Introduction to Health Care - 5th Edition

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 Introduction to Health Care, Fifth Edition © 2021, 2017, 2012 Cengage Learning, Inc.
Lee Haroun and Dakota Mitchell
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 Contents
Preface xi
Dedication xviii
About the Authors xviii
Acknowledgments xviii
About this Book xix

Unit 1 | Health Care Today The Future of Health Care 48

Challenges in Health Care Today 48
CHAPTER 1
Providing Affordable Health Care 48
Your Career in Health Care 1
Providing Long-Term Care 49
Your Future in Health Care 2
Improving Social Conditions 49
Getting Off to a Good Start 3
Eliminating Racism in Health Care 50
Essential Core Qualities of Health
Maintaining the Quality of Care 50
Care Professionals 3
Treating Alzheimer’s and Other
Learning for Mastery 4
Forms of Dementia 51
Volunteering 5
Addressing Public Health Concerns 52
Professional Organizations 5
Encouraging Medication Adherence 52
Returning Adult Students 5
Managing the Opioid Crisis 52
Learning to Think Like a Health Care Professional 6
Preventing Antibiotic Resistance 52
Problem-Solving Process 6
Preventing Suicides 53
Making a Career Decision 9
Dealing with TV Prescription Drug Ads 53
Educational Requirements 9
Health Care Facilities and Services 53
Standards for Health Care Professionals 10
Hospitals 53
Occupational Profiles 11
Ambulatory Services 55
Therapeutic and Treatment Occupations 12
Long-Term Care Facilities 55
Diagnostic Occupations 24
Home Health Care Providers 56
Sources of Additional Information 32
Hospice 57
CHAPTER 2 Consolidation of Health Care Services 57
Health Care Yesterday, Today, and Tomorrow 36 New Types of Health Care Facilities 57
The History of Western Government Health Services 58
Health Care 37 State Health Departments 58
Trends and Issues in Health Local Health Departments 58
Care Today 42
CHAPTER 3
Specialization 42
Aging Population 43 Ethical and Legal Responsibilities 64
Cost of Health Care 43 The Purpose of Ethics 65

Variety of Approaches to Health Care 44 Ethics and the Law 65

Wellness 44 Ethics and Health Care 66

Holistic Medicine 44 Professional Codes of Ethics 68

Complementary, Alternative, and Personal Values 69

Integrative Medicine 45 Professional Values 69
iii

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iv | Contents

Guiding Principles of Health Care Ethics 69 Ratios 112

Preserve Life 69 Converting Decimals, Fractions,
Do Good 73 Percentages, and Ratios 112
Respect Autonomy 73 Rounding Numbers 112
Uphold Justice 76 Solving Problems with Proportions 114
Be Honest 77 Estimating 116
Be Discreet 78 Statistics 116
Keep Promises 80 Military Time 116
Do No Harm 81 Roman Numerals 118
Patient Rights 82 Angles 118
Handling Ethical Dilemmas 84 Systems of Measurement 119
Who Decides? 84 Household System 119
Metric System 120
Unit 2 | The Language of Health Care Apothecary System 122
CHAPTER 4 Converting Systems of Measurement 122

Medical Terminology 89 Medication Safety 124

Importance of Medical Terminology 90 Temperature Conversion 124

The Building Blocks of Medical Language 90

Word Roots and Combining Forms 90
Unit 3 | The Human Body
Suffixes 93 CHAPTER 6
Prefixes 95 Organization of the Human Body 129
Deciphering Medical Terms 96 The Basis of Life 130
Example # 1 cardiology 96 Cells 130
Example # 2 polyarthritis 97 Tissues 133
Example # 3 echocardiogram 97 Describing the Body 133
Eponyms 97 Body Planes 134
Words with Special Meanings in Medicine 97 Directional Terms 134
Names of Drugs 97 The Body Cavities 134
Spelling and Pronunciation 97 Abdominal Descriptions 136
Medical Abbreviations
CHAPTER 7
and Symbols 99
Medical Dictionary 101
Structure and Function of the Human Body 140
The Importance of Anatomy and Physiology 141
Mastering Medical Terminology 101
Genetics 141
CHAPTER 5 The Systems of the Body 142
Medical Math 106 Systems for Movement and Protection 142
Importance of Math in Health Care 107 Skeletal 142
Math Anxiety 107 Muscular 150
Basic Calculations 107 Integumentary 152
Whole Numbers 109 Systems for Providing Energy and
Decimals 109 Removing Waste 154
Fractions 110 Circulatory 154
Percentages 111 Respiratory 161

