Lesson 1

I’m a Medical Student

VOCABULARY

nurse [nE:s] медсестра, медбрат

noble [nqVbl] благородний
anatomy theatre [q'nxtqmi TIqtq] анатомічна зала
to gain knowledge ['nPlIG] здобувати знання
skill [skIl] вміння, навик
fundamental ["fAndq'mentl] основний, базовий
credit test ['kredIt test] залік
department [dI'pRtmqnt] відділення
vital signs ['vaItl saInz] життєво важливі ознаки
to record [rI'kLd] записувати
case history ['keIs hIstri] історія хвороби
to administer [qd'mInIstq] призначати
treatment ['trJtmqnt] лікування
procedure [prq'sJGq] процедура
research ['rJsE:C] наукове дослідження
to attend [q'tend] відвідувати
scientific ["saIqn'tIfIk] науковий
society [sq'saIqti] гурток
guideline ['gaIdlaIn] вказівка
responsibility [rI"spPnsq'bIlqti] відповідальність

LEAD-IN

 Why is it important to make the right choice of a profession?

 Who helped you to choose your occupation?
 Why have you decided to become a nurse?

READING
1
 I am a Medical Student
My name is Vlad Boiko. I am from Ukraine. I am 17 years old. Now I
am a third-year student of the Professional Medical
College of Ivano-Frankivsk National Medical
University, one of the most famous higher medical
schools in our country. I’m going to become a nurse. I
consider this profession to be very noble and interesting.
I like my student life. We go to classes, spend time with our
groupmates, go to hospitals where we meet patients and try to learn how to
communicate with them. After classes we have to do hometasks, go to the
library or visit anatomy theatre.
Nursing education consists of the theoretical and practical training.
Students gain knowledge and skills that are required to take care of people
who are in need of attention. First-year students study fundamental medical
and biological disciplines. Then they study clinical subjects and nursing in
different situations. At the end of each term the students take credit tests and
exams. Much time is devoted to the work in Anatomy classes and laboratories.
We have practical courses at different departments in hospitals and
clinics. We are taught to take the vital signs, to record the patient’s case
history, to administer treatment and to carry on different medical
procedures. There are all facilities for talented students to carry on
research work. They attend scientific societies at different departments
where they are offered modern guidelines for research activity.
I understand that it is necessary to study a lot to become a good
specialist. I also understand that this profession requires great
responsibility. I believe that the study at college will help me to gain
professional knowledge to become successful in future.

1. Read the text and answer the following questions.

1. What do you know about Ivano-Frankivsk National Medical

University?
2. What does nursing education consist of?
3. What subjects do you study here?
4. What skills are you taught at college?
5. What can you do now to become a good specialist in future?
2
2. Match the words to make word-combinations. Use them in the
sentences of your own.
1. Nursing a) student
2. third-year b) profession
3. higher c) education
4. noble d) training
5. anatomy e) procedure
6. theoretical f) medical school
7. surgical g) responsibility
8. medical h) theatre
9. great i) activity
10.research j) department

3. Read the nurses’ grades which are used in Britain and match
them with their definitions.
charge nurse nursing auxiliary staff nurse district nurse
nurse manager student nurse ward sister
1. a nurse who is still in training
2. a nurse who has completed the training course
3. a more experienced nurse responsible
for a ward or department charge nurse
4. a nurse who is in charge of several wards
5. a senior nurse in charge of a ward
6. an unqualified assistant to a nursing practitioner
7. a nurse who goes to people’s houses to give them
medical treatment and advice

4. Odd one out.

1. a)Architecture b) Medicine c) Pharmacy d) Dentistry

2. a) hospital b) college c) university d) school

3. a) interesting b) fascinating c) exciting d) boring
4. a) teacher b) physician c) rector d) professor
5. a) discover b) learn c) relax d study
3
 6. a) staff nurse b) charge nurse c) ward sister d)manager’s sister
Lis
LISTENING
5. Look at the notice board. Then listen to three conversations.
. Write the name of each person and the number of the
conversation (1-3) next to the job titles (a-e).

1. - Hello, I’m Staff Nurse Gillian Campbell.

