ELSEVIER SAUNDERS An Imprint of Elsevier 11830 Westline Industrial Drive St. Louis, Missouri 63146
Student Workbook to Accompany ESSENTIALS OF HUMAN DISEASES AND CONDITIONS
Third Edition Copyright © 2004 by Elsevier All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any informa-
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Publishing Director: Andrew Allen Executive Editor: Adrianne Rippinger Senior Developmental Editor: Rae L. Robertson Publishing Services Manager: Linda McKinley Project Manager: Julie Eddy Designer: Julia Dummitt ISBN-13: 978-1-4160-0092-1 ISBN-10: 1-4160-0092-5
Last digit is the print number:
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lGetanerenereraceyel eveloping an understanding to disease ID processes is an exciting and fascinating facet of the health care provider’s education. Considering that disease conditions are universally experienced, most of us have not only a natural curiosity about them, but as health care providers, it is essential that we are cognizant of the many components of disease. The study of current medical information on the more common clinical disorders encountered in the health care field presents a chal-
lenge to any student. Essentials of Human Diseases and Conditions, third edition, attempts to condense and simplify current medical information on the more common clinical disorders encountered in the health field and physician office. This companion workbook is intended to present an orderly and concise review of information and to assist you in investigating diseases of the human body. The authors of this workbook, both medical-assisting educators and CMAs, recognize
how essential it is for you to have an organized means of reinforcing and reviewing information presented in the text and during class sessions. It is our goal to provide a tool that will bolster the educational experience as you study pathophysiology, as well as to help you approach learning the basics of the human pathologic condition. Students have previously expressed their desire to have a workbook or study guide to help with studying notes and preparing for examinations. This workbook is a means to review pertinent information, making it more likely that you will remember diseases along with their signs, symptoms, and treatments. This workbook has been planned to follow the textbook chapters in an orderly fashion. Each chapter of the workbook follows the body systems and presents the review material in the following order: ¢ Word Definitions Glossary Terms Short Answer Fill-in-the-Blank Anatomical Structures Patient Screening Patient Teaching Essay Question Certification Exam Review (Multiple Choice)
WoRD
DEFINITIONS
The sections titled Word Definitions list essential words to help you develop and understand disease entities. The use of a medical dictionary or medical
terminology book may be necessary to arrive at the correct meaning of each word as it is used in the textbook.
GLOSSARY
TERMS
Glossary terms
are boldfaced
and/or
italicized in
each chapter and presented in the glossary section in the back of the textbook. It is suggested that you attempt to recall the information presented in class lecture and then confirm the definition with the textbook glossary.
SHORT ANSWER Short-answer questions are included in each chapter as a method of providing you with a means of recall. These questions address pertinent facts of selected diseases discussed in the chapter.
FILL-IN-THE- BLANK Fill-in-the-blank questions provide an opportunity for you to apply one-word or short answers, again to help reinforce and review the information presented. Answers are provided in Word Lists for rapid recognition.
ANATOMICAL
STRUCTURES
Illustrations of anatomical structures and processes are included for labeling. Knowledge of anatomy is crucial to understanding the concepts of disease processes. These labeling exercises are intended to enhance learning.
PATIENT SCREENING Selected patient-screening scenarios are presented to enable you to relate how you would handle telephone calls to the medical office. For these exercises, you should apply the following general guidelines for patient screening in combination with critical thinking skills to formulate a typical screening response. Five typical phone calls are presented per chapter.
GUIDELINES EXERCISES
FOR PATIENT-SCREENING
Typically, the medical assistant has the responsibility Introductionof screening telephone calls from patients requesting an appointment or reporting treatment progress or lack of progress. The medical assistant is often the initial contact for the patient or patient’s family, and
critical thinking and a prompt response are required. Many offices have established guidelines regarding the extent of assessment that can be made over the telephone in compliance with state practice acts. It is essential that office staff be aware of and follow office guidelines. Additionally, the medical assistant who is answering the phone may have a list of questions that he or she is expected to ask along with suggestions for appropriate responses regarding appointments or acceptable referrals. Important guidelines for life-threatening situations are listed in the textbook and in this workbook. It is recommended that you review the information in the text regarding patient screening. The guidelines listed are not intended for diagnosing a caller’s medical condition or for providing curative advice. These exercises offer general clues to enable you to recognize the urgency for an appointment, to identify individuals reporting an emergency, and to discern the kind of calls that require referral to the physician for response. These exercises are not intended to focus on the skill of medical triage, which state practice acts generally reserve for certain licensed
professionals.
nal, flank, or pelvic pain
¢ Sudden onset of blurred vision accompanied by severe throbbing in the eye ¢ Children and other individuals with a history of asthma and sudden onset of difficulty breathing Additional symptoms requiring prompt assessment include but are not limited to: e Sudden or recent onset of unexplained bleeding including blood in urine, stool, or emesis ¢ Coughing or spitting up of blood e¢ Unusual and unexplained or heavy vaginal bleeding e Elevated body temperature of sudden onset or for a prolonged period e¢ Continued abdominal, back, or pelvic pain
e Sudden onset of headache-type pain ¢ Children with elevated temperatures or continued vomiting e Infants with sudden onset of projectile vomiting It is essential to document all calls according to office policy and to notify the physician in an emergency situation.