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 Contents | v

Digestive 164
CHAPTER 10
Urinary 166
Infection Control 217
Systems for Sensing, Coordinating, and Controlling 168
Importance of Infection Control in Health Care 218
Eyes and Ears 168
Scope of the Problem 218
Nervous 172
Endocrine 177 Regulatory Agencies 219

Systems for Producing New Life 180 Microorganisms 219

Female Reproductive 180 Types of Microbes 220

Male Reproductive 182 Defense Mechanisms 224
How Infections Spread 224
CHAPTER 8
Preventing Infection 224
Growth and Development 187
Breaking the Chain of Infection 225
Knowing Your Patient 188
Handwashing 226
Life Stages 188
Personal Protective Equipment 229
Prenatal 189
Patient-Care Equipment 232
Infancy 191
Toddler 191 Antiseptics, Disinfectants, and Sterilization 232

Preschooler 192 Surgical Asepsis 236

School-Age Child 192 Standard Precautions 236

Adolescence 193 Environmental Control 239
Young Adulthood 193 Blood-Borne Pathogens 239
Middle Adulthood 194 Transmission Precautions 241
Later Adulthood 194 Disposal of Hazardous Waste 243
Care Considerations 196 Neutropenic Precautions 244
Other Developmental Theories 198 The Challenges 245
Jean Piaget 198 Influenza 245
Lawrence Kohlberg 198 Workplace Risks 245
Carol Gilligan 199 Other Infectious Diseases 251
Future Trends 199
Drug-Resistant Organisms 251
Death and Dying 200
Reporting Accidental Exposure 253

Unit 4 | Personal and Workplace Safety CHAPTER 11

CHAPTER 9 Environmental Safety 258
Body Mechanics 205 Importance of Environmental Safety in Health Care 259
The Importance of Prevention 206 General Safety Guidelines 259
Repetitive Motion Injuries 206 Moving Safely 259
Computer Use and Repetitive Motion Injuries 207 Dressing for Safety 259
Preventing Repetitive Motion Injuries 207 Working Safely with Patients 260
Visual Problems 208 Protecting Yourself and Others 261
Exertion Injuries 210 Reporting for Safety 262
Preventing Exertion Injuries 212 Workplace Violence 262
Treatment of Musculoskeletal and Nerve Injuries 213 Fire and Electrical Hazards 263
Back Belts 214 Chemical Hazards 268
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vi | Contents

Radiation Hazards 268

CHAPTER 13
Infectious Waste 268
Professionalism 298
Oxygen Hazards 269
The Meaning of Professionalism 299
Bioterrorism 269
Professional Attitude 299
Emergency Code System 270 Professional Behaviors 300
Emergency Preparedness Plan 270 Technical Skills 301
Triage 271 Professional Appearance 301
Professional Distance 302
Unit 5 | Behaviors for Success Handling Difficult Situations Professionally 302
CHAPTER 12 Professional Acceptance of Criticism 303
Lifestyle Management 275 Professionalism Outside the Workplace 303
Importance of a Healthy Lifestyle 277 Professional Leadership 303

Habits and Health 277 CHAPTER 14

Diet and Nutrition 277 Professional Development and
Nutrients 277 Lifelong Learning 307
Calories 279 Professional Development 308
Carbohydrates 279 Professional Organizations 308
Sugars 279 Importance of Lifelong Learning 309
Fats 279 Keeping Up with Changes in Health Care 309
Salt (Sodium) 280 Continuing Education Units 310
Processed Foods 280 Ways to Earn CEUs 311
Organic Foods 280 Self-Directed Learning 312
Healthy Eating 281 Learn from Role Models and Mentors 313

Maintaining a Healthy Weight 282 Career Ladders 314

Body Mass Index 283

Unit 6 | Communication in the Health
Weight-Loss Diets 283 Care Setting
Vegetarian Diets 283
CHAPTER 15
Eating Disorders 284
The Patient as an Individual 317
Physical Activity 284
Patients as Individuals 318
Sleep 285
Philosophy of Individual Worth 319
Preventive Measures 285
Understanding Patients 319
Stress in Modern Life 286
The Meaning of Culture 320
External and Internal Stressors 286
Dominant Culture 321
Dealing with Stress 287
Individuals and Culture 321
Minimizing Health Risks 290 Cultural Differences 322
Smoking 290 Health Care Beliefs 324
Substance Abuse 291 Religious Beliefs and Health 324
Occupational Hazards 291 Harmony and Health 324
Safe Sex 292 Herbs and Plant Medicines 325
Burnout 292 Human Needs 327
Helping Patients Develop Healthy Lifestyles 293 Implications for Health Care Professionals 327