- Hi, I’m Amy Bower. I’m a healthcare assistant for Ward C.
- Nice to meet you, Amy.
2. - Excuse me, are you Ward Sister Margaret Jenkins?
Yes, I am.
- Pleased to meet you. I’m Charge Nurse Paul Gallagher.
- Good to meet you, Paul.
3. - Hi. My name’s Paul.
- Hello, Paul. I’m David. So, where are you from, Paul?
- I’m from Dublin. I’m the new charge nurse. What do you do on
the ward?
4
 - I’m a student.
LANGUAGE PRACTICE

I he / she / it you / we / they

+ I am a student. + He is a staff nurse. + You are my friend.
- I am not a nurse. - She isn’t a teacher. - We aren’t groupmates.
? Am I right? ? Is it interesting? ? Are they in the ward?

6. Complete these conversations with the correct form of be.

.
1 Mike: Hello, I (1) _____ Staff Nurse Mike Davies.
(2) _____ you the charge nurse?
Sonya: Hi. Yes, 1 (3) _____ . I’m Sonya Varma.
Mike: Nice to meet you, Sonya. Where are you from?
Sonya: I’m from India.

2 Student nurse: Excuse me, (4)______ you Ward Sister

Kennedy?
Sister: No, I (5) _____ not.
Student nurse: Oh! Sorry about that. (6) _____ she in Ward C?
Sister: No, she (7) _____ . She (8) _____ in Ward B.
Student nurse: Oh, OK. Thanks a lot.

3 Student nurse: Excuse me, I need a healthcare assistant.

Healthcare assistant: I (9) _____ a healthcare assistant. Can I help
you?
Student nurse: Hi, sorry. I (10)______ a student nurse. 1 need a
little help.
5
 Healthcare assistant: No problem. What do you need?

PRESENT SIMPLE
 he works
 facts, habits,  he does not work
permanent situations ? does he work?

+ verb / verb+s I study at college.

- do/does not + verb He doesn’t study at college.
? do/does … + Where do you study?
verb?

7. Read the text about part of a nurse’s daily routine. Rewrite the
text changing I to she and underline the changes.
I am 18 years old. I study for a diploma in nursing at Denver Nursing
College. I want to be a nurse because I like working with people and I’m
interested in science, but I really don’t like doing paperwork. I intend to be
a pediatric nurse as I really enjoy working with children. One day I hope to
work in a children’s hospital in London, which I saw on television. I’m
good at talking to people and making them feel comfortable, and I’m very
organized. In my free time I play the guitar, and go out dancing most
weekends.
She is 18 years old. She studies for …

8. Put the words in the correct order to make questions a patient

might ask a nurse.
1. normal / my / are / analyses Are my analyses normal?
2. have / you / coffee / do
3. need / to have / do / an injection / I
4. much / I / weigh / do
5. all / pulse / is / my / right
6. the doctor / does / receive / today / patients

9. Look at these sentences that a nurse or patient might say.

Complete the sentences with the correct form of the word in
brackets.
6
 1. The bathroom is (be) outside on your left.
2. What _____ (be) your date of birth, please?
3. The nurse _____ (not have) a lot of free time.
4. This tympanic thermometer _____ (take) a patient’s temperature.
5. Our hospital number _____ (be) 463817.
6. The machine _____ (say) your blood pressure’s fine.
7. I _____ (not be) allergic to morphine.
8. Your daughter _____ (weigh) 22 kilos.
9. (be) _____ there anything else you need?
10. He _____ (have) a slow pulse. It’s 56.


WRITING

10. Read Luna Gomes’ application and complete her CV format.

. Think about where you want to be 10 years from now and write
your own letter of application to get a job in your favourite
hospital.
Dear Madam,
I have recently learned from RN Pauline Leblanc that there is an
opening for nurses in the ICU, OR, and ER in the International Clinic. I
want to apply for the post in the OR as an experienced nurse.
I am 32 years old, Canadian, with a Bachelor Degree from the Minas
University and a Diploma from the a Bachelor Degree from the Thomas
Jefferson University where I spent 6 months on a postgraduate course on
the management of diabetic patients. I have been a registered nurse since
2016. I can speak English, some Spanish and French of course! I worked at
the A&E in the Minas General Hospital till 2020. At present I am at the same
hospital but working as a charge nurse in the ICU. I would like to work at
your International Clinic where I can share my experience and my skills.
I am married. I have 2 children, and we would be happy to move
overseas. I am a hard-working nurse – some of my colleagues say I am a
workaholic, independent and enjoy challenges. If references are needed, I
can provide them. CV follows.
I look forward to your reply.
Sincerely yours,
7
Sister Luna Gomes
3693 Queens Sq, Toronto
Ontario, Canada
Phone number 519-223-1776
CURRICULUM VITAE Luna Gomes Yours
Name and Surname:
Place of birth:
Nationality:
Marital status:
Permanent address:
Present position:
Employment history:
Education/Qualifications:
Languages:

SPEAKING
11. Do this in pairs! Ask your partner more about her/his personal
.
information. Use this questionnaire. After asking your partner, take
turn to answer his/her question.
1. What’s your name? 1. My name is …
2. Where are you from? 2. I’m from …
3. Where do you live now? 3. I live in …
4. What three words best 4. I’m …, … and …
describe you? 5. I think it’s …
5. What is your greatest 6. One of the things I … about
my lifestyle is …
achievement?
6. What do you like most/least
about READING EXTENSION
12. Choose the correct
.
prepositions in the following sentences.
Since/From online distance learning is becoming a widely accepted
path for/at higher education, it opens for/up a lot of possibilities about/for
nursing students. Taking the online path to earning a nursing degree on/in
the Internet makes sense for/ from a lot of people who want to further
their education or perhaps change careers. There are several online
universities abroad that offer a Bachelor of Science degree at/in Nursing

8
and even opportunities to earn a Master’s degree too. Most programs
generally follow a typical college semester, just as if/while you were
attending an ordinary school. However, when/where earning an online
nursing degree, you can study and complete assignments for/on your own
time clock. You have the power of/from structuring your schedule, fitting
in/for your studies from/with other responsibilities like jobs and children.

9
 Lesson 2
Healthcare Facilities

VOCABULARY

health care ['helT keq] охорона здоров’я

healthcare facility ['helTkeq fq'sIlqt медична установа
i]
pharmacy ['fRmqsi] аптека
staff [stRf] персонал
to be equipped [I'kwIpt] бути оснащеним
diagnosis ["daIqg'nqVsIs] діагноз
surgical ['sE:GIkl] хірургічний
injured ['InGqd] поранений
cancer ['kxnsq] онкологічне захворювання
psychiatric ["saIki'xtrIk] психіатричний
illness ['Ilnqs] захворювання
geriatric ["Geri'xtrIk] геріатричний
terminally ill ['tE:mInqli Il] невиліковно хворий
ambulance crew ['xmbjqlqns krH] бригада швидкої допомоги
intensive care [In"tensIv 'keq] відділення інтенсивної
терапії
to admit [qd'mIt] госпіталізувати
emergency [I'mE:Gqnsi відділення екстреної
department допомоги
dI'pRtmqnt]
to schedule ['SedjHl] планувати, складати
inpatient care ['InpeISnt] стаціонарний догляд
recovery [rI'kAvqri] одужання
outpatient care ['aVt'peISnt] амбулаторний догляд
shift work [SIft] позмінна робота
bedside manner ["bedsaId 'mxnq лікарський такт, манера
]

LEAD-IN
 What healthcare facilities are there in our country?
10
  Which hospital departments need nurses the most?
 Have you ever stayed overnight in hospital?

READING
At the Hospital
Healthcare facilities are places that provide health care for people.
They include hospitals, clinics, specialized care centers, pharmacies and
doctors’ and dentists’ offices.
A hospital is staffed and equipped for the diagnosis, treatment, both
medical and surgical, of the sick and the injured; and for their housing during
this process. Some hospitals specialize in particular
conditions like cancer or psychiatric illness. Other
hospitals specialize in particular types of patients like
geriatrics, children, or the terminally ill. However,
the best-known type of hospital is the general
hospital which deals with almost everything, has
ambulance crews and beds for both intensive care and long stay. A teaching
hospital integrates patient care with medical students as well as nurse
education.
People may be admitted to the hospital through the emergency
department for problems that need immediate medical treatment. Others are
scheduled to have surgery, special medication, or other treatments prescribed
by their doctors. If they receive inpatient care, they will be monitored by a
healthcare team in a hospital throughout their treatment and recovery.
Outpatient care, also called ambulatory care, does not require hospitalization.
Hospitalized patients need nursing care 24 hours a day; therefore, shift work is
needed.
Working days at the in-patient department are very busy. Sometimes
cases are complicated. Work at the hospital requires deep knowledge of
medicine, quick thinking, and a great sense of responsibility. A good bedside
manner is also of great importance.

