涉外护理英语unit 1 Admiting a patient.ppt
137页
涉外涉外 护理英语护理英语Unit 1 Admitting a patient 对外经济贸易大学出版社对外经济贸易大学出版社 UNIT1ADMITTINGAPATIENT Taking a medical history of a patient Using active listening strategies to put a patient at ease Giving a nursing handover Charting blood pressure and pulse Charting Respiratory Rate Giving an oral report of the case DESCRIPTION Admittingapatienttothenursingunitpreparesthepatientforhisstayinahospital.Whethertheadmissionisscheduledorfollowsemergencytreatment,effectiveadmissionproceduresshouldaccomplishthefollowinggoals:confirmthepatient’sidentity,assesshisclinicalstatus,makehimascomfortableaspossible,introducehimtohisroommatesandthestaff,orienthimtotheenvironmentandroutine,andprovidesuppliesandspecialequipmentneededfordailycare.翻译 DESCRIPTION单元描述元描述患者入院患者入院护理旨在理旨在为患者住院接受治患者住院接受治疗做好准做好准备。
无无论是是预约好的入院好的入院还是急是急诊入院，都必入院，都必须有效地完成入院程序并达到以下目有效地完成入院程序并达到以下目标：确：确认患者患者身份；身份；评估其身心状估其身心状态；；让患者尽可能舒适；把患者尽可能舒适；把患者介患者介绍给室友和医室友和医护人人员；帮助患者熟悉医院；帮助患者熟悉医院环境和日程安排；境和日程安排；给患者提供日常照患者提供日常照护所需的用所需的用品和品和专用用设施 Admitting the adult patient Speak slowly and clearly, greet the patient by his proper name, and introduce yourself and any other staff present. Confirm the patient’s identity using two patient identifiers according to the hospital’s policy. Verify the name and its spelling with the patient. Notify the admission office of any corrections. Quickly review the admission form and the practitioner’s orders. Note the reason for admission, any restrictions on activity or diet, and any other orders for diagnostic tests requiring specimen collection. Escort the patient to his ward and, if he isn’t in great distress, introduce him to his roommate. Then wash your hands, and help him change into a gown or pajamas; if the patient is sharing a room, provide privacy. Itemize all valuables, clothing, and prostheses on the nursing assessment form or in your notes if your hospital doesn’t use such a form. Encourage the patient to store valuables or money in the safe, or preferably, to send home along with any medications he may have brought with him. Show the ambulatory patient where the bathroom and closets are located. Work DescriptionWork Description翻译 翻译WorkWork DescriptionDescription Take and record the patient’s vital signs, and collect specimens if ordered. Measure his height and weight if possible. If he can’t stand, use a chair or bed scale and ask him his height. Knowing the patient’s height and weight is important for planning treatment and diet and for calculating medication and anesthetic dosages.Show the patient how to use the equipment in his room. Be sure to include the call system, bed controls, TV controls, telephone, and lights. Explain the routine at your hospital. Mention when to expect meals, vital sign checks, and medications. Review visiting hours and any restrictions. Take a complete patient history. Include all previous hospitalizations, illnesses and surgeries; current drug therapy and food or drug allergies. Ask the patient to tell you why he came to the facility. Record the answers as the chief complaint. Record any wounds, marks, bruises on the nursing assessment form. After assessing the patient, inform him of any tests that have been ordered and when they are scheduled. Describe what he should expect. Before leaving the patient’s room, make sure he’s comfortable and safe. Adjust his bed, and place the call bell and other equipment (such as water pitch and cup, emesis basin, and facial tissues) within easy reach. Post patient care reminders (concerning such topics as allergies or special needs) at the patient’s bedside to notify coworkers. 成年患者入院护理u说话声音要清晰，语速要慢；正确称呼患者并打招呼；介绍自己及在场的医护人员。
u根据医院规定使用两个患者标识确认患者的身份向患者核实姓名及拼写如有改动须通知入院处u快速查看入院表和执业医师开出的医嘱记录患者入院原因、活动限制和饮食禁忌，或其他要求采集标本的诊断性检查医嘱u护送患者去病房，如果他情绪不是十分低落，可介绍给室友然后洗手，帮助患者换上病号服；如果患者与他人共用病房，要提供私人空间将贵重物品、衣物和假体列记在护理评估单上，如医院没有这类表格则记录在笔记本上提醒患者把贵重物品或钱财放入保险箱，或最好连同随身携带的药物一起送回家告诉能下床活动的病人浴室和衣柜的位置u测量并记录患者的生命体征，并遵医嘱采集标本如有可能，测量患者的身高和体重如果患者不能站立，使用椅秤或床秤称量体重并询问患者的身高了解患者的身高和体重对制定治疗与饮食计划、计算药物和麻醉剂用量有着重要的意义u告诉患者如何使用病房内的设备，包括呼叫系统、病床控制、电视控制、和灯光调节u向患者解释医院的日程安排告诉患者何时吃饭、何时测量生命体征及何时给药提醒患者探视时间及相关规定u采集患者完整的病史包括之前所有的住院治疗史、疾病史和手术史等；当前的药物治疗情况；有无食物和药物过敏情况询问患者为何入院把患者的回答作为患者主诉记录下来。
在护理评估表上记录任何的伤口、伤痕或瘀伤u评估患者之后，告知患者医嘱所开出的检查项目和检查时间安排向患者解释需做的事情u护士离开病房前，应确认患者舒适和安全调整患者的床位，将呼叫铃和其他设施（如水瓶和水杯、痰盂、面巾纸）放在患者伸手可及的地方u张贴患者护理提醒条（如过敏及特殊需要）于病床旁以提醒同事WorkWork DescriptionDescription Yourinitialgoalwillbetoestablishafriendly,trustingrelationshipwiththechildandhisparentstohelprelievefearsandanxiety,whichcanhindertreatment.Rememberthatachildunderagethreemayfearseparationfromhisparents;andanolderchildmayworryaboutwhatwillhappentohim. Speakdirectlytothechild,andallowhimtoanswerquestionsbeforeobtainingmoreinformationfromhisparents. Whileorientingtheparentsandchildtotheunits,describethelayoutoftheroomandbathroom,andtellthemthelocationoftheplayroom,televisionroom,andsnackroom,ifavailable. Teachthechildrenhowtocallthenurse.Stressthatshe’llalwaysbeavailabletotakecareoftheirneeds,suchashelpingthemtothebathroom. Explainthefacility’srooming-inandvisitingpoliciessotheparentscantakeeveryopportunitytobewiththeirchild. Inquireaboutthechild’susualroutinesothatfavoritefoods,bedtimerituals,toileting,andadequaterestcanbeincorporatedintotheroutine. Encouragetheparentstobringsomeofthechild’sfavoritetoys,blankets,orotheritemstomakethechildfeelmoreathomeamidunfamiliarsurroundings.翻译WorkWork DescriptionDescriptionAdmitting the pediatric patient 儿童患者入院护理u首先要与患儿及其家长建立友好而信任的人际关系，减轻其恐惧和焦虑，以免妨碍治疗。
记住，三岁以下的儿童会担心与父母分开；而年长的孩子往往担心将要发生的事情u直接与孩子对话，让孩子先回答提出的问题，然后再向父母咨询更多的信息u把孩子和父母带向病房时，描述病房和浴室的布局，并告之游戏室、电视房和点心屋的位置u教孩子们如何呼叫护士要强调护士在他们需要时会随叫随到，如帮助上卫生间u解释医院的亲子同室设施和探视的规定，让父母抓住每一个机会陪伴孩子u询问孩子日常生活习惯，以便于给孩子制定日常生活安排时可融入孩子爱吃的食物、睡觉习惯、如厕习惯和睡眠时长等u鼓励父母带来孩子喜欢的玩具、毛毯或是其他物品，以使孩子在不熟悉的环境中有家的感觉 Task 1 Taking a medical history of a patient DescriptionRelated InformationDiscussion of the nursing topicCommon questions in taking the patient’s historyPractice of the task DESCRIPTION Taking a patient’s medical history is a necessary part of nursing assessment. It involves asking the patient about the reason for the visit, and then asking about the health history, as well as the histories of the immediate family members.翻译 采集患者病史是护理评估工作必不可少的部分，包括询问患者此次住院的原因、既往健康史以及家庭史。
任务描述任务描述 TheinformationtobegatheredAnimportantpartofadmittingapatientisinformationgathering.Althoughhospitalenvironmentsmaydiffer,theinformationgatheredgenerallyconsistsofsixpartsasfollows. PersonaldetailsTheseincludecontactdetailsforthepatientandthenextofkin.Thisinformationisalsoimportantfordischargeplanning(whenthepatientleavesthehospital).Nextofkinmeansthenearestrelative.Whatfamilymemberisclosesttoyou?Thatisyournearestrelative,ornextofkin.翻译Related Information Medical and surgical history Old notes can be retrieved from Medical Records. But if the patient is new, more questions have to be asked because the medical history has a lot of information. A record of past events and circumstances may be gathered because they are related to a patient’s current state of health，including past diseases, injuries, treatments, and other medical facts about the patient, and his family’s medical health. Surgical history is any past surgeries a person had and if he/she had complications from them. Allergies Some people are allergic to food, medications or latex. An increasing number of patients are allergic to latex products and non-latex products are ordered in these cases.