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CALIFORNIA MEDICAL ASSISTANTPublished Bi-Monthly by the California Medical Assistants Association, Inc. for Medical Office Professionals
CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015 1
CM
AA
UNITY IS STRENG
TH
KNOWLEDGE
ISPO
WER
l
NOVEMBER/DECEMBER2015
________________________CALIFORNIA
MEDICAL ASSISTANTSASSOCIATION, INC.
P.O. Box 5694Petaluma, CA 94954-5694Toll Free 1.888.464.2622
Fax 208.730.3763
www.cmaa-ca.orgEmail address: cmaahq@aol.com
Greetings CMAA Members!
Fall Conference in review: Our FallConference Co-chairmen Margie Hattoxand Theresa Henderson worked so hardto put together a fun and informativeconference for CMAA. Alvarado Hospitalwas a great location for the meeting andthe surrounding San Diego area providedwonderful night life and entertainmentwhen the conference wasn’t in session.See Fall Conference Pictorial Highlightson page 3.
I am thrilled to introduce the new SanDiego Regional Representative LisaAllan. Lisa is an MA Program Directorand Instructor in the San Diego area. Shemade some key connections at the con-ference with other local members and Iam certain that this Region will beginmeeting on a regular basis very soon!
Some key business decisions were madeduring this conference. The 2016 Budgetthat our Secretary/Treasurer Byron Clintonpresented was approved by our members.Our Ways and Means Chairman, BaileyNelson had many items available for saleand had an exciting drawing as well. Sheand her committee members did a greatjob and they brought in over $300 forCMAA. The CMAA logo vinyl windowclings were handmade by Bailey! Theywere very popular and Bailey is able tomail them to you! Contact her directly atbaileynelson.cmaa@gmail.com toorder yours.
We have seen a trend over the years andfound both membership and attendance atstate meetings declining. As a result,CMAA is struggling to stay afloat. Becauseof this, the members were faced withsome tough decisions to make. Thesedecisions were made with the support ofall the Past Presidents in attendance andwere made unanimously. The members
voted to suspend all dues disbursementsfor all regions in lieu of a dues increase.Secondly, the members voted and agreedto dissolve the Kinn fund and put thatmoney into the general fund for operatingexpenses. The Kinn Fund was establishedby one of CMAA’s founding members,Mary Kinn. She is a true Medical Assistingtrail blazer and brought much recognitionto our profession over the years. Thefunds have always been earmarked tohelp fund education for our organization.While it began with a donation fromMary Kinn herself, members have donatedto this fund in honor of other memberover the years. This decision was made asan effort to hold the organization steadyfor the time being. Many members pres-ent are willing to seek out donations anddouble their current efforts to increaseour membership and market the benefitsof CMAA.
More than ever before, your opinionmatters! Please plan now to attend theCMAA Annual Meeting in Sacramentonext March. The Sacramento Region isplanning now to host a wonderfulconference that may even include a tour!Mark your calendars now and watch ourwebsite and Facebook page for registra-tion and speaker updates as they occur.The conference will be March 10ththrough the 13th. �
Let’s Get Back to the Future at CMAA Annual Meeting 2016!
Shannon Tinsley, CCMA-ACCMAA State President
WHAT’S INSIDE� PRESIDENT’S MESSAGE .................... 1
� CMAA HEADQUARTERS:CMAA Wants to Come to You............ 2
� FALL CONFERENCE 2015:Pictorial Highlights ............................. 3
� ANNUAL MEETING 2016:Announcement ..................................... 4Tenative Agenda ................................. 5
� MARKETING/MEMBERSHIP:A Message From the Desk ofDebra A. Carpenter, Chairman .......... 6
� SOUTH OF THE BORDERVISIT WITH EDUCATION: ................... 7
� CERTIFYING BOARD UPDATE:Newly Certified CMAs .................. 8-10
� CONTINUING EDUCATION:Dialysis and How It Works...............11-13Self-Assessment Test ....................... 14Article Order Form............................. 15Personal Certificate ofParticipation Form............................. 16
California Medical Assistant
E D I T O R
KIM JONES, CCMA-CEast Bay Region
Email: KKJ6997@yahoo.com
P U B L I C AT I O N C OMM I T T E EC H A I R M A N
THERESA HENDERSON, CCMA-ACRiverside Region
Certifying Board Administrator
C O O R D I N AT O R
VICKEY MARTINEZ, CCMA-CRiverside Region
C M A A P R E S I D E N T
SHANNON TINSLEY, CCMA-AC
Sonoma Region
Email: stinsley@empirecollege.com
For Advertising contact:
CALIFORNIA MEDICAL ASSISTANTSASSOCIATION, INC.
at
CMAA, INC.P.O. Box 5694
Petaluma, CA 94954-5694
Toll Free: 1.888.464.2622
Fax: 208.730.3763
Email: cmaahq@aol.comwww.cmaa-ca.org
Material contained herein may NOTbe used without the permission of the
California Medical Assistants Association, Inc.
