Cron aan ence Men TCs Po ee Cee OC ety Symptoms Peery Ror cag Perri m a) OO — Symptoms and injuries ————— Vocabulary 1 Complete the text about emergency rooms with the words in the box. abdominal chest contusion injury respiratory sprain Why do people visic ER? The most common reason is for an '__, in most cases a strain, ?____ or 9______.. The second most common reason on the list is signs and symptoms of either *____or | *____ pain. People are also frequently brought into ER with = problems. 2 Look at the patients af in the Emergency Room and discuss. 1 Why do you think each patient has come to the Emergency Room? What health problems do they have? 2 Which order do you thi k the triage nurse should see the patie! Listening 3 Listen to the six patients describing their problems. Label the pictures a+f in the order you hear them 1-6. 4 Listen again and write the description of the problem next to the person asthma black eye bleeding broken wrist colic contusion heart problem infection nausea = SSVocabulary 5 Complete the sentences about the patients’ injuries and symptoms with the correct form of the words in the box. bleed breathe bruise cough dizzy (x2) infect pain (x2) sickness swell 1 Aisha is ____a lot and having difficulty 2. Sandip has _____ in his chest and feels : 3. Desiree is ____ heavily from a bad cut and is worried about 4 Jasmine has a bad stomach ___. Twice I gave her milk, but she was almost immediately. 5 Winston’ shoulder and wrist are very and painful. He banged his head hard and still feels ____ and nauseous. 6 Jason fell off his bike and has cuts and ____ on his right arm. 6 Complete the table with the correct word forms. Which nouns are synonyms for more formal medical words? Noun ‘Verb ‘Adjective _ blood ee bloody breathlessness _to be short of breath 2 to bruise bruised infection toe infected ___ a pan swelling toe swollen sickness tofeel/tobe® Language ‘Past simple v past continuous ‘We use the past simple tense to talk about finished | started taking gentle exercise and my asthma | actions in the past. symptonts improved. : : _| We use the past continuous to talk about continuous or You were coughing ail night - / heard you. | uninterrupted actions in the past. 7 Complete the sentences with the correct form of the verb in brackets. 1 Myson_____ (play) soccer in the park with his dad and he (fall over) and —____ (pull) a muscle in his leg. 2 Mywife (cough) all night so ____ (phone) the medical helpline. They ____ (tell me to make an appointment with her GP. 3. Kira_____ (run) a high temperature when the ambulance services, (bring) her 4. My headaches —__ (not / stop) immediately. The tablets | (take) _____ (no / be) strong enough. 5. The patient _____ (present) to ER at I 1pm. He ______ (suffer) from serious vomiting. 6 Can you tell me what you ____ (do) when your asthma attack (start)? 7 My father ____ (have) difficulties walking and he ___ (trip) and all) in the street. 8 1 (not think) and I__ (give) him the wrong dose of aspirin. He's only three. What should I do? I'm really worried.Asking about symptoms and injuries Speaking 1 Lookat the patient in this photo. Work in pairs and discuss these questions. 1 What are the patient's symptoms? 2 What do you think the patient is suffering from? 3 What do you think he was doing when his problem started? Listening 2 Listen to the nurse Interviewing Mr Daniels and check your answers in 1. 3 Listen again and complete the patient record. med TRUST @ hospital Patient Record ‘Mr Daniels s 54. He has pains inthe ' cond is suffering from 2. of breath The pain located inthe ’___ ofthe ches ond radiates down hs et cond up into his * The pain usually lasts for around * minutes. The pain began when he ’___ot his wotk place. The patient works in a supermortt. The ptint hs ulfered from the cocks fr *___—_ months. This is ‘attack. He is also suffering from problems with his" ‘he pain improves when he takes painkillers. He is" about his condition. He thinks siress makes his condition Vocabulary 4 Match the begi nurse's questions. ings 1-8 and the endings a-h to complete the 1 How would you describe a) how bad was the pain? 2 Can you b) move at all? 3 Ona scale of one to ten, ©) me how it started? 4. Does the pain 4) the pain in your chest? 5 How long e) makes it worse? 6 Can you tell 1) about your condition, Mr Daniels? 7 Anything that g) explain where exactly? 8 How do you feel hh) did the pain last this time? 5 Turn to audio script 31 on page 74 to read all the nurse’s questions and check your answers in 4. Answer these questions. 1 Circle all the closed questions (questions with only one possible answer). Underline all the open questions (questions that invite the patient to express their own ideas). What are the advantage and disadvantages of asking open questions? 