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 Contents | vii

Defense Mechanisms 330 Business Letters 367

Dealing with Loss 330 Using Form Letters 368
Treating Patients as Individuals 331 Writing Effective Letters 368
Business Letter Formats 368
CHAPTER 16
Preparing Letters for Mailing 372
The Communication Process 337 Memos 372
Importance of Communication in Health Care 338
Meeting Agendas 372
Communication with Patients 338
Minutes of Meetings 372
The Communication Process 340
Patient Education Materials 373
The Six Steps of the Communication Process 340
Confidentiality of Written Materials 374
Communication through the Life Span 347
Proofreading Written Work 374
Overcoming Communication Barriers 348
Patients Who Are Terminally Ill 348 CHAPTER 18
Patients Who Are in Pain, Medicated, Computers and Technology in Health Care 378
Confused, or Disoriented 349 Computers in Health Care 379
Patients with Dementia 349 Information Management 380
Patients Who Are Depressed 349 Creation of Documents 382
Patients Who Are Anxious 350 Spreadsheets 382
Patients Who Have Hearing Impairments 350 Diagnostics 384
Patients Who Have Visual Impairments 351 Medical Lab Testing 385
Patients Who Have Speech Impairments 351 Patient Monitoring 388
Patients Who Are Angry 352 Research 388
Patients Who Do Not Speak English 352 Education 389
Special Applications of Communication Skills 352 Communication 389
Telephone Communication 353 Virtual Communities 391
Patient Education 353 Telemedicine 391
Presentations to Groups 354 Using Computers Effectively 392
Gossip and Patient Privacy 354 Computer Security 393
Maintaining the Human Touch 394
CHAPTER 17
Learning More about Computers 394
Written Communication 359
Written Communication: A Vital Link in Health Care 360 CHAPTER 19
The Components of Good Writing 361 Documentation and Medical Records 398
Organizing Content 361 Medical Documentation and Recordkeeping 399
Preparing to Write 361 Purposes of Medical Documentation 399
Starting to Write 362 Characteristics of Good Medical
Spell Your Way to Success 362 Documentation 400
Spelling Tips 363 Making Corrections on Medical Documentation 401
Grammar at a Glance 363 Contents of the Medical Record 402
Capitalization Rules 363 Progress Notes 404
Punctuation Rules 364 Electronic Health Recordkeeping 405
Writing Numbers Correctly 367 Example of a Computerized System 406
Writing Titles Correctly 367 Advantages of Computerized Systems 407

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viii | Contents

Challenges of Computerized Systems 407 Unit 8 | Business of Caring

Providers’ Concerns 408
CHAPTER 22
Personal Health Record 408
Paying for Health Care 481
Safeguarding Health Records 408
The Rising Costs of Health Care 482
HIPAA 409
Impact of Costs on Individuals 483
Cybersecurity 409
Health Care Institutions 483
Sending Protected Information 409
History of Health Care Reimbursement 484
Health Care Payment Methods 484
Unit 7 | Health Care Skills
Government Programs 484
CHAPTER 20 Veterans Health Care 485
Physical Assessment 413 Medicare and Medicaid Reimbursement 485
General Assessment 414 Managed Care 486
Noting Variances from Normal 415 Types of Managed Care Plans 486
General Survey 415 Prepaid Plans 486
Psychosocial Observations 416 Negotiated Fees 487
Physical Observations 416 Primary Care Providers 487
Pain Evaluation 419 Review of Services 487
ADL Evaluation 419 Providing Affordable
Vital Signs 419 Health Care 488
Temperature 420 Controlling Organizational Costs 489
Pulse 424 Health Care Professionals’
Respirations 428 Impact on Costs 490
Blood Pressure 429 Personal Efficiency 491
Height and Weight 433 Acting with Thought 492