翻译 MedicationsTheseincludeprescribeddrugs,OTC(over-the-counter)medications,herbalmedicinesandsupplementssuchasvitamins.Patientsmaynotconsidermentioningmedicationsboughtatachemist’s,orherbalmedicinesorsupplementswhenbeingaskedthehistoryofmedicationsbecausetheyarenotprescribedbyadoctor.However,interactionswithprescribedmedicationsarepossibleandcanbelife-threatening.LifestyleThisincludesactivitiesuniquetoaperson,includingdiet,levelofphysicalactivity,substanceabuse.AdvanceDirectiveorLivingWillAdvanceDirectivesareinstructionsgivenbyapersonthroughalegaldocumentwhichclearlysetoutthesortsofdecisionabouttreatmentorlackoftreatmenttheywishtobemadeontheirbehalfiftheyarenolongerabletomakesuchdecisionsthemselvesbecauseofillhealthordementia.翻译 Greeting Greetingapatientinawarmandwelcomingmannercreatesafeelingoftrustandconfidenceinthewardstaff.Itisanopportunitytodiscoverhowmuchthepatientknowsabouttheirillnessandascertainthelevelofanxietywhichthepatientmaybefeeling.Greetingisaritualthathelpsbreaktheiceandpavesthewayforotherappropriateinteraction.Thewordsusedingreetingscanchangesignificantlywiththecultureandcontext.Informalgreetingsoftenusenon-wordsandshortformslike‘Hi’.Formalmeetingsusemoreformallanguage,suchas‘Hello’,‘Howareyou’,‘Howareyoufeelingtoday’.翻译 需收集的信息需收集的信息收集患者的信息是接收患者入院的一项重要任务。
虽然不同的医院环境会有所差异，但收集的信息通常都由以下六个部分组成个人信息个人信息个人信息包括患者及其近亲联系方式的详细资料这些信息对于安排出院计划（当患者离开医院）也很重要近亲是指关系最为密切的亲属哪个家庭成员和你最亲近？那就是你的至亲或近亲病史和外科手病史和外科手术史史我们可以在医疗记录上提取以往的记录但是如果患者第一次入院，就必须向患者细致提问，因为患者病史包含许多信息应收集患者既往病史及相关情况的记录是因为这些信息与患者现有的健康状况相关，即患过的疾病、受过的伤、做过的治疗，以及其他与患者相关的医疗实际情况，还包括患者家属的健康状况外科手术史是指患者以前做过的任何外科手术，以及外科手术是否有并发症过敏史敏史有些人对食物、药物或乳胶过敏越来越多的人对乳胶或制品过敏，这种情况下，须选用非乳胶医疗用物 相关信息相关信息 用药史用药史所用药物包括处方药、非处方药、中草药以及维生素补充物由于 药店所购的药品、中草药或营养品不是医生开出的药物，在被询问用药史时，患者可能不会提及这些药物但是这些药物可能与处方药相互作用而威胁患者的生命。
生活方式生活方式指一个人所特有的活动，诸如日常饮食、活动能力及药物滥用等生前预嘱生前预嘱生前预嘱是指患者通过一份具有法律效应的文件所作的指示，当病人健康状况不佳或是痴呆时，这份具有法律效应的文书可以代表患者作出继续治疗或不治疗的决定问候问候以一种温暖、亲切的态度问候患者能够让患者对病房的工作人员产生信任和信心这是了解患者对所患疾病认知度的机会，也有助于探知患者有无焦虑及其程度问候是一种礼节，有助于打破僵局并且为以后适当的交流做准备问候语中用到的词语会随着文化和环境而显著变化非正式的问候通常运用非语言沟通和简短的形式，如“嗨”正式的接待运用更多正式的语言，如“你好”、“你好吗”、“你今天感觉怎么样啊” Discussion of the nursing topic1.What do you think you should do when a patient is admitted to a hospital? Nurses should be directly involved in the admission process—assigning a patient to a room, making sure that the necessary diagnostic tests are completed, and providing for continuity of care when the patient is admitted.2.What information should be collected when admitting a patient?The kind of information collected would be personal details such as name and contact number of next of kin, past medical and surgical history, and details of allergies. 3.3.Is this information important? Why? Is this information important? Why? Yes. Because it is important to alert Yes. Because it is important to alert staff to allergies and any problems in the staff to allergies and any problems in the patientpatient’’s past medical or surgical s past medical or surgical histories.histories. COMMON QUESTIONS IN TAKING THE PATIENT’S HISTORY1.What is your full name? Or what is your first, last, and middle name?2.What is your date of birth? Or when were you born? 3.What is your address?4.What is your phone number? Or what is the best way to contact you?5.What brings you here today? Or what seems to be the trouble today?6.Why are you here? How severe is your pain? 7.Have you had any serious illnesses in the past medical history? 8.Have you had any operations?9.Do any of your family members have health problems?10.Do you have any allergies?11.Are you allergic to anything?12.Are you taking any medications / medicines?13.How often do you smoke or drink alcohol?14.What kinds of foods do you eat regularly? Practice of the task(Lara, the ward nurse, is admitting Mrs. Smith. Mrs. Smith suffers from hypertension and her BP is unstable recently.)Lara:Good morning, Mrs. Smith. My name’s Lara. I’ll be admitting you to the ward today. Would you like to come into the Patient Admission Office so I can get some paperwork done?Mrs. Smith:Good morning, Lara. Yes, thanks. Can I sit down and then do it?Lara: Yeah, please take a seat here. You can put your stick on the edge of the chair if you like.Mrs. Smith:Oh. Thank you, dear.Lara:How are you feeling today?Mrs. Smith:Not too bad, thank you. I haven’t been waiting for too long at all. Lara:That’s good. Now, I’m going to be taking down some details before you’re admitted to the Cardiac Unit today. I’d like to ask you a few questions, if it’s all right with you.Mrs. Smith:Yes, of course. That’s fine.Lara:All right, well now, let me just get the admission form. Would you mind if I check out some details first?Mrs. Smith:No, not at all. What would you like to know?Lara:(smiles) I’d just like to check your name and date of birth and see if your identity bracelet is correct. Can you tell me your full name, please?Mrs. Smith:Yes, it’s Doreen Mary Smith and my date of birth is the fifth of June nineteen thirty-three. Quite a while ago, isn’t it?Lara:(smiles and laughs) Not so long ago. Time goes very fast when you’re busy, doesn’t it? Right now, let’s see. Doreen Mary Smith. S-M-I-T-H. That’s correct, isn’t it? Mrs. Smith:Yes, that’s right. Lara:And your date of birth is the fifth of June nineteen thirty-three.Mrs. Smith:Yes.Lara:All right. Can you tell me what brings you here?Mrs. Smith:Well, um, I’ve got high blood pressure. These days I have not been feeling very well. I’m here for some tests. My doctor asked me to come here to see what’s going on.Lara:OK. Now I’d like to ask you something about your past medical history. Have you had any serious diseases in the past?Mrs. Smith:Yes, I had a mild heart attack two years ago. I was scared at that time. Lara:[leans towards the patient and nods] Yes, I’m sure you were. Now, er, what about past surgical history? Have you ever had any operations?Mrs. Smith:I had an ankle replacement ten years ago. It has been working very well. Lara:Yeah, a long time ago, but it’s lucky that it works well. Now, are you taking any medications at the moment?Mrs. Smith:Yes, my doctor put me on some blood pressure tablets after my heart attack.Lara: [nods] Do you know what they’re called?Mrs. Smith:I don’t know, but I’ve got them here with me. I was told to bring them.Lara:Mm. That’s good. (smiles) Do you think you can show them to me, please?Mrs. Smith:Yes, I can. I’ve got them somewhere in my bag. Here they are. I take them in the morning with breakfast. Lara: Right, that’s fine. You’re taking metaprolol to lower your blood pressure. I’ll just write down the name of the medication on the admission form. Ok, metaprolol. Do you have any allergies to any medications?Mrs. Smith:Not that I know of.Lara:Um. What about food allergies? Any food which are not agreeable to you?Mrs. Smith:No, no, nothing like that.Lara:Good. [smiles] Are you allergic to sticking plaster or latex?Mrs. Smith:No, I’ve never had any problems before.Lara:All right. Can you tell me the name of your next of kin?Mrs. Smith:It’s my son, Jeremy. Jeremy Smith.Lara:Thanks. That’s all for me. I’ll leave you here for a minute while I get the admitting doctor to come and see you. Are you comfortable?Mrs. Smith:Yes, thanks. I’m quite all right here. A. Read the conversation above and answer the following questions.1.Is Mrs. Smith mobile?2.Has she been waiting long?3.Which hospital unit is she being admitted to?4.Why is Mrs. Smith in hospital? Yes, with the help of a stick. No, she hasn’t. She is being admitted to the Cardiac Unit. She has high blood pressure and is in for some tests. 