ALL ITEMS FOR PUBLICATIONSHOULD BE SENT
DIRECTLY TO THE EDITOR.
2 CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015
MISS ION STATEMENT
CALIFORNIA MEDICAL ASSISTANTS ASSOCIATION, INC.
The purpose of the California Medical Assistants Association, Incorporated,is to promote the professional and educational growth of medical assistants.
CM
AA
UNITY IS STRENG
TH
KNOWLEDGE
ISPO
WER
l
California Medical Assistant
— NEXT ISSUE —
January/February 2016
To submit items to be published in thisnewsletter, please mail or email:
KIM JONES, CCMA-C
Email: KKJ6997@yahoo.com
DEADLINE: December 1, 2015All materials must be submitted by the
deadline date to be included in the next issue!
CMAA WANTSTO COME TO
YOUWe need your meeting
space!
Does your company have a meeting room that couldbe used by CMAA to host an Education Day?
Would you be willing to assist our Education Chairmanwith planning a seminar in your town?
Please email Carol at CMAA Headquartersso we can schedule a date for this year.
cmaahq@aol.com
C a l i f o r n i a M e d i c a l A s s i s t a n t s A s s o c i a t i o n , I n c .
CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015 3
Pictorial HighlightsPictorial Highlights2 0 1 5 F A L L C O N F E R E N C E
CMAAAnnualMeetingMarch 10–13, 2016RANCHO CORDOVA, CA
4 CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015
Upcoming C.M.A.A. Meeting
Mark your calendars nowand plan to go
“Back to the Futurewith CMAA”
March 10–13, 2016!
Sacramento Region will be hosting us in Rancho Cordova
and they have already secured some educational speakers
for us as well as an exciting tour that is eligible for CEU’s!
We have James Champlain the Director of the Optical
Program at National Career Education Center. He has
a wide area of expertise in the optical industry. He’s an
awesome instructor who was awarded teacher of the
year. He will be providing us with 2 clinical CEU’s on
All Things Optical. Kellie Zumont, PA with the Neurology
Department at Dignity will educate us on Headaches and
the use of Botox to treat migraines. Please join us in our
state’s capitol area for education, fun, and networking.
Take a tour:Shriners Hospitals for ChildrenNorthern CaliforniaTHURSDAY, MARCH 10TH
2425 Stockton BoulevardSacramento, CA 95817(916) 453-2000
CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015 5
Hosted by the Sacramento Region • Rancho Cordova, CaliforniaMarch 10-13, 2016
C a l i f o r n i a M e d i c a l A s s i s t a n t s A s s o c i a t i o n , I n c .
~ TENTATIVE AGENDA ~THURSDAY, September 10, 2016
12:00 noon TOUR of Shriner’s Children’s Hospital with CEU Opportunity!
6:00 pm Executive Committee Meeting
FRIDAY, March 11, 20168:00 am Registration Opens
8:00 – 12:00 noon Education Session12:00 noon Lunch with Vendors
1:00 – 2:00 pm Education Session2:15 pm All Members Register with Credentials
2:30 pm CMAA Business Meeting with Members and Guests
2:45 pm Honoring all New CCMA’s during the Business Meeting
3:30 – 5:30 pm Education Session7:00 pm Dinner Flashback to the Past (dress representing your favorite decade)
SATURDAY, March 12, 20168:00 am Registration Opens
8:30 – 10:00 am Reference Comittees (All members are encouraged to attend!)
10:00 – 12:00 noon Education Session12:00 noon Lunch honoring 2015 CMAA Officers and Committee Chairmen
1:30 – 2:30 pm Education Session2:45 pm All Members Register with Credentials
3:00 pm CMAA Business Meeting continued
4:00 – 5:00 pm Education Session7:00 pm Installation Banquet
SUNDAY, March 13, 20168:00 am Combined Executive Committee Breakfast Meeting
9:30 – 10:30 am Education Session10:45 am All Members Register with Credentials
11:00 am Closing Business Session for Members and Guests.
2016 ANNUAL MEETING
6 CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015
Greetings Fellow CMAA Members:
I would like to take this opportunity to address the membership as your
Marketing/Membership Chairman.
First, I would like to encourage all members to make a difference by attending the annual
state meetings and conferences. When members attend they are eligible to vote on all issues,
projects and elections concerning the CMAA. All members are encouraged to be active so we
can all make a difference.