PATIENT TEACHING
When a patient calls,
careful listening is essential because the caller often relays information that will help the medical assistant to decide the appropriate action required. Ideally, the outcome of telephone communication between caller and screener will benefit the patient and avoid potential medical and legal problems. The importance of sensitivity to human suffering, strict confidentiality,
e Sudden onset of weakness and unsteadiness or severe dizziness e Sudden loss of consciousness or paralysis e Flashes of light in field of vision ¢ Sudden and progressively worsening abdomi-
and a keen
awareness
of the
priority of meeting the needs of patients are necessary skills of the telephone screener and cannot be overstated. The medical assistant must always keep in mind the following important facts: ¢ Only physicians and nurse practitioners may diagnose disease and prescribe medications. e Established office protocol must always be followed during the screening process. e All calls and referrals must be documented according to office policy. The following list of serious and life-threatening conditions require immediate assessment and intervention: e Sudden onset of unexplained shortness of breath ¢ Crushing pain across the center of the chest e Difficult breathing occurring suddenly and rapidly worsening, often in the middle of the
night e¢ Vomiting bright red or very grounds”—appearing blood
dark
“coffee-
Selected patient-teaching scenarios are included to enable you to convey how you would handle patientteaching opportunities in the medical office. For these exercises, you should apply the following general guidelines for patient teaching.
GUIDELINES EXERCISES
FOR
PATIENT-TEACHING
These exercises are intended to provide you with an opportunity to develop patient-teaching skills. The actual implementation of these skills is dependent on state practice acts and office policies. You have the responsibility to make yourself aware of your state’s practice acts and office policy before attempting actual patient teaching. Once you have ascertained that patient teaching is within your scope of practice, you should check office policy for suggested protocol. Many offices have established guidelines for patient teaching, as well as printed materials to assist the health care professional in patient-teaching responsibilities. ¢ Most offices have patient instructions that are written on the encounter form at the end of the physician’s contact with the patient. e As the patient signs out or before he or she leaves the examination room, the medical assistant reviews these instructions with the patient. ¢ Often the scheduling of a return visit is the only instruction the physician may write.
Other identified instructions may be the scheduling of additional testing or the inclusion of information about diets or prescribed medications. Although these instructions are a form of patient teaching,
reinforcing
patient
instructions
and
obtaining patient feedback that confirms his or her understanding of the instructional material is usually considered an essential responsibility for any health care provider. You are encouraged to review general principles of patient teaching as provided in the text. ¢ It is important to remember that the patient is a partner in health care and that patient teaching, as an ongoing process, requires interaction with the patient and his or her family or caregiver. ¢ Presenting the material to the patient must be done at the patient’s level of understanding. As you approach each patient-teaching experience, you should have a goal in mind. Usually patients will express goals for a recovery or improvement in their health situation during the intake assessment procedure. Encouraging input from the patient and family or caregiver in setting goals and delegating responsibility for suggested procedures or activities are in the best interest of the patient. The development of a trusting relationship and _ effective communication helps because individuals are encouraged to assume responsibility for their health and recovery. The patient-teaching scenarios provided are possible patient-teaching opportunities for the health care professional. The scenarios are presented for every chapter except Chapter 1. You should describe how you would approach the appropriate teaching activity for each situation. Certain patientteaching opportunities could be duplicated because
many teaching concepts are generalized for similar conditions. Once wound care has been explained, it
is not necessary for you to repeat this type of instruction in a detailed manner in similar scenarios. Daily weights and requirements for taking medications at the same time every day are examples of patientteaching opportunities that apply to many patientteaching situations. Handwashing reminders are an important factor to be mentioned in most teaching opportunities.
ESSAY QUESTIONS One essay question is included for each chapter. These questions will provide you with an opportunity to discuss or explain in detail certain disease-related topics presented in the chapter.
CERTIFICATION REVIEW
EXAMINATION
Multiple choice-style questions simulate the typical format found in the certification examination. These questions are incorporated to prepare students for what they will encounter in the certification examination. It is our goal to furnish you with the optimal study instruments to achieve an understanding of the disease entities you may encounter in a physician’s office. We wish you success in your endeavor. Margaret Schell Frazier, RN, CMA, BS Tracie Fuqua, CMA, BS
Introduct
Illustration Credits CHAPTER 2
CHAPTER 11
Unn Fig 2-1 (Circulation patterns before and after birth) From Applegate EJ: The anatomy and physiology learning system, 2 ed, Philadelphia, 2000, Saunders.