5.What happened to her two years ago?6.Does she have any allergies?7.Does she have a relative who can be contacted during an emergency? She had a mild heart attack. No, she doesn’t think she has any allergies. Yes, her son, Jeremy Smith. B.Answer the following questions according to the conversation above.1.Can you tell me your full name, please?2.Can you tell me why you’re here today?Yes, it’s Doreen Mary Smith Well, um, I’ve got high blood pressure. These days I have not been feeling very well. I’m here for some tests.3.Have you had any serious illnesses in the past? Yes, I had a mild heart attack two years ago. 4.Have you ever had any operations?5.Now, are you taking any medications at the moment?6.Do you have any allergies to any medications?7.Can you tell me the name of your next of kin? I had an ankle replacement ten years ago. Yes, my doctor put me on some blood pressure tablets after my heart attack. Not that I know of.It’s my son, Jeremy, Jeremy Smith. C.Work in pairs. Create a conversation between a nurse and a patient for taking a patient history, using the following information.PATIENT’S NAME: Jane Nelson CASE NUMBER: 021286-ENDDATE OF BIRTH: 05/21/1940 DATE: 06/20/20×× CHIEF COMPLAINT: Jane Nelson is a 76-year-old woman who was admitted to the hospital for a chest X-ray and other tests.Past medical history: The patient has a long history of arthritis. She had her appendix out when she was sixteen. He had pneumonia two years ago. She takes aspirin every day for her arthritis. Over the last 10 days the patient has had at least five episodes of chest pain, all relieved by rest. She had an episode while gardening which lasted almost 5 minutes before subsiding. She went to her cardiologist office and then was immediately sent to this hospital for further evaluation. She also smokes one pack of cigarettes per day. She is not diabetic. Her family history reveals a brother who has had a coronary artery bypass graft. She’s allergic to peanuts. C.Work in pairs. Create a conversation between a nurse and a patient for taking a patient history, using the following information.Open TASK 2 USING ACTIVE LISTENING STRATEGIES TO PUT A PATIENT AT EASEDescriptionRelatedInformationThediscussionofthenursingtopicCommonpatternsandquestionsfoundindialoguewhentakingaMSUPracticethetask DESCRIPTION Active listening strategies ensure that the listener gives feedback to show understanding or interest in the speaker’s message in order to put the patient at ease.翻译 积极的倾听策略可确保对患者传递的信息作出回馈，表示理解或感兴趣，以使患者放松。
任务描述任务描述 RELATEDINFORMATIONThe importance of active listening strategiesThe patient being admitted to a hospital may feel worried about what will happen. It’s very important to put a patient at ease. If the patient is not at ease, he may feel anxious and not take in important information. At the same time, the patients who are anxious do not comply well with instructions. So active listening strategies are used to put the patients at ease, show interest in what is being said, and confirm understanding of what has been said. These include gestures, body position—for example, leaning towards the speaker—nodding, making “listening noises”, respecting personal space and maintaining comfortable eye contact. 翻译 积极倾听策略的重要性积极倾听策略的重要性刚入院的患者往往会担心将要发生的事情。
让患者放松很重要，患者如果没有放松，可能会感觉焦虑而不会接收医务人员告知的重要信息，同时，焦虑的患者不会很好地听从医务人员的指导因此积极的倾听策略可以让患者放松，可以表现出听者对说话人话语的兴趣及对话语的理解这些策略包括手势、体位（例如身体倾向说话者），点头示意，边听边作出回应，尊重私人空间，以及保持舒适的眼神交流相关消息相关消息 Tips of easing the patientSensitive topics can be broached more easily if the patient feels relaxed and comfortable. The kindly words, the cheerful greetings, the sympathetic looks are understood by the patient. Meanwhile, when talking to the patient, the use of non-verbal communication such as body language, body postures or body movements is also very important. There should be no mismatch between verbal and non-verbal communication. Gestures, usually hand movements, which add non-verbal cues, may have different meanings in different cultural settings and should be used with cautions. 翻译 让病人放松的小贴士让病人放松的小贴士如果患者感觉放松和舒适，这时展开敏感话题就更容易了。
体贴的话语、愉快的问候、同情的表情能让患者接受同时，与患者沟通时，非语言沟通的运用例如肢体语言、手势、肢体移动同样也都非常重要，语言沟通和非语言沟通之间必须匹配手势，通常是手的动作，会增加非语言沟通暗示但在不同的文化背景下，手势的含义不同，因此要小心运用 CultureCulture may be defined as the learned and shared beliefs, values and life ways of a particular group. Cultural competence is the ability to provide effective care for clients who come from different cultures. Culture care in nursing is defined as “the subjectively and objectively learned and transmitted values, beliefs and patterned life ways that assist, support, facilitate, or enable another individual or group to maintain their health and well-being, to improve their human condition and life way, or to deal with illneses, handicaps, or death. Acquiring skills related to culturally competent nursing practice is important for better client outcomes, satisfaction and quality of care. 翻译 文化背景文化背景文化背景是指一个特定群体共有的习得、信仰、价值观和生活方式。
文化能力是指可对来自不同文化背景的患者提供有效照顾的能力文化护理是指通过主观和客观上习得传承下来的价值观、信仰和生活模式去帮助、支持、促进或使另一个体或群体能够保持他们的安康幸福，改善身体状态和改变生活方式，帮助应对疾病、残疾和死亡等获得跨文化护理能力十分重要，它能提高病人的愈后满意度以及护理质量 COMMON PATTERNS AND QUESTIONS IN PUTTING A PATIENT AT EASE1.I wonder if I could have a talk with you about your blood pressure management before you go home.2.Now, you’ve had a bit of a shock with your blood pressure, haven’t you?3.You did well to remember all the information. 4.It’s a lot to take in at once and I’m really pleased that you’re ready to go. Discussion of the nursing topic1.Why is it important to put a patient at ease? If patients are not at ease, they may feel anxious and not take in important information. Patients who are anxious do not comply well with instructions.2.What are active listening strategies? Active listening strategies include gestures, body positions—for example, leaning towards the speaker, nodding, making “listening noises”, respecting personal space and maintaining comfortable eye contact. 3.Do you think listening strategies are important and why?Active listening strategies are important because they are used to put the other person at ease, show interest in what is being said, and confirm understanding of what has been said.4.What roles does cultural sensitivity play when putting a patient at ease?It is important for better client outcomes, satisfaction and quality of care. PRACTICETHETASK(Susanna, the ward nurse, is giving an instruction to Mr. Cox, who is going home from hospital.)Susanna:Hello, Mr. Cox. I wonder if I could have a talk with you about your blood pressuremanagement before you go home.Mr. Cox:Hello. Susanna. Yes, go ahead.Susanna:Great. I’ll just sit down and then chat with you [gets a chair and sits down]. Now, you’ve had a bit of a shock with your blood pressure, haven’t you?Mr. Cox:Yeah, you’re right there. I had no idea about my blood pressure. I mean I was feeling easily more tired than usual, and my wife said she noticed that my face was a little flushed. The problem is that I never thought about blood pressure.Susanna:Mm, yeah (nods). That’s probably why it is called the “silent killer”. For most people, they don’t know they are hypertension sufferers until a shock comes to them. The only symptom people have of hypertension is high blood pressure itself.