CHAPTER 21 CHAPTER 23
Emergency Procedures 441 Quality Control and Customer Service 497
Emergency Situations 442 Quality of Care 498
When an Emergency Occurs 443 Approaches to Measuring Quality of Care 498
Cardiopulmonary Resuscitation (CPR) 444 Quality Improvement 499
First Aid Procedures 444 Centers for Medicare and Medicaid Services 499
Allergic Reactions 445 The Joint Commission 499
Bleeding and Wounds 447 Agency for Healthcare Research and Quality 500
Bone, Joint, and Muscle Injuries 447 American Hospital Association 500
Injuries to Facial Structures 452 Internal Monitoring 500
Burns 452 Reducing Medical Errors 501
Drug Abuse 461 Medication Errors 502
Poisoning 461 Customer Service 502
Temperature-Related Illness 462 Taking Responsibility for Quality 504
Other Conditions 466 Customer Satisfaction 505
Bandaging 466 Internal Customers 505

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 Contents | ix

Unit 9 | Securing and Maintaining Accepting the Job 540

Employment Declining the Job 542
Dealing with Rejection 542
CHAPTER 24
Filling out Applications 542
Job Leads and the Resume 512
Overview of the Job Search 513 CHAPTER 26
What Do You Have to Offer? 513
Successful Employment Strategies 549
What Are Your Expectations? 513
Getting Off to a Good Start 550
Organizing Your Time 514
Learning about the Job 550
Organizing Your Space and Supplies 514
Policies and Procedures 550
Projecting a Professional Image 514
Probationary Period 551
Finding Job Leads 515
Guidelines for Workplace Success 552
School Career Service 515
Act with Integrity 552
Community Career Centers 515
Demonstrate Loyalty 552
Networking 515
Follow the Chain of Command 552
Internet 516
Give a Full Day’s Work 553
Clinical Experience 518
Become Part of the Team 554
Cold Calls and Visits 518
Go Beyond the Minimum 554
Job Fairs 518
Employment Laws 555
The Resume 519
Grievances 555
Resume Contents 519
Sexual Harassment 557
Formatting the Resume 521
Tracking Your Progress 557
Important Resume Guidelines 524
Moving Up 558
Recent Resume Trends 524
Moving On 559
Cover Letters 524
If You Are Fired 561
Writing Good Cover Letters 528

CHAPTER 25 APPENDIX 1
Interview, Portfolio, and Application 531 Health Care Professional Organizations 565
The Job Interview 532 Therapeutic and Treating Occupations 565
The Importance of Proper Preparation 532 Dental Occupations 565
Learn About the Employer 532 Emergency Medical Occupations 565
Prepare to Demonstrate Your Qualifications 532 Home-Care and Long-Term Care
Prepare Your Questions 533 Occupations 565
Questions to Avoid 533 Massage Therapy Occupations 565
Anticipating an Employer’s Questions 533 Medical Office Occupations 565
Creating a Professional Appearance 535 Mental Health Occupations 566
Securing References 536 Nursing Occupations 566
Creating a Portfolio 537 Occupational Therapy Occupations 566
What to Take to an Interview 537 Pharmacy Occupations 566
Practice, Practice, Practice 538 Physical Therapy Occupations 566
Starting Off on the Right Foot 538 Respiratory Therapy Occupations 567
Recent Trends in Interviews 539 Surgical Occupations 567
After the Interview 539 Veterinary Occupations 567
Additional Requirements 540 Vision Care Occupations 567

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x | Contents

Diagnostic Occupations 567 APPENDIX 2

Diagnostic Imaging Occupations 567
Useful Spanish Expressions for
Medical Laboratory Occupations 568
Health Care Professionals 569
Health Information Management
Occupations 568 Glossary 571
Environmental Occupations 568
Biomedical Engineering Occupations 568 References 583
Dietary Services Occupations 568
Index 589