Unn Fig 11-1 (Gross anatomy of the urinary) From Gould B: Pathophysiology for the health professions, 2 ed, Philadelphia, 2000, Saunders.
Unn Fig 2-2, A (Ventricular septal defect) Used with
Unn Fig 11-2 (Internal structure of the kidney) From Gould B: Pathophysiology for the health profes-
permission of Ross products Division, Abbott Laboratones; from Congenital Heart Abnormalities (Clinical
sions, 2 ed, Philadelphia, 2000, Saunders. Unn Fig 11-3 (The nephron) From Patton KT, Thi-
Education Aid no 7, 1992.
bodeau GA: Mosby’s handbook of anatomy & physiology, St Louis, 2000, Mosby. Unn Fig 114 (Formation of urine) From Gould B: Pathophysiology for the health professions, 2 ed,
CHAPTER 5 Unn Fig 5-2 (The visual pathway) From Gould B: Pathophysiology for the health professions, 2 ed,
Philadelphia, 2000, Saunders.
Philadelphia, 2000, Saunders.
CHAPTER 13
CHAPTER 6
Unn Fig 13-1 (Normal brain) From Gould B: Patho-
Unn Fig 6-1 (Normal skin) From Patton KT, Thibodeau GA: Mosby’s handbook of anatomy & physiology,
physiology
for the health
professions,
2 ed,
Philadelphia, 2000, Saunders.
Unn Fig 13-2 (Spinal cord) From Gould B: Pathophysiology for the health professions, 2 ed, Philadelphia,
St Louis, 2000, Mosby.
CHAPTER 8
2000, Saunders.
Unn Fig 8-1 (Main and accessory organs of the normal digestive system) Redrawn from Miller M: Pathophysiology: principles of disease, Philadelphia, 1983, Saunders.
Unn Fig 13-3 (Neuron) From Gould B: Pathophysiology for the health professions, 2 ed, Philadelphia, 2000, Saunders. Unn Fig 13-4 (Functional areas of the brain) From
Gould B: Pathophysiology for the health profes-
CHAPTER 10
sions, 2 ed, Philadelphia, 2000, Saunders.
Unn Fig 10-1 (Anterior view of the heart) From Patton KT, Thibodeau GA: Mosby’s handbook of anatomy & physiology, St Louis, 2000, Mosby. Unn Fig 10-2 (Posterior view of the heart) From Patton
Unn Fig 13-7 (Autonomic nervous) From Bonewit-West K: Clinical procedures for medical assistants, 6 ed, Philadelphia, 2004, Saunders.
KT, Thibodeau GA: Mosby’s handbook of anatomy & physiology, St Louis, 2000, Mosby. Unn
Fig 10-3 (Cardiac cycle) From Gould B: Patho-
physiology
for the
health
professions,
2 ed,
Philadelphia, 2000, Saunders.
Unn Fig 10-3 (Layers of the heart wall) From Applegate EJ: The anatomy and physiology learning system, 2 ed, Philadelphia, 2000, Saunders.
Copyright ©2004, Elsevier. All rights reserved.
Contents MECHANISMS OF DISEASE, DIAGNOSIS, AND TREATMENT, 1 DEVELOPMENTAL, CONGENITAL, AND CHILDHOOD DISEASES
AND DISORDERS, 9 IMMUNOLOGIC
DISEASES AND CONDITIONS OF THE
RESPIRATORY SYSTEM, 98
10 11
DISEASES AND CONDITIONS OF THE ENDOCRINE SYSTEM, 35
12 13
DISEASES AND CONDITIONS OF THE INTEGUMENTARY SYSTEM, 61
DISEASES AND CONDITIONS OF THE REPRODUCTIVE SYSTEM, 143 NEUROLOGIC
DISEASES AND
CONDITIONS, 156
DISEASES AND DISORDERS OF THE EYE
AND EAR, 47
DISEASES AND CONDITIONS OF THE
URINARY SYSTEM, 129
DISEASES AND
CONDITIONS, 23
DISEASES AND CONDITIONS OF THE CIRCULATORY SYSTEM, 110
14 15
MENTAL DISORDERS, 175 DISORDERS AND CONDITIONS RESULTING FROM TRAUMA, 185
DISEASES AND CONDITIONS OF THE MUSCULOSKELETAL SYSTEM, 71 DISEASES AND CONDITIONS OF THE
DIGESTIVE SYSTEM, 87
vii