翻译 Mr. Cox:Like what? You say, it’s come as a bit of a shock. So, what do I have to do when I go home? What should I watch for?Susanna:Well now, do you remember yesterday we discussed the sort of lifestyle changes I’d like you to look at?Mr. Cox:Yes, I’ve got all the information about the Stop Smoking service, and I’ve started on the nicotine patches. The dietitian told me yesterday about a healthier diet. My wife even bought a cookbook, especially for a hypertension sufferer! Both of us will start the exercise program here at the hospital. Was there anything I should pay attention to?Susanna:(laughs) I hope the recipe book works for you. I can see you cooking up a storm in the kitchen.Mr. Cox:I have no idea about that. I don’t think my wife would agree with you.翻译 Susanna:You did well to remember all the information. It’s a lot to take in at once and I’m really pleased that you’re ready to go. The only other thing that we need to talk about is your blood pressure itself. It would be a good idea to buy a small digital blood pressure monitor and take your blood pressure regularly. That way you can keep an eye on it by yourself. It puts you in charge of your own health. I think that’s important, don’t you?Mr. Cox:Yeah, you’re right. It’s much better that way.翻译 任任务案例案例（病房护士苏珊娜，正在给准备出院的科克斯先生作指导。
苏珊娜：您好，科克斯先生在您回家之前我们能谈谈您的血压控制吗？科克斯先生：你好，苏珊娜可以啊，开始吧苏珊娜：太好了，我坐下来跟您谈吧拿了把椅子坐下目前，您已经因为血压发生过一次休克了，是吗？科克斯先生：是啊，我对自己的血压一无所知我是说，我比平常更容易疲劳我的妻子说她注意到我的脸有一点潮红问题是我以前从没想过血压问题苏珊娜：嗯，是的（点头示意）那也可能是血压问题被称为“沉默杀手”的原因对于大多数人来说，直到发生休克后才知道患有高血压高血压患者唯一的症状就是血压高科克斯先生：正如你说的，休克了才知道是高血压造成的那么，回家之后我必须要做些什么呢？又要注意些什么呢？苏珊娜：好的，您还记得我们昨天讨论过的我希望您考虑改变生活方式吗？ 科克斯先生：是的，我已经记住了关于戒烟服务的所有信息，而且我已经开始使用尼古丁贴片了昨天，营养师还告诉了我更为健康的饮食我妻子甚至买了本特别针对高血压患者的食谱我们在医院就开始了这种高血压患者的锻炼计划我还需要注意什么吗？苏珊娜：（笑）我希望食谱能够起到作用，我能想到您在厨房手忙脚乱的情景了科克斯先生：我不知道食谱能否起作用，但我妻子不会在厨房手忙脚乱苏珊娜：您记住了所有重要的信息，非常好。
要您一时半会接受这些信息确实太多了，但我真的很高兴您要准备出院了还有另外一件我们必须要谈的事就是您的血压本身建议您去买一个小型电子血压测量仪，这样您就可以定期测量您的血压，并自己监控血压了您要自己管理健康，我认为这一点很重要，您觉得呢？科克斯先生：是的，最好买一个 A. Read the conversation above and then answer the following questions. 1.Why did Susanna want to talk to Mr. Cox? Because she wanted to have a talk with him about his blood pressure management before he goes home. 2.Did Susanna use active listening strategies whilst taking Mr. Cox’s details? If yes, find out the examples. Yes, she gets a chair and sits down, nods and laughs. She also uses mm. 3.What could be changed for Mr. Cox? His lifestyle.4.Is there a need for Mr. Cox to take his blood pressure regularly? Yes, that way he can keep an eye on it by himself.5.How to take Mr. Cox’s blood pressure according to Susanna? It would be a good idea to buy a small digital blood pressure monitor and take blood pressure regularly. B.Complete the following active listening strategies, using the words and phrases in the box.eye contact mm nodding your head hm I see1.Using expressions such as Really? Is that right?___________ and Yes or No.2.Making “listening noises” like ___________and_____________ shows that you are interested in what the speaker is saying.3.Leaning towards the other person and_________________ also shows interest.4.Smiling while maintaining ___________ puts a patient at ease. B. Complete the following active listening strategies, using the words and phrases in the box.1. I see2. mm/hm3. nodding your head4. eye contact C.Match the strategies for putting a patient at ease (1–4) to the rationales (a–d).1.Sit at the same level as the patienta.This encourages patients in their attempts at learning new information2.Make positive responses whilst nodding your headb.This shows respect for the patient’s right to make decisions about healthcare.3.Don’t make judgmental commentsc.This can lighten the atmosphere and help patients relax.4.Use humor to establish a good rapport with your patientd.This helps patients feel that you are interested in talking to them rather than over them C. Match the strategies for putting a patient at ease (1-4) to the rationales (a-d).1. d2. a3. b 4. c D.Create a conversation to put a patient at ease, using active listening strategies according to the following information you might use.Crystal, a Charge Nurse on the pediatric respiratory ward, is describing the normal glow of air into the lungs to a 10-year-old patient, Jack. He has been admitted after having his first serious asthma attack and needs education about managing his asthma.The strategies of putting a young patient at ease: 1. Use small talk, for example, asking about the child’s hobbies or interests.2. Stand or sit at the same level as the child.3. Use simple, clear sentences and check for understanding.4. Use pictures or diagrams to illustrate what you are saying.5. Involve the child in decision-making, for example, let’s call this one healthy airways—does it sound like a good idea?6. Give encouragement.7. Use short, simple phrases which appeal to children, for example, the little flap.8. Use a cheerful tone of voice.9. Explain medical terminology in simple terms. D. Create a conversation to put a patient at ease, using active listening strategies according to the following information you might use.Open TASK3GIVING A NURSING HANDOVERDescriptionRelatedInformationCommon patterns and questions in giving nursing handoverDiscussion of the nursing topicPractice of the task DescriptionThe nursing handover is the time when essential information is passed on to the next shift for clear and precise communication specifically to do with the patients’ medical, physical and mental well being and care, and make clear any instructions that the doctor prescribed.翻译 任务描述任务描述护理交接班是指不同班次的护士之间交接重要的信息。
通过清晰、准确的交流，具体交待患者的治疗情况、身心状态和护理措施等方面的信息并明确医嘱发出的指令 RELATEDINFORMATIONA Nursing handoverHealthcare professionals write entries about patients in their care in the Patient Record. The Patient Record documents patient care and, as such, forms a permanent legal record of treatment. At the end of each nursing shift, the outgoing nurses give a verbal handover to nurses on the incoming shift. The nurses on the incoming shift are briefed on changes in patient progress and patient care. The handover is usually performed face-to-face but some institutions use recorded handovers. The information which is reported during the handover is gathered from the Patient Record, the Care Plan and any other charts which document specific patient care. Handovers should alert nurses to the presence of IV therapy, drains, wounds, etc. Medication reviews and test results should be given. Staff should be informed of any tests or procedures which will occur during the next shift. Handovers should only give information about the changes in condition or treatment which have occurred during the relevant shift.翻译 Inaccurate handing over of information can lead to medication errors, incorrect preparation for tests, and missing appointments with other healthcare professionals, for example, X-ray.Handover time is often cited as one of the most difficult times of the day for nurses. Several communication skills are required to be able to manage a handover adequately including note-taking skills and comprehension skills. It is also important to have the ability to understand abbreviations and acronyms and have confidence in medical terminology and nursing jargon. Handovers are often given in crowded rooms where it may be difficult to hear the handover clearly. 相关信息相关信息护士交接班士交接班护理专业人员要在护理记录单上完整地写出患者的护理记录。