3. What are the advantages and disadvantages of asking closed questions?6 Decide if these questions are Open (O) or Closed (C). Imagine the situation and write a possible answer for each question How are you feeling this morning? What happens when you get angina? When did James start feeling ill? Does it hurt when I press your abdomen just here? How bad is the pain? Tell me, what were you doing when the symptoms appeared? Were you taking your medication? Can you describe the symptoms to me? Tell me how it happened. 10 Are you still in pain? HTT TE 7 Compare your answers with a partner. Which questions do you think are more Useful in a nurse to patient situation? feet Poe These patients have common sports injuries. Complete the dialogues with the nurse treating them in ER. Use the question forms from 4 and 6 to help you. 1 Nurse: Can youtell me !__? Ahmed: I don't know. I was playing really well and then *_ Nurse: How many times*____? Ahmed: This is the first time. Nurse: Does it hurt when ‘___? Ahmed: Argh, yes, t's’ Nurse: Onascales________? Ahmed: 2 Nurse: Ooo, that looks painful. Tell me * Vicky: * Nurse: Do you have any other symptoms? Vicky: I'm not sure. What do you mean? Nurse; "for example. Vicky: Speaking 9 [MZEEM Listen and check. Did you ask the same questions? Work in pairs and practise the dialogues. 31Asthma emergency - giving instructions ‘Speaking 1 You are going to read some information from the WHO (World Health Organization) about asthma. What are the symptoms and causes of asthma? Work in pairs and discuss Vocabulary 2. Match the words 1-6 with the definitions a-f, 1 breathless a) to make part of the body feel sore 2 irritate b) a fine powder produced by flowers 3° mucus ©) having problems breathing 4 pollen d) to stop the feeling of pain 5 relieve e) to breathe noisily and with difficulty 6 wheeze ) a thick liquid produced in parts of the body Reading 3 Read the text and check your answers to 1. Label the diagram with the words in the box. asthmatic bronchiole. bronchialtubes diaphragm —_—eft lung normal bronchiole right lung windpipe Asthma — a global problem ‘Asthma i a chronic respiratory disease. The symptoms are a ‘tight’, chest, coughing, wheezing and difficulty in breathing. When a person with asthma comes into contact with something that irtates their airways, the lining ofthe bronchial tubes starts to swell, This makes the alrways narrower and itis more difficult for air to get in and out ofthe Lungs. Sometimes mucus is also produced. Al f these cause the patient to wheeze, cough and become breathless. + Asthma fs the most common chronic disease among children. + Asthma fs a major public health problem for many countries in the world ‘+ The country with the highest level of asthma is the United Kingdom, followed by New Zealand. + Over 80% of asthma deaths happen in low and lower-middle income countries. + The causes of asthma are not completely understood. It is hereditary (it runs in family and is passed from parent to Child) and is linked with allergies. Things that cause allergic reactions include: © indoor allergens (e.g. dust, pet hair) © chemicals in the workplace © outdoor allergens (e.g. pollens) © air pollution. © tobacco smoke Although there is no cure for asthma, it is possible to control the symptoms and enjoy a good quality of tife.Listening 4 [EZEEM Kyle Jenkins is attending an asthma clinic run by Nina, a practice nurse. Listen to the dialogue. Are these sentences true (T) or false (FY? Correct the false sentences. 1 The patient has suffered two asthma attacks this week 2. The patient was playing tennis with je his cousin when he had the last attack. 3. The patient's attack lasted about ten minutes. 4. The patient's best friend is also asthmatic 5. The patient is going to practise how to use his inhaler correctly. 5 Put these words in order to form sentences. Then put sentences a-e in order 1-5 to form a set of instructions for using an inhaler. a) don't breathe / on your / Take a puff / inhaler at the same time / but / out immediately = b) your breath / the inhaler / Remove / for 10 seconds /hold /and. ©) the mouthpiece / as possible / as deeply / Place / breathe in / and / between your lips = « ifnecessary / Breathe / and / repeat / out slowly = ©) back slightly / tilt your head / gently / and / Breathe out aie Language ‘The imperative We use imperatives to give clear, simple instructions toa | Take your tim. patient. Don't le down, We can use staging words, 0.9 frst, then, next, finaly First, breathe out. Then, blow into the mouthpiece. followed by a