Next, I would like to say, “Support the CMAA!” Any association needs their membership
to be active and participate. We all made the same career choice to become CMA’s and when
we participate in all of the CMAA’s activities, we are networking a support group for every
member. My own personal experience and decision in joining the CMAA was when I attended a
conference in San Luis Obispo and all of us newly certified medical assistants were honored at
the conference by the California Certifying Board for Medical Assistants. It was such a positive
experience I decided then to become a member. There is a feeling of comradery at the meetings
between the members, which make it a positive experience.
In conclusion, we all need to look to the year 2016 with positive aspirations. Our member-
ship can only grow and I know we will see more attendance and participation from all of our
current members. Be sure to keep updated by reading all of the newsletters and by utilizing the
CMAA website.
If anyone has any questions, concerns and/or suggestions, please feel free to contact me
at: carpenterwhitedeb07@yahoo.com.
DEBRA A. CARPENTER
Marketing/Membership Chairman
A MESSAGE FROM THE DESK OF THE
MARKETING/MEMBERSHIP CHAIRMAN
CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015 7
SOUTH OF THE BORDERVISIT WITH EDUCATION
Parliamentarian Susan Gouig and President Shannon
Tinsley traveled to La Mission, Mexico to visit our
CMAA Past President, Kate Logan and her husband
Mike. They are living and serving the community of La
Mission, specifically at Door of Faith Orphanage. They
were amazing hosts and showed us the absolute best of
their community. We were housed in our very own home
for the duration of our visit and it was delightful.
The orphanage is not the only US based ministry in town.
A medical clinic by the name of Siloe’ ministry is just down
the street. This clinic is run by a Physician’s Assistant who
originally practiced at Loma Linda Univeristy.by the name
of Sarah Mayer. Kate arranged for us to tour the clinic that
Sarah runs. Not only did we get to have a personal tour of
the facilities, we were able to sit down with both Sarah and
Kate and learn more about the community in which they
serve as well as the medical care provided there. Both Sue
and Shannon were in awe of the care and professional
networking that Sarah has provided to help heal her patients.
This clinic is supported by many donations, both monetary
and physical supplies. To learn more about this clinic and
ministry, visit www.siloeclinic.org for more information.
Here is a current list of needs that the clinic is currently
asking for. Does your office or provider have any of these
supplies they are willing to donate?
Material donations are critical for our ministry, and we are
grateful for any medical supplies, medication, equipment and
Christian literature (Spanish). Currently, we have pressing
needs for the following items:
• urinalysis strips
• FOBT testing materials (guaiac cards/developer)
• paper rolls for exam table
• phlebotomy needles ( vacutainer)
• paper drapes, gowns
• medications–all kinds, but specifically topical steroids,