护理记录单上记录了患者的护理措施，具有法律效力每次护理值班结束时，要下班的护士会给刚上班的护士口头交接，并且简要介绍患者的病情变化以及护理措施交接班通常是面对面进行，但是有些医疗机构也使用交接班记录在交接班上汇报的信息来自于护理记录单、护理计划和其他特殊护理记录交接班必须提醒下一班护士注意有静脉输液治疗、引流管或伤口的患者必须回顾病人的用药情况及检查结果上一班护士必须告知下一班护士患者在下一班次内要做的检查和处置交接班应该只告知本班次发生的患者病情或治疗措施的变化信息不正确的交接班信息可能导致用药错误，不正确的检查前准备工作，会错过与其他科室的预约，如照X光交接班通常被认为是护士一天中最困难的时刻为能正确地交接班需要几种沟通技能，包括记笔记的技能和理解能力知道缩写、首字母缩略词、医学术语和护理术语并能运用自如，也十分重要交接班通常发生在十分拥挤的房间里，所以要听清楚交接班护士所说的话可能有些困难 The Patient RecordThe Patient Record includes the complete notes of all care given to a particular patient. All healthcare professionals who deliver care to a patient, for example physiotherapist, medical officers, nursing staff and social workers, must document the care in the Patient Record. Record keeping is an important responsibility of nurses not least because the Patient Record is a legal document and can be called on as evidence, making it essential that the record is factual and objective and does not contain subjective opinions.翻译 患者患者护理理记录单患者护理记录单包括给予某一患者所有护理措施的完整记录。
所有医护人员给予患者的护理措施必须记录，如理疗医师、医师、护士和社工保管护理记录是护士的一项重要职责，因为护理记录单具有法律效力并且能够作为证据带上法院，要保证记录真实、客观且不添加主观评论非常重要 Tips when giving nursing handoverWhen giving the handover, start by having a written report for each patient to be discussed, keep to the facts and ask other members of the team if they have anything to add. The report should contain every detail of the treatment and care given to the patient during the shift. It is best not to abbreviate medical and nursing terms as this can often lead to misunderstanding and confusion. If it’s necessary to be abbreviated, make sure that they can be fully understood. When giving the report, keep it as concise as possible, stick to the facts and try not to get sidetracked. If reporting at the bedside, remember that the patient is within earshot and be aware of what they know about their condition and treatment. When receiving the report, write down all the important points, don’t be afraid to ask when unsure of anything.翻译 护士交接班时的小贴士护士交接班时的小贴士当交接班时，先将每一位要交接的患者信息写出来，信息要实事求是，并且要询问其他人员有没有补充信息。
交接报告必须包含班次内给予患者的所有治疗和护理措施的详细情况最好不要使用缩写医疗护理术语，因为这样很容易造成误解和困惑如果有必要缩写时，要确定别人能完全理解缩写的意思当交接时，要尽可能地简洁、客观，避免转变话题如果是床边交接班，记住患者能够听见交接的内容，要清楚患者对自己的病情和治疗情况了解多少护士接班时应记下所有重点，不确定时不要害怕询问交班者 Common patterns and questions in giving nursing handover1.Mrs. Loewy was readmitted yesterday because of…2.She’s been quite distressed about it, according to…3.She presented to the unit with…, despite a little change in medication.4.This morning she complained of …open Discussion of the nursing topic1.What are the features of a good handover? Handovers should alert nurses to the presence of IV therapy, drains, wounds, etc. Medication revives and test results should be given. Staff should be informed of any tests or procedures which will occur during the next shift. Handovers should only give information about the changes in condition or treatment which have occurred during the relevant shift. 2.What can happen if handovers do not communicate important information from one shift to another?Inaccurate handing over of information can lead to medication errors, incorrect preparation for tests, and missing appointments with other healthcare professionals, for example X-ray.3.What communication skills are required in order to mange a handover?Several communication skills are required to be able to manage a handover adequately including note-taking skills and comprehension skills. It is also important to have the ability to understand abbreviations and acronyms and have confidence in medical terminology and nursing jargon 4.Why is it important to be clear and concise when giving a handover? Staff take notes as the handover is given and time is usually limited to around twenty minutes to hand over information about the whole unit. Practice of the task(Jonas, a ward nurse, is giving a nursing handover.)Jonas: Right, now Mrs. Lowey in bed Number Two. Mrs. Loewy was readmitted yesterday because of unstable hypertension. I think you remember her from last week. She went home but couldn’t manage her ADLs on her own. Her daughter had to visit her every morning and then give her a shower and help her during the day. She’s been quite distressed about it, according to her daughter. She presented to the unit with uncontrolled hypertension, despite a little change in medication. She has a past history of MI this year in June. Um, this morning she complained of chest pain. The SHO was called. Her BP at the time—er, that was 11 am—was two fifteen over one oh eight and her pulse was one hundred and two. She had an ECG done and was given GTN sublingually. We gave her some O2 via the mask and she seemed to settle. She’s in for cardiac catheterization tomorrow to assess the extent of the damage to her heart. I’ve booked the porter already. Strict fourth hourly obs. BP and pulse and report any chest pain immediately, of course. She’s had no chest pain this shift.翻译 A.Read the nursing handover above and answer the following questions.1.What is her present medical problem?Unstable / uncontrolled hypertension.2.What is her past medical history?She had a past history of MI (myocardial infarction) / a heart attack this year in June. 3.Does she manage her ADLs at home by herself?She couldn’t manage her ADLs on her own at home. 4.Has she been distressed? She’s been quite distressed about it, according to her daughter.5.What was her BP at 11 am? Her BP was two fifteen over one oh eight.6.What was her pulse at 11 am? Her pulse was one hundred and two. B.Abbreviations are often used in both Patient Records and verbal handovers. Some are only found in written documents. It is important to check which abbreviations are approved at the hospital where you are working, as there may be some variance. Match the abbreviations (1–14) to their meanings (a–n). Put the matching letter in Column ⅡⅡ and put them into Chinese in Column ⅣⅣ. ⅠⅠⅡⅡⅢⅢⅣⅣ1. BP a activities of daily living 2. P b four times a day 3. QDS c Senior House Officer 4. MI d electrocardiogram 5. GTN e sublingual, or under the tongue 6. SHO f myocardial infarction, or heart attack 7. 4° g blood pressure 8. c/o h complain of 9. SL i observations 10. O2 j four hourly, or every four hours; also 4/24 11. ECG k patient 12. ADLs l glyceryl trinitrate; also called nitrolingual 13. Pt m nitrolingual pulse 14. obs n oxygen Note: A senior house officer (SHO) is a junior doctor undergoing training within a certain specialty in the British National Health Service or in the Republic of Ireland. SHOs are supervised by consultants and registrars, who oversee their training and are their designated clinical (and in many cases educational) supervisors. 