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 Preface
Introduction to Health Care, time, today’s graduates face new challenges. Changes
Fifth Edition, is designed as an in health care are rapid and continuous. Professionals
introductory text for students at all levels are being given additional responsibilities.
who are entering college- Efficiency and flexibility, combined with competency,
level health care programs are vital to workplace success. To be competent and suc-
or for those who believe they cessful in this ever-changing environment, health care
may be interested in pursuing a career in health care. The professionals must be able to think for themselves and
fundamentals common to all health care professions are pre- learn and adapt as necessary to meet current employ-
sented in this full-color text to create a foundation on which ment demands.
students can build when they take their specific professional The authors recognize the need of health care educa-
courses. The topics included are appropriate for professions tors for materials that can assist them in preparing stu-
that involve direct patient care, such as nursing and dental dents to assess new situations, determine appropriate
assisting, as well as those that provide support services, such action, and apply on the job what they learned in the
as health information technology and pharmacy technician. classroom. This text is designed to help meet this need.
The goal of the text is to present a broad base of health care Students are introduced to the concept of thinking like
essentials. Therefore, skills and procedures that apply only to a health care professional (also called “critical thinking”)
specific professions are not included. in Chapter 1. The specific skills that make up applied
The text is written in easy-to-understand language. A thinking are explained in everyday language. A five-
variety of learning exercises are included in each chapter. step problem-solving model is clearly described to help
These exercises are designed to appeal to the different students systematically approach new situations. Every
ways that students comprehend and learn material. The chapter includes exercises called “Thinking It Through”
text can be used by students as a reference book after that require students to apply the concepts presented
completion of their introductory courses. in the text to typical on-the-job situations. Each chapter
then concludes with two application exercises and one
CONTENT FOR TODAY’S HEALTH CARE PROFESSIONAL problem-solving exercise that provide opportunities to
Introduction to Health Care, Fifth Edition, includes topics summarize and apply the chapter content. For a detailed
essential for today’s student and tomorrow’s health care review of the features in this book, see About This Book
professional. The basic concepts that create the foundation on page xix.
for health care education have been expanded beyond
those usually included in an introductory text. The follow- ORGANIZATION OF THE TEXT
ing topics have been included in response to the current
Introduction to Health Care, Fifth Edition, is divided into
needs of health care educators and employers:
nine units that contain between two and five chapters of
• Thinking skills related topics. The following overview highlights many of
• Study techniques the major concepts included in the text.
• Complementary and alternative medicine
Unit 1 | Health Care Today
• Prevention and wellness strategies
• Characteristics and trends of modern health care,
• Lifelong learning and continuing education
including changing patient demographics, chal-
• Documentation lenges in health care today, and complementary and
• Cost-control measures alternative medicine
• Performance improvement • Descriptions of many health occupations, organized
• Personal efficiency by type of work performed
• Customer service • Explanation of how to think like a health care
professional
EMPHASIS ON THINKING SKILLS • Personal characteristics required of health care
The dramatic growth of the health care industry promises professionals
to provide increasing numbers of employment opportu- • Legal and ethical responsibilities of health care
nities for graduates of health care programs. At the same professionals
xi

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xii | Preface

Unit 2 | The Language of Health Care Unit 6 | Communication in the Health Care Setting
• Introduction to basic concepts of medical terminology • Patients as individuals
• Examples of common word elements • Basic human needs
• Suggested ways to approach the study of terminol- • Acknowledging diversity while avoiding cultural
ogy and to learn it systematically stereotypes
• Review of math skills necessary for health care • The six-step communication process
applications • Using questions and observations to assess specific
• Measurement systems and methods of converting patient needs
between systems • Basic oral and written communication techniques
• Calculating drug dosages • Overview of computer applications in health care
• Tips for dealing with math anxiety • Basics of health care documentation and medical
records
Unit 3 | The Human Body
• Brief overview of the basic organization, structure,
Unit 7 | Health Care Skills
and functions of the body systems, intended as an • Basic assessment skills
introduction rather than a complete anatomy and • Hands-on skills, such as taking vital signs and mea-
physiology course suring height and weight
• Examples of diseases and conditions related to each • Normal ranges and significant changes
body system
• Step-by-step instructions for performing basic emer-
• Preventive measures for each system, including life- gency procedures (Cardiopulmonary resuscitation is
style management tips not included because certification is often required
• Physical and mental milestones of growth and devel- of health care students and the course is taught by
opment over the life span and the implications when certified instructors who use annually updated, writ-
providing health care ten materials instead of a textbook.)