topical antibiotics (clindamycin, bactroban), PO antibiotics
(peds and adults), HTN meds, antibiotic eye drops, any
OTC cough/cold meds
For more information about the Orphanage where our Past
President, Kate Logan and her husband Mike are serving, go
to www.dofo.org.
SOUTH OF THE BORDERVISIT WITH EDUCATION
www.dofo.org
8 CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015
NAME SPECIALTY HOMETOWN
• RECERT ++ ADDING 2ND SPECIALTY
C E R T I F Y I N G B O A R D U P D A T ECongratulations to the newly California Certified Medical Assistants
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
NAME SPECIALTY HOMETOWN
continued on page 9
ADAMS, NICOLE AC UKIAH
AGUILAR, NOE AC EL MONTE
AHMADI ARANGEH, MAHDANEH C CUPERTINO
ALEXANDER, KAY HILLARY • C FREMONT
ALLEN-THOMAS, DONNA A HAYWARD
ALVARADO, GLADYS MARIA AC COLTON
AMADOR, PATRICIA C SACRAMENTO
ANDERSON, SHERRY LYNN • AC FREMONT
ANDERSON, LINDSEY AC BAKERSFIELD
ANDREAZZI, SHARON • AC ROCKLIN
ANDREWS, LYNDA C. AC HUNTINGTON BEACH
AQUILINO, SANDRA C LA JOLLA
ARMENDARIZ, KARINA C HEMET
BAILEY, CAROLYN AC SHINGLETOWN
BAN, CLAUDIA ++ AC DOWNEY
BAUTISTA, YITZEL AC SAN BERNARDINO
BEALL, PATRICIA K. • AC ALBUQUERQUE NM
BERDEJO, MAYRA C INDIO
BERMUDEZ AGUILERA, MARIA G. C AROMAS
BIDDLECOMB, CARLY AC PLACENTIA
BINGHAM, KATHY E. C OAKLAND
BOELTL, NGHIA AC FULLERTON
BOGAN, LINDA A. AC CARSON
BRAGG, VICTORIA C MODESTO
BRAVOYOUNG, SERVANDO NICHOLAS AC REDDING
BROOKS, NICOLE RENEE AC LODI
BROWN, MYRICIA LUANN AC LIVE OAK
BUENO, BELLEN LUPITA A DINUBA
CAPETILLO, JESSICA ANDREA AC MOJAVE
CARTER, ROQUITA ++ AC CORONA
CARTER, GINGER S. C EUREKA
CARVALHO, ELANA R. • AC HEMET
CASOLA, LINDSAY AC MONTEREY
CASTILLO, MENA C SAN JOSE
CEJA, REBECCA A REDDING
CERRONI, ASHLEY MARIE C RIALTO
CHAVEZ, ZAENIA AC SAN YSIDRO
CHUI, SIN FI LAM • C SAN FRANCISCO
CISNEROS, DANIEL C FARMERSVILLE
CISNEROS-LOPEZ, MARISOL • AC WATSONVILLE
CLARK, KIRSTIE RAE C SAN MARCOS
COMBS, GAIL LEE • C PALO ALTO
COOK, KRISTINE • A SACRAMENTO
COOK, JACK L. C BUTTE CITY
CORONADO, MELISSA AC BAKERSFIELD
CORSO, ALLISON • C SANTA CRUZ
COSTA, STEPHANIE D. AC VISALIA
COSTA, ANASTACIA AC SAN JOSE
COTTRELL, STEPHANIE C MARYSVILLE
CRAIG, DAISY • AC ATWATER
CROTHERS-WILLIAMS, TAMARA S. C REDWOOD VALLEY
CRUZ, ALAN C INDIO
CUEVAS, IRMA • AC SANTA ROSA
CUNHA, OLIVIA M. ++ AC HAYWARD
DANG, CAROL N. C SUNNYVALE
DELGADO, NICOLE MARIE • C SANTA CLARA
DEMONTE, TONI MARIE C BUENA PARK
DENNIS, AMANDA DANNETTE • AC BAKERSFIELD
DIAZ, CHERI C CANYON COUNTRY
DOCKERY, MERCEDES A ISLETON
DOTY, KYLIE A. C WILLITS
DUNCAN, LACEY A REDDING
DUQUETTE, DONNA SOUZA • C RIVERSIDE
EDWARDS, ROMEIKA S. • C OAKLAND
EDWARDS, SHERRY LYNN C SUNNYVALE
ERSKINE, AMANDA • AC SAN DIEGO
ESTRADA, MOISES A BELL GARDENS
ESTRADA SOSA, NOVA RENEE C STOCKTON
EVANGELISTA, CRISPIN • AC SARATOGA
FARLOW-LOW, MELEA • C EUREKA
FEDUK, TANIA • AC FELTON
FIELD, JODI AC SACRAMENTO
FIGUEROA, PRISCILLA M. • AC WATSONVILLE
FIGUEROA, LOURDES AC WINTERS
FLORES, MARGARET AC BAKERSFIELD
FLORES, ROSA MARIA C BAKERSFIELD
FLORES GONZALEZ, JOCELYN AC LOS GATOS
FRAIDENBURG, BRIAN EUGENE AC TULARE
GARCIA, SUSAN MARIE C LONG BEACH
GARZA, BRIANA MARIE C BAKERSFIELD