1. g 血压2. m 脉搏3. b 每天四次4. f 心肌梗死5. l 硝酸甘油6. c 高级住院医师7. j 每四小时8. h 主诉9. e 舌下含服10. n 氧气11. d 心电图12. a 日常生活活动13. k 患者14. i 观察结果 PATIENT RECORDU/N U/N: 732910Surname: SmitsGiven names: LiviaDOB: 10.12.31 Sex: FemaleC.A Patient Record contains entries from every member of the patient’s team. As a nurse, you must read all entries in order to plan patient care efficiently.Another patient, Mrs. Smits, is handed over. Use the information from the Patient Record to complete what was said. Date and TimeAdd Signature, Printed name, Staff category, date and time to all entries18.5.200822.30 hrsMrs. Smits C/o chest pain at 22.00 hrs. SHO informed. O2 administered via mask. BP 220/100 p 120 at 2200hrs. SHO ordered ECG, attended by nursing staff. GTN sl administered at 22.05 hrs, chest pain relieved within 2 minutes. Karen (RN) AmyMrs. Smits (1) complained of chest pain at (2) _____________________. The (3)___________________ was informed. (4)_____________ was administered via a mask. Her blood pressure was (5)__________ and her (6) ___________was (7)_______________at (8)_______ . The (9)____________________________ ordered an (10)__________________ , which was done by nursing staff. GTN (11) _____________ was given with good effect. The chest pain was relieved within a couple of minutes. 1. complained of 2. 10 pm3. SHO4. Oxygen5. two hundred and twenty over one hundred6. pulse7. one twenty8. five past ten / 10:05 pm9. SHO 10. ECG11. sublingual. D.Work in pairs. Create a conversation to practice giving a handover, using the Patient Record below.PATIENT RECORDU/N:2235689Surname: LancasterGiven names: BobDOB:21.4.1945 Sex: MaleDate and TimeAdd Signature, Printed name, Staff category, date and time to all entries15:305/05/09Mr. Lancaster had a restless night. c/o chest pain at 0215 hrs. Night SHO called. BP 215/105 and P92 at 0220 hours. ECG ordered and attended by nursing staff. O2 via mask and GTN sl administered. BP dropped to 180/86 p82 at 0240 hours. No c/o further chest pain L. Anna (RN) Anna D. Work in pairs. Create a conversation to practice giving a handover, using the Patient Record below. Open TASK 4 CHARTING BLOOD PRESSURE AND PULSEDescriptionRelatedInformationDiscussion of the nursing topicCommon questions in doing general observationsPractice of the task DESCRIPTIONCharting blood pressure and pulse is noting down the blood pressure and pulse in a specific time to make clinicians aware of the deteriorating patient. Blood pressure is defined as the lateral force exerted by blood on the arterial walls. Blood pressure is measured in millimeters of mercury (mm Hg). The pulse is a recurring wave of blood created by contraction of the ventricle.翻译 任务描述记录血压和脉搏是指记录具体时间的血压、心率，让临床医生注意到患者的病情变化。
血压指血管内的血液对于单位面积血管壁的侧压力血压测量用毫米汞柱表达脉搏是指心脏收缩和舒张时血液冲击动脉管壁而引起的博动 RELATEDINFORMATIONBlood pressure readingsBlood pressure (BP) readings are expressed as the systolic reading over the diastolic reading. The systolic reading is the top numeral of the BP result and records the period of contraction of the heart. The diastolic is the numeral at the bottom of the BP reading and records the period of relaxation of the heart.For example, a BP reading of 90/60—spoken as ninety over sixty or ninety on sixty— records the systolic reading of 90 and the diastolic reading of 60.翻译 相关信息读取血压血压读数表示为收缩压/舒张压。
收缩压读数是心脏收缩期时动脉血压的最高值，舒张压是心脏舒张期时动脉血压的最低值比如，血压值90/60 mmHg，读为90/60，记录为收缩压为90、舒张压为60 Meaning of blood pressureRisks of illness and death are related to changes in blood pressure. There is no particular dividing line which indicates a person is definitely ill. This can be interpreted only by a physician in light of the total health picture of the individual.Specific instructions will be followed in reporting the blood pressure measurements to the client. This action is taken so that the client is informed of any findings that are outside of normal limits.翻译 血血压的意的意义疾病与死亡的危险与血压的变化有关，但没有一个特定的分界线可表明患者一定生病了。
血压变化的临床意义只能由医生结合患者的总体健康状况作出解释向患者报告血压测量结果时要给出具体的指导，说明血压是否正常 Vital signs Traditionally the vital signs have consisted of temperature, pulse, respiratory rate and blood pressure, although oxygen saturation is commonly considered to be a fifth vital sign. Other physiological measures and clinical information that are commonly recorded on observation charts include consciousness, urine output and analysis, bowels, weight, blood sugar level and pain score.翻译 生命体征生命体征传统的生命体征由体温、脉搏、呼吸、血压组成，而血氧饱和度通常被称作第五生命体征。
记录在观察表上的其他的生理指标和临床资料往往包括：意识、尿量分析、大便、体重、血糖值和疼痛评分 Observation chartsObservation charts are the primary tool for recording information about vital signs and other physiological measures, and they therefore have a critical role in the identification of patients at risk. Here is an example of a chart in Australia.翻译 观察图表观察图表观察图表是用来记录生命体征和其他生理指标的重要工具，由此在辨别患者有无危险上起着至关重要的作用下面是一张澳大利亚的观察图表 ×××× HospitalSurname ______Given Name________Other names ________ Sex_______D. O. B.________________ Address__________________________GENERAL OBSERVATION CHARTOTHER CHARTS IN USENeuro Insulin Infusion Alcohol WithdrawalFluid Balance Pain / Epidural / Patient Control Analgesia Other ___________Anticoagulant Neurovascular Other ___________VARIATIONS TO FREQUENCY OF OBSERVATIONSDATE: FrequencyRequired RN name Signature ALTERATIONS TO CALLING CRITERIA (MUST BE REVIEWED AT LEAST EVERY 72 HOURS)ANY ALTERATIONS MUST BE CONFIRMED BY CONSULTANT DATE: Respiratory Rate Systolic BloodPressure SpO2 Heart Rate Other RN Name Signature INTERVENTIONS1234567 ××××医院医院姓姓______名名________其他用名其他用名 ________ 性别性别_______出生日期出生日期________________ 住址住址__________________________一般观察图表一般观察图表同时使用的其他图表同时使用的其他图表神经神经 胰岛素输注胰岛素输注 酒精戒断酒精戒断 体液平衡体液平衡 疼痛疼痛/硬膜外麻醉硬膜外麻醉/患者自控镇痛力患者自控镇痛力 其他其他_______抗凝剂抗凝剂 神经与血管神经与血管 其他其他_________观察频次的变更观察频次的变更日期日期 要求观察的频次要求观察的频次 注册护士的名字注册护士的名字 签名签名 每每72小时须调用行业标准的变化，任何变更必须由会诊医师确认小时须调用行业标准的变化，任何变更必须由会诊医师确认日期日期 呼吸频率呼吸频率 收缩压收缩压 脉博氧饱和度脉博氧饱和度 心率心率 其他其他 护士名字护士名字 签名签名 措施措施 Discussion of the nursing topic1.What are commonly recorded on observation charts?Information about vital signs and other physiological measures are commonly recorded on observation charts.2.Have you seen an observation chart commonly used in Chinese hospital? Can you tell the differences between that and the chart introduced above?(Open) Common questions in doing general observations1.I’m just going to do your observations, is that alright?2.I’ll just pop this thermometer under your armpit for a short while, would you please keep your arm firmly up against your chest until I take it out?3.I’m just going to take your pulse, can I have your wrist please?4.I’m just going to take your blood pressure, if that’s OK.5.Do you have any history of high blood pressure?6.Have you taken any medication for your blood pressure today?7.I’m just going to check your oxygen saturation, would you please put your finger into this probe? PRACTICE OF THE TASK(Mrs. Linz has been admitted with hypertension, which has been poorly managed at home. Her doctor decides to review the medication she is taking to control her high blood pressure. For the first day after admission, her blood pressure and pulse will be observed regularly. The admitting doctor has placed her on four hourly observations of blood pressure and pulse. Debbie, the Ward Nurse, is handing over Mrs. Linz to the afternoon shift.)Debbie:All right, now I’ll just let you know about Mrs. Linz’s BP. As you know, she was admitted just before 10 am yesterday with poorly managed hypertension. She’s quite elderly and trying to cope at home, but the previous medication wasn’t working well for her at all. Doctor Robert wants to put her on something else and wants to monitor her BP in hospital for three days. If you look at her Obs. Chart from yesterday, you’ll see that she was quite hypertensive on admission. BP was one hundred and seventy four over one hundred and two, pulse eighty-six. At 6 am her BP was about the same, one hundred seventy-four over ninety-five and pulse seventy-six. During the morning shift at 10 am she shot up to two hundred and three over one thirty one, with a pulse of a hundred and eleven. She complained of some chest pain, too. Doctor Robert came up to see her about the chest pain and high BP. He did all the usual things for her ECG, GTN sublingually, and she settled a bit by 2 pm. By two, her BP was one hundred ninety-five over ninety and her pulse was ninety-seven. I took her obs. again at 3pm, just before handover. She’s gone down to one hundred eighty-six. Doctor Robert’s happy with that but just keep an eye on her, will you? 任任务案例案例（林茨夫人因高血压在家里控制不好而入院。
