Medical Assistant Prep / Unit 12 MAS 296 review, 2 to 3 minutes
Vital Signs on an Anxious Patient
The idea
This scene is constructed for this course. It shows a medical assistant taking vital signs on a nervous patient and recording exactly what she finds, without explaining any of it away.
In practice
A young woman sits on the exam table, visibly tense, and tells the medical assistant that doctors' offices make her nervous. The medical assistant asks whether she has had anything to eat or drink recently, and learns that she finished an iced drink in the car ten minutes ago. Instead of taking an oral temperature, the medical assistant uses the tympanic route, as the practice allows, and records the route with the reading. The radial pulse is fast and seems uneven, so she counts it for a full minute, starting with one on the first beat, rather than taking a short count. She counts respirations for a full minute too, while still watching the wrist so that the patient does not change her breathing. Both rates are above the adult range. The medical assistant knows that nervousness can speed the heart, but she does not decide that nerves explain the readings. She records the numbers, notes that the pulse felt irregular and that the patient described herself as anxious, and tells the provider about the fast, uneven pulse before the provider enters the room.
Where people slip
The anxious feeling and the fast pulse may well be connected, but deciding so is a clinical judgment. An irregular rhythm in particular is something the provider must hear about whatever the likely cause. Recording the facts and the patient's own words, and passing them on, protects the patient whichever explanation turns out to be true.
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