short pause to make it easier forthe pationt io Understand the instructions. | 6 Use the verbs in the box to complete the instructions the practice nurse gives Kyle in an emergency. call continue lean liedown —put'— repeat sit’ take. \__ down at a table. Don't * 3 forward slightly and “____ your arms on the table. ’_______up to six puffs of your inhaler. an ambulance after six minutes if your symptoms don’t improve. to take your inhaler every six minutes, for a maximum of six puffs. these steps, if your symptoms begin again. Speaking 7 Rewrite the instructions in 6 to include staging words. Work in pairs and take turns to practise reading them aloud. Pause slightly after each staging word. Then listen and check,SOAP notes Patient Name: Kyle Jenkins Dos: 06.04.2001 Record No: — T7-5810 11133, Subjective: ‘My chest feels all tight” Objecti RR 28, wheezing, SOB, abdominal exertion Assessment: breathing pattern rt asthma Plan: 1) position pt in High Fowlers 2) administer meds via nebulizer Reading 1 Look at the SOAP note that Nina wrote about Kyle. Then read the text about SOAP notes. Complete the text with the words in the box. documents help measure summary symptoms _—_treat SOAP notes are '____ that nurses use to record information about a patient. A SOAP note has four parts — Subjective, Objective, Assessment and Plan. | The Subjective is whac the patient says about his or her problem. It is the* the pacient (or che patient's family) describes. ‘The Objective is what the nurse sees or observes at che time. It is the symptoms that the nurse can see, feel, hear, touch and » ; The Assessment is the nurse's ‘_____of what the patient's immediate medical problems are. ‘The Plan is what the nurse plans to do to ”____ the patient’s symptoms and § with the problem. Vocabulary 2 Read Kyle's SOAP note again and find the expressions or abbreviations in the note which mean the following, medicine or medication patient related to short of breath his abdomen is working hard because he is having problems breathing give respiratory rate 8. apiece of equipment that administers medication that the patient breaths in Speaking 3 What is High Fowler's? How does High Fowler's help an asthmatic patient? Explain how to position a patient into the High Fowler's position.Reading 4 Look at the SOAP notes for the two patients below and answer these questions. 1... suffers from arthritis? 2... would like to lose weight? 3... will see their old school friends a year from now? 4... will have their next appointment in three months? 5 6 doesn’t suffer from drug allergies? has to write down their feelings in a diary as part of their treatment? [ | Patient Name: Nancy Suzman DOB: 14.10.62 Geraldo Record No. FM-967-PPK DOB: 1705.1957 S ‘I've a been overweight since Record No. the birth of my twin daughters in YF- 556-Uli68 2001 and | get frustrated trying S ‘t've had this pain to diet. My 25-year reunion is next year and Id really like to lose some weight? NKDA, NKA. Wt = 95 kg Ht = 1m 60 IBW = 115 kg Chol = 255 BP = 120/75 A Obese at 183% IBW, hypercholesterolemia P. Long Term Goal: Change lifestyle habits to lose at least 27 kg over a 10-month period. Short Term Goal: Client to begin a 1500 calorie diet with walking 30 minutes per day. Instructed Pt on lower fat food choices and smaller, food portions. Client will keep a daily tod and mood record to review next session. Follow-up in one week. Patient Name: Massimo in my right knee for four months; its worse when I walk or do any exercise’ NKDA. Wt. 69 kg, Ht.1m 67, normal ROM both knees no redness or swelling Possible osteoarthritis; R/O rheumatoid arthritis, (1) blood work-sed rate rheumatoid factor (2) X-ray R knee PA and lateral (3) ibuprofen 400 mg ti.d. p.o. (4) recheck in 3 months. Signature: Mae. Fares Signature: A/20. Fasv-es Vocabulary [Abbreviations key: IBW = ideal body weight ood sugar [Link].= twice a day ‘Chol = cholesterol rine analysis ABC = airways, breathing, right circulation let IBP = inettective breathing PA-= posteriorlanterior mg = milligram pattern NKDA-= no known drug tid. = three times a day © = oxygen allergies .0.= by mouth [Link].= as required NKA=no known allergies IAC = inetfectve airway clearance hr = hour 5 Work in pairs. Practise saying these abbreviations as complete words. Speaking 6 Work in pairs. Student A, look at the information below. Student B, turn to page 68. Dictate the nursing terms to your partner, who will write the abbreviation. Add seca ‘two more of your own examples, When you have finished, swap roles. biood test : : thatcan show > Gholeterl «Sno Bown allerges 5 urine anals Mere, 3 rule out 6 ineffective airway clearance ~ activity in the body 35