为控制血压，医生决定复核她正在服用的药物住院第一天需定期监测她的血压和脉搏，住院医生开出每四小时观察一次血压、脉搏的医嘱病房护士黛比正将林茨夫人交接给下午班的护士黛比：好的，现在我将告诉你有关林茨夫人的血压正如你所知道的，林茨夫人由于血压控制不好而在昨天上午10点前入院，她上了年纪，想尽量在家里处理，但是之前的药物并没有起到较好的效果罗伯特医生想更换别的降压药物，要求她住院三天，观察三天血压如果浏览她昨天的生命体征表，你会注意到她入院时血压相当高，血压是174/102，脉搏是86今天早上6点与入院时血压接近，血压是174/95，脉搏是76上午10点交接班时她的血压突然上升到203/131，脉搏111，她也主诉有胸痛，医生罗伯特来查看了她的胸痛和高血压值，给她做了常规处理：心电图检查、硝酸舌下给药甘油，到下午2点才下降一点，血压是195/90，脉搏是97下午3点就在交接班前我又看了她的观察图表，血压降至186罗伯特医生很高兴，但是还是需要密切观察，可以吗？ A. Read the handover above and answer the questions. 1.How long will Mrs. Linz be in hospital for?She will be in hospital for three days.2.Why did Dr Robert come to see her? Dr. Robert came to see her because her BP had increased and she was complaining of chest pain.3.What did Debbie do just before handover? Debbie took her observations before giving the handover.4.What was her BP at 2:00 pm? Her BP was one ninety-five over ninety.5.What was her BP at 3:00 pm?Her BP has gone down to one eighty-six. ↑→↓risestabilizefallB.Look at Mrs. Linz’s handover above and find phrases describing changes in her pulse or blood pressure readings. What other phrases could you use? Add them to the table. 。
↑→↓increaseshoot up topeak (maximum result) settleremain the sameto be constantto be steadydecreasego downplummet (sudden decrease) C.Blood pressure readings are spoken as the first number on or over the second. For example, 90/60 is ninety over sixty or ninety on sixty. How would you say the following blood pressure readings?1. 110/70 3. 142/992. 150/90 4. 86/401. One hundred and ten over/on seventy2. One hundred and fifty over/on ninety3. One hundred and forty-two over/on ninety-nine4. Eighty-six over/on forty D. Complete the nurse information leaflet about the pulse, using the words in the box.beats rate bradycardia heatbeats tachycardia chamberHeart rate is the number of ___________ per unit of time, typically expressed as _____ per minute. The heart usually beats between 60 and 100 times a minute in an adult at rest. ____________is a slower-than-normal heart rate. The ______ are fewer than 60 times per minute. __________ is a faster-than-normal heart rate. It means that the _______ in the upper chambers or lower chambers of the heart, or both, are increased significantly. heartbeatsrate Bradycardia beats TachycardiachambersD. Complete the nurse information leaflet about the pulse, using the words in the box. E. Match the types of pulse (1–8) with its location (a–h).1. pedala. in the elbow cavity on the inside of the arm2. poplitealb. at the wrist near the thumb3. brachialc. in front of the ear on the temples4. tibiald. behind the knee when the leg is bent at an angle of 120°5. carotide. found in the groin6. temporalf. found on the top of the foot7. femoralg. found in the neck8. radialh. found behind the ankle E. Match the types of pulse (1-8) with its location (a-h).1. f2. d3. a4. h5. g6. c7. e8. b F.Work in pairs and create a conversation to practise handing over Mrs. Fox according to the following information.PATIENT RECORDDateTimeTPRRBPCommentSign name4.8.201102:0036.38518172/101 Julie(RN)4.8.201106:0036.47518175/95 Julie(RN)4.8.201110:0036.410020210/125 Julie(RN)4.8.201114:0036.39618185/95 Julie(RN)4.8.201115:0036.47716170/80 Julie(RN) F. Work in pairs and create a conversation to practise handing over Mrs. Fox according to the following information.Open TASK 5 CHARTING RESPIRATORY RATESDescriptionRelatedInformationDiscussion of the nursing topicCommon questions in doing general observationsPractice of the task DescriptionRespiratory rate is the number of breaths per minute or, more formally, the number of movements indicative of inspiration and expiration per unit time. In practice, the respiratory rate is usually determined by counting the number of times the chest rises or falls per minute. By whatever means, the aim is to determine if the respirations are normal, abnormally fast (tachypnea), abnormally slow (bradypnea), or nonexistent (apnea).翻译 任任务描述描述呼吸频率指每分钟呼吸的次数，或者更正式一点的表述，单位时间内吸气和呼气运动的次数。
实际上，呼吸频率是通过观察每分钟胸部起伏的次数来计数的不管用哪种方法，其目的是确定呼吸是否正常，有无异常增快（呼吸急促）或异常缓慢（呼吸过缓），以及没有呼吸（呼吸暂停） Related InformationSignificance of the respiratory rateThe normal respiratory rate is 16-20 breaths per minute. Evidence suggests an abnormal respiratory rate is a significant predictor of deterioration, cardiac arrest and / or need for admission to ICU. There is much evidence to support the view that abnormal vital observations are evident in patients before acute deterioration and cardiac arrest. These observations include temperature, pulse, blood pressure, respirations, and oxygen saturation levels. Recording respiratory rate is a simple, basic, bedside observation.。
相关信息相关信息呼吸呼吸频率的意率的意义成人正常的呼吸频率是每分钟呼吸16～20次有证据表明，异常的呼吸频率是病情恶化，心脏骤停的重要征兆，以及可帮助判断是否需要入住ICU有很多证据都能支持这一观点，在病情发生急性恶化和心脏停跳前，各项生命体征显著异常这些体征包括体温、脉搏、血压、呼吸和血氧饱和度记录呼吸频率是一种基本的、简单的床边观察法 Four Types of Breathing PatternsAll details related to all regular (or periodic) types of respiratory patterns at rest, including the ideal breathing pattern (present in very rare people with super health), normal breathing pattern (present in healthy people), ineffective breathing pattern (present in moderately sick people with chronic diseases), and heavy breathing pattern (for the severely and critically sick). 四种呼吸方式四种呼吸方式安静时，周期性的呼吸方式有如下四种；理想呼吸方式（于极少数非常健康的人）、正常的呼吸方式（见于健康人群）、无效呼吸方式（见于中度慢性疾病患者）和沉重呼吸方式（见于垂危患者）。
Discussion of the nursing topic1.Why is it important to take a patient’s respiratory rate? Evidence suggests an abnormal respiratory rate is a significant predictor of deterioration, cardiac arrest and/or need for admission to ICU.2.How to record the respiratory rate in an observation chart? Recording respiratory rate is a simple, basic, bedside observation by counting the number of breaths per minute. Common questions in doing resps observations1.Mr. Williams is on hourly resps, isn’t he?2.How is his respiratory rate now?3.When did he come back from the operation?open Practice of the task(Mr. Williams, 60 years old, who lives alone, has been admitted to hospital for treatment with a past history of respiratory problems relating to chronic asthma.)Lisa: Hi, Rosa. Do you mind if I go through Mr. Williams’ chart before I have a break? There are few things to do while I’m away, if you don’t mind.Rosa: That’s OK. I don’t mind. Mr. Williams is on hourly resps, isn’t he?Lisa:Yeah. That’s right. He’s had a history of respiratory problems, and he became breathless after his operation yesterday. In any case, we’re still doing hourly resps while he is using PCA for relieving pain.Rosa: Uhha, all right. How is his respiratory rate now?Lisa:Um, you can see his pre-op resps at 6:30 am were eighteen. That’s normal for him. I checked his resps at 7:30 am before he was taken to the theatre and they were still eighteen. Rosa: Mm, when did he come back from the operation?Lisa: He came back a couple of hours ago, um, at 2:30 pm. He was undergoing a lot of pain, er, scoring eight out of ten on the pain scale. He was quite breathless. His resps went up to twenty-seven. I started him on some oxygen at five litres per minute for an hour between 2:30 and 3:30 pm because of his breathlessness.Rosa: Mm, OK. I see it. It looks like he feels better since then. The PCA worked and his pain score at 3:30 pm was four out of ten from this chart, I can see. Yeah, that’s better.Lisa: Right. I just did his Obs. a few minutes ago at 3:30 pm and his resps were down to twenty so that’s better too. I’ve put the oxygen back to three litres per minute.Rosa: Ok. I will keep an eye on him while you are in a break.Lisa: Thanks. I’ll be back in an hour. I’ll do his Obs. at 4:30 then.Rosa: Ok. 任任务案例案例（威廉先生是一位60岁的老人，独居，因既往哮喘病有关的呼吸问题入院治疗。