GARZA, TAWNI C TULARE
GATES, LYNN MARIE • C PETALUMA
GEYER, SARAH MICHELLE AC ALAMEDA
GONZALEZ, MARYBELLE • C CHULA VISTA
GOURLEY, SHERALYNNE C HERALD
GUTIERREZ, LIA C BERKELEY
HAHN, CHERENE LEE C COTO DE CAZA
HAIRGROVE, MARIANNE ARLENE C SAN LUIS OBISPO
HALL, CHRISTY C PLACERVILLE
HANAN, HALEY M. AC REDDING
HANNA, DESPINA • AC BELMONT
HARMS, BELINDA AC BAKERSFIELD
HARRIS, NICOLE L. C RIVERBANK
HARRISON, DEBBIE A SAN LEANDRO
HARROD, BRANDIE • AC YUBA CITY
HEITMEYER, DEBORAH ANN C MORENO VALLEY
HERNANDEZ, LUISA I. A RED BLUFF
HERRERA, VIRGINIA G. A BAKERSFIELD
CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015 9
NAME SPECIALTY HOMETOWN
• RECERT ++ ADDING 2ND SPECIALTY continued on page 10
C E R T I F Y I N G B O A R D U P D A T E
NAME SPECIALTY HOMETOWN
– continued from page 8 –
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
HILD, JOHN C. AC BAY POINT
HILL, KIMBERLEY A. C FAIRFIELD
HUGHES, TEENA MARIE AC STOCKTON
HUKILL, CAREY L. A BAKERSFIELD
INOCENTE, BARBI C OXNARD
JIMENEZ, VIRIDIANA D. • AC BAKERSFIELD
JIMENEZ, VERONICA AC OAKLAND
JOHNSON, GEOFFREY A BERMUDA DUNES
JUAREZ SALDANA, MARISOL • C SUNNYVALE
JUNTADO, TERESA C SOQUEL
KAHLON, INDERDEEP S. AC SAN JOSE
KAHN, JENNIFER JEAN C PALM SPRINGS
KARLSTAD, GRETCHEN AC ESPARTO
KIDD, MARJORIE E. C BISHOP
KINDER, ANGELICA AC STOCKTON
KNARR, CASEY C GRASS VALLEY
KOHL, NANCY A. C WINDSOR
LARSON, KRISTINA AC LANCASTER
LASSUS, DENISE • C SAN BRUNO
LATORRE, MERIELLYN L. C MOUNTAIN HOUSE
LAZARIT, ERIKA ROSIO AC BAKERSFIELD
LE, VANESSA C SACRAMENTO
LEE, YOOMEE • C FREMONT
LEONG, MARLENA WAN AC LOS ALTOS
LEWIS, REGINA LLANES C BAKERSFIELD
LEWIS-LASATER, BRITTANY DIANNA ++ AC GALT
LIMON, ANNETTE C. AC SALIDA
LIVINGSTON, KAREN • AC SANTA ROSA
LLAMAS, MARIA LUISA A STOCKTON
LOPEZ, NOHELY ALDANA C HUNTINGTON PARK
LOVETT, LISA A. C VENTURA
LOZANO, ANALAURA AC SAN JACINTO
LUGO, HAZEL REBECA C OXNARD
LUNA, ERICA C. C SAN JOSE
MARTIN, LAURA ASHLEY • AC BAKERSFIELD
MATA, CONSUELO C WATSONVILLE
MATTEUCCI, JULIE ANN AC WINDSOR
MATTHEWS, CINDY AC COTTONWOOD
MAXWELL, TRACY REYNOLDS ++ AC FELTON
McANDREW, SLOAN K. A FAIR OAKS
McCOMBS, PENNY AC TURLOCK
McCORMICK, REBEKAH J. AC REDDING
McGILL, SHANNON RACHELE C TEMPLETON
MELGAR, ELISA C PANORAMA CITY
MENDEZ, RICARDO AC WATSONVILLE
MENDEZ, TRACY M. C HOLTVILLE
MENDOZA, JENNIFER G. • C DANA POINT
MENENDEZ, CRYSTAL LILIAN C LANCASTER
MERRILL, JUDITH L. AC SANTA ROSA
MOLLINEDA, ROSA L. AC RIALTO
MONTANO, MARILISA AC BAKERSFIELD
MONTERROSA-ARAUJO, JOSIE A SAN JOSE
MONTOYA, TAIISHA AC APTOS
MOORE, KYLEEN A. AC ATASCADERO
MOSS, CYNTHIA A. • C FORT BRAGG
MOTA, SARA MARLENE A ANAHEIM
MUNOZ, KARLA ANGELINA • AC BAKERSFIELD
NAJERA, ANA LIZETTE C DINUBA
NAVARRO, JESSICA L. AC BAKERSFIELD
NELSON, ERIC THOMAS AC FORESTHILL
NELSON, CURTIS M. C ANTIOCH
NGO, LOI C OAKLAND
ORTIZ, LEANNE M. AC BAKERSFIELD
ORTIZ, BEATRIZ C FILLMORE
PACE, STEPHANIE L. • C SALEM
PADILLA, ALICIA ++ AC CHULA VISTA
PALM, JANELLE A SANTA ROSA
PARKER, TERRY LYNN C RANCHO CORDOVA
PARREIRA, ELIZANJELA M. C HANFORD
PATTERSONvKAREAMA L. AC BAKERSFIELD
PENA, CARLA C MODESTO
PENA FRANCOvRUBY C BOONEVILLE
PHOMSOPHA, PAT • AC MENIFEE
PRECIADO, GUADALUPE M. AC FILLMORE