Unit 4 | Personal and Workplace Safety Unit 8 | Business of Caring

• Basic skills and habits needed to protect both health • Health care as a business
care professionals and patients • Improving care while controlling costs
• Explanations of body mechanics and infection • Working efficiently
control • Customer service
• Hands-on skills, such as using a fire extinguisher
Unit 9 | Securing and Maintaining Employment
Unit 5 | Behaviors for Success • Application of job search skills to health care
• Self-care practices important for health care profes- employment
sionals, including dealing with stress • Tips for remaining successfully employed
• Characteristics of professionalism essential for career • Behaviors for job success, including teamwork and
success leadership skills
• Lifelong learning and continuing education strategies • Employment legalities

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Preface | xiii

MAJOR CHANGES TO THE FIFTH EDITION

Book Chapter Description of Changes
Chapter 1 • Reordered material in chapter to be more logical: beginning chapter with “Getting Off to a Good Start”
and ending with career profiles
• Added more specific study tips and resources
• Deleted references to learning styles, now considered inaccurate
• Added information and suggestions about volunteering and joining a professional organization in
preparation for a career in health care
• Updated career information and added Occupational Outlook Handbook web addresses for each
within the text
• Added information about the levels of education needed for various health care careers
Chapter 2 • Reorganized chapter content for more logical presentation
• Updated health care industry statistics
• Expanded list of advancements in medicine and health care
• Added section on future of health care, including discussion of precision/personalized
medicine
• Added topics: health disparities, racism in health care, managing the opioid crisis and increase in
suicides, and concerns about TV drug ads
• Added definition of western medicine
• Deleted some events in table on history of health care to make more manageable for
students
Chapter 3 • Added sections on professional values, patient rights, and legalization of medical marijuana
• Updated information on physician-assisted suicide
• Expanded information on the Patient Care Partnership
Chapter 4 • Added root words for colors, how drugs are named, eponyms, and acronyms
Chapter 5 • Revised section on solving problems with proportions to make more clear
• Added the basic formula method for calculating medication dosages
• Added section on statistics in health care
Chapter 7 • Added a few diseases and conditions related to the various body systems
Chapter 8 • Revised Erikson’s stages of psychosocial development
Chapter 9 • Major reorganization of content for more logical flow
• Added section specific to exertion injuries
• Revised discussion about back belts, including opinions that they should not be used routinely.
Replaced all figures showing health care professionals wearing back belts
• Included ways to help prevent back injuries
Chapter 10 • Reorganized chapter content for better flow
• Updated current disease threats
• Added information about influenza
Chapter 11 • Added sample contents of an incident report
• Updated safety data sheets, previously called material safety data sheets
• Added information about violence in the health care workplace
(continued)

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xiv | Preface

Book Chapter Description of Changes

Chapter 12 • Reorganized section on nutrition for better flow
• Updated information on effects of cholesterol in foods
• Revised definitions of carbohydrates and fiber
• Distinguished between different types of fats
• Added information about sodium and its effects
• Added discussion about sugar
• Expanded section on causes of overweight and obesity
• Updated statistics for:
°° Leading causes of death in the United States
°° Prevalence of overweight and obesity
°° Deaths due to smoking and secondhand smoke
°° Incidence and deaths from substance abuse
°° Cases of HIV
Chapter 13 • Added discussion about empathy
• Updated information about tattoos and piercings in the workplace
• Added professionalism outside the workplace, including on social media
Chapter 14 Added new sections on professional development, learning from role models and mentors,
and career ladders
Chapter 15 • Deleted table listing characteristics of various cultural and ethnic groups
• Expanded information on bias, including strategies for recognizing bias
Added explanation of implicit bias
• Expanded view of culture to include factors such as socioeconomic status (poverty)
• Revision of section on Abraham Maslow, including deletion of his hierarchy
Chapter 16 • Added discussion of health literacy
• Explained “teach back” as a communication-check technique
• Added discussion of communication through the life span
• Expanded section on communicating with people who have dementia
• Revised and updated the patient education section
Chapter 17 • Added material on writing emails and email etiquette
Chapter 18 • Added guidelines for writing and sending professional emails
• Added section on computerized testing in medical labs
• Moved information on electronic medical records to Chapter 19
Chapter 19 • Reorganized content for more logical flow
• Added information on purposes of medical documentation
• Added negative consequences of poor records
• Moved electronic records to this chapter from Chapter 18 and expanded to include advantages,
sample situation with a patient, challenges
• Added section on cybersecurity
• Expanded section on HIPAA, including sending protected information
Chapter 21 • Added RICE mnemonic for treating bone, joint, and muscle injuries and SAMPLE for getting
information about an illness or injury
• Updated information on properly removing ticks from the skin
Chapter 22 • Expanded information on Medicaid
• Added section on Veterans’ Health Administration
• Added section on impact of health costs on individuals
(continued)

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