment of the examination is completed. In addition, the provider may want the medical assistant to document findings as the examination progresses. If the provider wants to examine the anal area, have the patient turn onto the left side and assist the patient into the Sims position. As this is done, make sure the patient remains draped. After the patient is in the Sims position, adjust the drape on an angle so that it can be easily lifted for the final part of the examination.
      A digital rectal examination (DRE) may be done to identify abnormalities in the rectum (see Chapter 27). To do the DRE, the provider inserts a gloved, lubricated finger into the rectum to feel for abnormalities in the prostate, bladder, and so on. The provider may use an anoscope to examine the anal area. For this exam, a short speculum is inserted into the anal canal and lower rectum. This allows for the detection of hemorrhoids, polyps, fissures, fistulas, and abscesses.


Assisting with Diagnostic Procedures
Learning Objective: Describe the medical assistant’s role in diagnostic procedures for gastrointestinal diseases and disorders.
      Many tests and procedures are used to help diagnose gastrointestinal diseases and disorders. TABLE 19.2 describes common diagnostic procedures. The medical assistant should be familiar with the description of these tests and the patient preparation required. TABLE 19.3 describes medical laboratory tests for gastrointestinal diseases and disorders. (Refer to Chapter 35 for stool-based tests.)


Colonoscopy
A colonoscopy is a procedure in which the provider uses a colonoscope to look into the rectum and colon. The visual inspection of the colon and rectum allows the provider to see irritation, swelling, ulcers, polyps, and potentially cancerous areas.
      In the past, many providers did colonoscopies in the office setting, where it was important for the medical assistant to know how to set up and assist with the procedures. Today, anesthesia plays an important part in sedating patients for the procedure. This is one of the main reasons colonoscopies are now usually done in a hospital or ambulatory surgical center. The medical assistant’s role is preparing patients for the procedure. Procedure 19.2 describes how a medical assistant should coach a patient on the procedure.
      As with all procedures, the patient needs to be informed of any medication changes or when to not take medications. The provider will determine when the patient needs to stop taking any blood-thinning prescriptions and over-the-counter medications. If the patient is on diabetic, antihypertensive, or heart medications, the provider will determine how these should be handled. The medical assistant needs to communicate these instructions to the patient.

Assisting with Treatments
Learning Objective: Describe the medical assistant’s role in treatments for gastrointestinal diseases and disorders.
      TABLE 19.4 describes common treatments for gastrointestinal diseases and disorders. Patients can also be prescribed a variety of medications. The following are some of the more common classifications of medications:
              • Antacid: Used to treat gastric hyperacidity
              • Antidiarrheal: Used to treat diarrhea
              • Antiemetic: Used to prevent and relieve nausea, vomiting, and motion sickness
              • Laxative: Used to increase and hasten bowel evacuation
              • Proton-pump inhibitor: Used to treat gastroesophageal reflux disease (GERD) and ulcers
      Refer to TABLE 19.5 for information on the medication classification, including indications for use, desired effect, side effects, adverse reactions, and generic and trade names. Medical assistants should be familiar with medications that are prescribed to patients.