RAMIREZ, MONIQUE A MODESTO
RAMIREZ, SONIA C TRACY
REYNOLDS, KELLY DANIELLE AC LANCASTER
RIDER, REBECCA L. • AC APTOS
RIOS, MARGARITA (MAGGIE) AC UKIAH
RODRIGUEZ, CAROL C INDIO
ROGERS, SAVANNAH MARIE C SAN JACINTO
ROISMAN, REBECCA AC BERKELEY
ROJAS, McKENA L. AC BAKERSFIELD
ROMERO, NATALIA ++ AC PALMDALE
ROMERO MIRANDA, SELENE C BAKERSFIELD
ROSALES, GENESIS A RANCHO SANTA MAR-
GARITA
ROSS, THERESA A. C DELHI
ROXAS, FILIPINA C CARSON
RUIZ, MARINA IVONNE C BRAWLEY
SALAZAR-MUNIZ, ANGELINA • C FRESNO
SAMANO, DAISY C FONTANA
SANCHEZ, ELEANA R. AC HIGHLAND
SANCHEZ, NORMA C FREEDOM
SANCHO, MICHELLE • C SARATOGA
SANDOVAL, CARMEN C RIVERBANK
SANGALANGvMARYANTOINETTE A. AC WATSONVILLE
SANTOS, JASMIN C PALMDALE
10 CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015
Congratulationsto each of these medical assistants.From the California Certifying Board
for Medical Assistants
• RECERT ++ ADDING 2ND SPECIALTY
C E R T I F Y I N G B O A R D U P D A T E
NAME SPECIALTY HOMETOWN NAME SPECIALTY HOMETOWN
– continued from page 9 –
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
SANTOYO, ROSA Y. A LODI
SCHWEMMER, KRISTI ELIZABETH C CLOVIS
SEGURA JIMENEZ, MARIA B. C UKIAH
SHARP, ALISON C WEST SACRAMENTO
SHIPLEY, SUZANNE • AC AUBURN
SINGH, RANIESHLA JEET AC SACRAMENTO
SISLAK, NICHOLE MARIE C SAN JOSE
SMITH, KAITLIN • AC SAN LUIS OBISPO
SOLORIO, STEPHANIE A JOSHUA TREE
SOTO ACEVEDO, ARIANA AC HAMILTON CITY
STENDERUP, BROOKE • C SOQUEL
STEVENS, BRITTANY NICHOLE AC TEHACHAPI
STREEVALvCHEYENNE E. C OCEANSIDE
SULTAN, AFSHAN ++ AC LODI
TERRY, ANGELA AC DESERT HOT SPRINGS
THOMPSON-YOUNG, LACHELL AC MORRO BAY
TOLENTINO, PATRICIA AC UPLAND
TOM, KEYING C OAKLAND
TORRES, DESTINEE C GRASS VALLEY
TORRES, GERALDINE C BAKERSFIELD
TOTTEN, KELLI JEAN AC FORTUNA
TREVINOvYANEHT F. AC OCEANSIDE
TURNERvALISSA C BAKERSFIELD
VALADEZ-MORENO, SARAH T. C UKIAH
VANG, BAO C FRESNO
VAZQUEZ, FABIOLA • C SANTA ROSA
VAZQUEZ, FLOR Y. C VISALIA
VEGA, CLAUDIA C VALLEJO
VENTURA-NEGRETE, MAYRA C SANTA MARIA
VERA, CECILIA C COLTON
VERBOOM, CHRISTYANNA AC ORLAND
VERDUGO, DAVID C SAN JOSE
VILLARREAL, ALICIA C FONTANA
VILLARREAL, DIANA C PALMDALE
WAHL, RACHAEL C SAN LUIS OBISPO
WALKER, STEPHANIE C. C HAYWARD
WALLER, CHRISTOPHER A MORENO VALLEY
WATSON, SHANNON C HAYWARD
WELLINGTON, CLAIRE ++ AC SONOMA
WHITAKER, MATTHEW J. C WEST HILLS
WHITLEY, ELADIA M. AC TEMECULA
WILLIAMS, DEBORAH J. AC HANFORD
WINKLER, MEGAN A. C FILLMORE
WINTERS, GEORGETTA ANN C SANTA ROSA
WOODHOUSE, MARGARITA AC SUNNYVALE
XANITIS, JOSEPH C CATHEDRAL CITY
XUONG, MINH THI C MODESTO
YEUNG, TSANG FUNG • C FREMONT
YOUNG, SUZANNE M. AC PALMDALE
ZAHROON, NADIA AC LANCASTER
ZAMORA ORDONEZ, MARCO C SANTA CRUZ
ZAMORA-CASTILLO, ALMA DELIA AC WATSONVILLE
ZATARAIN, CLAUDIA • C POTRERO
ZENTENO JIMENEZ, JONATHAN C LOS ANGELES
ZHONG, WANNA C SAN LEANDRO
CCBMA reviewed the three test banks with psychometric and statistical analyses provided by our testing company, PearsonVue. This review resulted in the updating and republishing of the Basic, Clinical and Administrative exams. The new versionswent live on May 18, 2015. Pass/Fail results will be provided at the end of each exam session.