丽莎：你好，罗莎，你介意我在休息前再看看威廉先生的观察图表吗？我不在时，有几件事情要做罗莎：可以，我不介意每小时要观察威廉先生的呼吸频率，是吗？丽莎：是的他既往有呼吸问题病史，昨天手术后他变得呼吸急促不管怎样，他在使用自控镇痛泵缓解疼痛时，我们还是要每小时监测他的呼吸罗莎：啊哈，好的，那他现在的呼吸频率是多少呢？丽莎：你能看到他之前观察记录上早上6:30的呼吸频率是18，对于他而言已经很正常了早上7:30他去手术室前我测量了他的呼吸，仍是18 罗莎：嗯，他什么时候手术回来的？丽莎：他几个小时前回的，嗯，下午2:30他回来后感觉疼痛厉害，评分是8分（满分10分）他呼吸相当困难，呼吸频率上升到27因为他呼吸急促，我在下午2:30到下午3:30之间持续给氧，氧流量是5 L/min，给他一小时罗莎：嗯，好的，我知道了自从给氧后他看上去感觉好多了自控镇痛泵发挥了作用，从图表看到，下午3:30他的疼痛评分降到了4是的，好多了丽莎：几分钟前即下午3:30时，我对他进行了观察，他的呼吸频率降至了20，好多了，我已将给氧流量调至3 L/min罗莎：好的，你休息时我会观察他的丽莎：谢谢，我一小时后回来，下午4:30再观察他。
罗莎：好的 A. Fill in the missing information on the chart according to the conversation.PATIENT RECORDU/N:563421Surname: WilliamsGiven names: TroyDOB: 12.8.1951 Sex: MaleDateTimeTPRRBPPainCommentSign name5.6.201106:3036.872 110/720/10 Lisa(RN)5.6.201107:3036.776 108/680/10 Lisa(RN)5.6.201108:30 OT 5.6.201109:30 OT 5.6.201110:30 OT 5.6.201111:30 OT 5.6.201112:30 OT 5.6.201113:30 OT 5.6.201114:3036.278 120/76 PCALisa(RN)5.6.201115:3036.576 115/60 PCALisa(RN)5.6.201116:30 5.6.201117:30 A. Fill in the missing information on the chart according to the conversation.PATIENT RECORDU/N:563421Surname: WilliamsGiven name: TroyDOB: 12.8.1951 Sex: MaleDateTimeTPRRBPPainCommentSign name5.6.201106:3036.87218110/720/10 Lisa(RN)5.6.201107:3036.77618108/680/10 Lisa(RN)5.6.201108:30 OT 5.6.201109:30 OT 5.6.201110:30 OT 5.6.201111:30 OT 5.6.201112:30 OT 5.6.201113:30 OT 5.6.201114:3036.27827120/768/10PCALisa(RN)5.6.201115:3036.57620115/604/10PCALisa(RN)5.6.201116:30 Lisa(RN)5.6.201117:30 B.Read the following record. Find out the abbreviations in the Patient Record to match their meanings.PATIENT RECORDU/N:563421Surname: WilliamsGiven names: TroyDOB: 12.8.1924 Sex: MaleDate and TimeAdd signature, printed name, staff category, date and time to all entries11:0025/03/09New admission to the ward with a diagnosis of poorly managed asthma. Patient URTI treated with antibiotics. Pt still c/o SOB. RR elevated. For CXR and review by Respiratory Team in am. Started on p/f readings and Pt ed. Regarding asthma. G. Julie(RN) JULIE 1.respiratory rate: RR 2. peak flow; the most air which is expired: p/f 3. chest X-ray: CXR 4. patient education: Pt ed.5. upper respiratory tract infection: URTI6. shortness of breath; difficulty breathing (dyspnoea) SOB C. Figure out the meanings of the medical terms and then match. 1.apnoeaa.the patient has labored breathing or difficulty breathing2.bradypnoeab.the patient is not breathing at all3.eupnoeac.the respiratory rate is rapid; it has increased to between 20 and 30 breaths per minute4.tachypnoead.the patient’s breathing is slow rate; the respiratory rate is less than 12 breaths per minute5.dyspnoeae.the patient is breathing at a normal respiratory rate—between 12 and 20 breaths per minute C. Figure out the meanings of the medical terms and then match.1. b2. d3. e4. c 5. a D.Read the following patient record made by Dr Hans and answer the following questions.PATIENT RECORDU/N:563421Surname: AlexanderGiven name: EmilyDOB:23.3.1924 Sex: FemaleDate and TimeAdd signature, printed name, staff category, date and time to all entries05/04/09Surgical SHO SmithPt is consciousTachypoeic 36 RRAfebrileLung auscultation ↘ ↘AE bilat. BaselyNo crackles or wheezesPlan CXR in amFBC today pleaseAspirin to be restarted next week F.H.Hans HANS(bleeper 4321) Questions:1.Does Mrs. Alexander have a high temperature?No, she doesn’t.2.Are her respirations fast or slow? Her respirations are fast.3.When will she have the blood test done? She will have the blood test done today.4.Was she taking aspirin before? Yes, she was. Task 6 Giving an oral report of the caseRead the following medical document and then complete the tasks.Attached Hospital and Medical Center47 Yuquan South Road，，Xiaogan 432000 0712-2852116 PATIENT NAME: Hilary Nelson CASE NUMBER: 435678 DATE OF BIRTH:06/25/19** DATE:07/21/20**____________________________________________________________________________________CHIEF COMPLAINT: Hilary Nelson is a 35-year-old Asian female presenting with an episode of syncope at work, complaining of successive urination and thirst and fatigue for approximately 1 month.HISTORY OF PRESENT ILLNESS: For the past 4 weeks she has been having polyuria and polydipsia, drinking 4 to 5 quarts of water daily for the past 12 days. This has also resulted in nocturia, getting up 3 to 4 times a night to void. She denies anorexia, nausea, vomiting, hematemesis, or any abdominal pain.MEDICAL HISTORY: She is allergic to latex. No previous hospitalizations. She has a history of 10 years’ smoking. She has had no recent illness.FAMILY HISTORY: Mother died of a cancer at age 67. Father is still living at the age of 82, but has had diabetes mellitus for 15 years. She has three brothers, each of them in good health, and one sister.SOCIAL HISTORY: Unmarried without children. She quits smoking and uses alcohol rarely.PHYSICAL EXAM: Temperature, 98.5. Pulse, 78. Respirations, 23. Her blood pressure is 120/78. Her weight is 138 pounds, down 8 pounds since her last routine visit 2 months ago. HEENT: Normal. CHEST: Clear to auscultation and percussion. HEART: Regular rhythm. No murmurs or extra heart sounds. ABDOMEN: Soft, non tender, bower sounds normal, without evidence of organomegaly. RECTAL: Unremarkable. EXTREMITIES: No cyanosis, clubbing, or edema. Pedal pulses are intact. NEUROLOGIC: Alert and oriented to time, person and place. Cranial nerves II through XII are grossly intact.LABORATORY FINDINGS: Random blood sugar was discovered to be greater than 600 mg/dl. Urinalysis showed moderate ketonuria. Guaiac was negative.ASSESSMENT: Diabetic ketosis, most likely caused by Type 1 diabetes mellitus.。
PLAN: Administer IV fluids and insulin. Schedule endocrinology consult for this afternoon for complete diagnosis and treatment. Mary Maynard, MDSignature A.Find out the words that you don’t know in the above medical document and list them in the following chart. Look them up in the dictionary and write down their English definitions and Chinese meanings. An example is given. syncope: ['s k«p ] a spontaneous loss of consciousness caused by insufficient blood to the brain晕厥晕厥 B. Work in pairs to give an oral report to your partner. 。
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