Free continuing education courses are available through the Medicare Learning Network for individuals needing adminis-trative credits for recertification. CCBMA approved a list of fourteen web-based training courses that can be accessed atwww.cms.gov and searching “earn credit”.
What’s New at CCBMA...
CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015 11
What choices of dialysis areavailable?
There are two general types of dialysis.One is performed in a clinic setting andthe other is performed in the patient’shome.
In Center Hemodialysis or ICHD - usesan artificial filter (dialyzer) to clean theblood. A surgically created access isplaced in one of the arms throughwhich the blood will be drawn from thebody through synthetic tubing to thedialysis machine and then returned tothe body free of toxins and excess fluid.This procedure is performed by a thor-oughly trained professional medicalteam and there is no training requiredfor the patient. There are several sched-ule options available for ICHD, such asearly morning, afternoon and overnight.
Home Hemodialysis or HHD – is thesame process as ICHD but is performed
What is Dialysis?
Dialysis is a process that mimics kidneyfunction by removing excess fluid andfiltering waste from the body when thekidneys are damaged or fail entirely.
What happens when the kidneysstop working?
Think of the human body as an aquari-um. If the filter stops working the watergets polluted and is not suitable for sus-taining life. The kidneys work in thesame fashion. Human kidneys are aboutthe size of an adult fist, and althoughthe kidneys are small, they perform awide variety of very important func-tions. Healthy kidneys control fluid andelectrolyte balance, produce hormones,control blood pressure and keep bonesstrong. The kidneys operate 24 hoursper day, seven days per week, and 365days per year. Therefore, dialysis treat-ments are scheduled to occur on a reg-ular basis; typically three days per weekon alternating days for about four hoursat a time in order to adequately rid thebody of toxins and byproducts that thehuman body naturally produces.
What causes the kidneys to stopworking?
There are a variety of conditions thatcause kidney dysfunction or failure. Thetwo most prevalent causes are diabetesand hypertension, but there are othercauses such as inflammation, infectionand genetic conditions that may lead toimpaired kidney function as well. It’simportant to know that you aren’talone. In fact about 1 million people inthe US are receiving treatment for kid-ney failure. It’s a great idea to talk tothe physician or healthcare providerabout what caused the kidney diseaseand what can be done to treat theunderlying cause or caused if possible. continued on page 12
CONTINUING EDUCATION
at home by the patient and their carepartner who will complete approximate-ly 1 month of training. Treatments aretypically longer and more frequent thanICHD.
Peritoneal Dialysis or PD – uses thebody’s natural filter (peritoneum) locatedin the abdomen to remove toxins andexcess fluid. A small, flexible, synthetictube called a catheter is surgically placedwithin the abdomen and is used to con-nect to bags of dialysate. PD offers aflexible schedule but is performed daily.There are no needles and no blood isremoved from the body. This type ofdialysis has been shown to preserveresidual kidney function and is per-formed at home by the patient or a carepartner if needed. The patient or care-giver will complete approximately 2-3weeks of training before performing theexchanges independently.
Dialysis and How it Works
12 CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015
be placed, a surgeon will place a tem-porary central venous catheter (CVC) inthe patient’s neck. CVCs are made ofsynthetic tubing placed in a large vesselin the neck that travels to the heart toprovide access to the patient’s blood.Due to high rates of infection andcomplications CVCs are used onlywhen no other access is an option orwhen an ideal access is maturing andnot ready for use.
Peritoneal dialysis access is located inthe lower abdomen and is made of asoft, flexible synthetic material. Patientswill undergo a minor surgical procedureand allow about 2 weeks for the accessto heal. Peritoneal dialysis does notrequire access to the patient’s blood sothere are no needles involved.
What if the patient decides thatdialysis is not an option?
This is a personal choice that should bemade with the guidance of the physi-cian. If a patient decides to foregokidney replacement therapy, such asdialysis, the patient should be educated
CONTINUING EDUCATION
on what to expect and how to prepare.In this case, the patient would bechoosing palliative care; also referred toas conservative care. If you choose pal-liative care your physician and healthcare team will work together to manageyour symptoms and help keep you ascomfortable as possible.
For most patients the ultimate goal isreceiving a kidney transplant. A trans-plant can come from a cadaver or livingdonor who has completed a thoroughscreening and matching for compatibility.A kidney transplant is not cure butrather another form of kidney replace-ment therapy. Transplant recipients arerequired to take anti-rejection medica-tions for the rest of their life and bevery closely monitored by the physician.
How will dialysis impact thepatient’s life?
Many things in the patient’s life willchange with a diagnosis of kidneyfailure, but with careful attention andplanning the patient will still be able toenjoy a life in much the same way
What is an access?
An access is a surgically created entrypoint into the blood vessels or peri-toneum. For dialysis patients theiraccess is their lifeline. The golden stan-dard and most desired access is called afistula. To create a fistula a vascular sur-geon will suture together a patient’sown artery and vein to make an accesspoint that is able to withstand the highblood flow rates required for hemodialy-sis. If a patient’s vessels are too weak ortoo small to create a fistula the surgeonwill create a grafted access. A graft is apiece of synthetic material that will con-nect the patient’s artery and vein.Grafts function similarly to fistulas butdo not last as long as fistulas and willrequire interventions and replacement.Fistulas need advanced planning so thatthey have time to mature and healbefore being used for dialysis; typicallysix weeks. Grafts do not “mature” butthey do need a short time to heal,usually about a week or two. In theunfortunate event that a patient needsdialysis in an emergency, and there isnot sufficient time for an ideal access to
Dialysis and How It Works – continued from page 11
CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015 13
Dialysis and How It Works – continued from page 12
CONTINUING EDUCATION
Read the Continuing Medical Education Article
Dialysis and How It Workslocated on pages 11 - 13,
then complete the Self-Assessment Test on page 14 for CME credit.
before the diagnosis. Diet, medications,and lifestyle choices will need someadjustments to maintain optimal health.With the help of the physician andother healthcare professionals, thepatient will be able to navigate throughimportant decisions that will comealong.
What can I eat on dialysis?
Generally speaking patients can contin-ue to enjoy the majority of the foodsthat you ate before dialysis. Thechanges come in the form of how muchand how often. It is important to close-ly monitor the intake of protein, potas-sium, sodium and phosphorus. All theseare important to long term health butwhen items are consumed in excessthey cause serious complications andside effects.
Protein intake is a very important nutri-ent for patients receiving dialysis.Protein intake is determined by a bloodtest that measures albumin. Albumin isvital to a patient’s health. It is responsi-ble for wound healing, fighting infec-tions, maintaining muscle mass andreduces swelling. For most patients, thephysician recommends about one gramof protein per kilogram of body weightper day. For example a 180 poundmale would need to consume about 80
grams of protein per day. The source ofprotein is important too. The majorityof your protein intake should comefrom a high biological source; chicken,eggs, fish, beef or pork. The remaindercan come in the form of supplements;such as powders and bars. The health-care team will talk to the patient aboutspecific needs and provide diet sugges-tions appropriate for that patient.
How much liquid can a patientdrink on dialysis?
Typically the physician will recommendthat the patient limit their fluid intake toone liter (32 ounces) per day. However,for patients that still urinate, theallowance may be greater. Fluid controlin dialysis is one of the most importantaspects to follow. Fluid volume overloadis the number one reason dialysispatients are hospitalized. Too muchfluid causes shortness of breath,swelling, high blood pressure and heartproblems. Limiting the amount of fluidgains between treatments will preventmost hospitalizations and emergencyroom visits. It’s worth noting that notonly beverages count as fluid. Foodsthat are liquid at room temperaturesuch as ice cream, popsicles, ice andgelatin are also counted as fluid intake.There are ways to curb your thirst sothat you do not overdo it on fluids. The
physician and dietitian can providehelpful tips and suggestions to help.
This is a lot of information.Where do I start?
The first place to go for more educationand help is to the kidney physician alsoknown as the nephrologist. They canprovide individualized guidance to helpthe patient on their journey. In additionto seeing the physician regularly it isalso important to start or maintainhealthy habits. Smokers should workwith the physician to develop a plan tohelp them quit. Maintain a healthyweight. If the patient has some weightto lose, talk to the physician about start-ing an exercise and nutrition plan that isright for them. Above all else it’s impor-tant to keep a positive outlook anddevelop healthy coping skills to facechallenges along the way. �
SOURCES:
• www.webmd.com
• The National Kidney Foundationwww.kidney.org
• www.healthline.com
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14 CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015
CONTINUING EDUCATION
Dialysis and How It Works – Self-Assessment Test
SELF-ASSESSMENT TESTAVAILABLE FOR DOWNLOAD SEPARATELY.
CALIFORNIA MEDICAL ASSISTANT — NOVEMBER/DECEMBER 2015 15
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