1. Read the text and answer the following questions.

1. What is a hospital?
11
2. What types of hospitals do you know?
3. What is the difference between inpatient and outpatient care?
4. Why do people need to go to the hospital?
5. What does work at the hospital require?
2. Match the opposites.
1. busy 1. long
2. good 2. common
3. quick 3. quiet
4. short 4. gradual
5. sick 5. simple
6. particular 6. outpatient
7. pediatric 7. bad
8. immediate 8. healthy
9. complicated 9. slow
10.inpatient 10. geriatric

3. Use the words in the box to complete the definitions of these

hospital departments.
X-rays babies children operations elderly exercises heart kidney
nervous system skin disorders test results emergency cases
1. Casualty is the place where they treat _____ .
2. Surgery is where surgeons carry out _____ .
3. Medical staff in the Renal Unit specialize in _____ diseases.
4. The Dermatology Department is where they deal with _____ .
5. Specialists in Geriatrics treat problems related to the _____ .
6. Pathology is where they analyze patient _____ .
7. Midwives deliver _____ in the Maternity Unit.
8. Pediatrics is where they treat _____ .
9. Patients with _____ disease visit Cardiology.
10. The Radiology Department is where they take _____ .
11. Disorders of the _____ are treated in the Neurology Department.
12. In the Physiotherapy Department, patients learn special _____ to help
them recover.

4. Write a word that is similar in meaning to the words in bold.

. 12
1. An ambulance brought the patient to the A&E. a) Paediatrics
2. As her husband suffered from excruciating renal
colic, he was admitted to Renal Unit. b) Casualty
3. He became the Chief of Hepatology Department
when it was created in January 2021. c) Otolaryngology
4. Andrew’s son is sick, so he takes him to the
d) Cardiology
Children’s Unit.
5. Alex is at the Cardiac Care Unit because his heart e) Nephrology
is beating abnormally.
6. My sister is pregnant; so, she must be in the Obs f) Gastroenterolog
and Gynae.
7. Francesca is going to the ENT Unit to pick up her y
prescription.
g) Gynaecology

5. Signs and symbols make hospitals and other healthcare facilities

. easier to navigate. Match the symbols a-i with the facilities 1-9.
1. canteen 4. pharmacy 7. cashpoint
2. registration desk 5. waiting area 8. toilets
3. vending machine 6. coffee shop 9. gift shop

Lis
LISTENING
6. You are going to hear people giving directions to different
. hospital facilities. Listen and complete the instructions.
1 Visitor: Excuse me; I’m looking for the canteen. Can you help me?
Nurse: Yes of course. Go _____ _____ and it’s in _____ _____
you, _____ the _____ of the corridor.
13
2 Visitor: Excuse me, do you know where the Maternity Unit is?
Nurse: It’s on the _____ floor. Turn _____ here, go straight on, and
when you get to the information desk, _____ right. At the
end _____ the corridor, _____ _____ again and take
elevator A. The Maternity Unit is the first door on the left.

3 Visitor: Hello. Do you know if there’s a shop in the building? We

want to buy some magazines.
Nurse: Sure. Just _____ _____ here and _____ down the corridor,
there’s a gift shop _____ _____ the pharmacy. You can buy
magazines there, I think.
LANGUAGE PRACTICE

PREPOSITIONS OF PLACE

 in a room  at the bus stop  on the ceiling

 in a building  at the door/window  on the floor
 in a town/in a country  at the top/bottom  on the wall
 in the ocean/river.  at the entrance  on the table
 in a lift  at work  on the page
 in the hospital.  at sea  on the left/right.

7. A Senior Staff Nurse is explaining the layout of the hospital.

Choose the correct prepositions in italics to complete the explanations
1-6.
1. The car park is in front / inside / opposite the main entrance.
2. There’s a sign under / over / at the door.
3.. Turn left / away / on after Pathology.
4. The Pharmacy is the second door on / at / opposite the right.
5. The Dermatology Department is between / at the Neurology
Department at / and / in Geriatrics.
6. Room 246 is at / in / on the 8th floor, just on in front of / the left of the
lift.
14
7. You can find the Renal Unit at / in / on the first floor, opposite / at
Pediatrics.
8. Your wife is at / in / on the Maternity Unit at / in / on the end of the
corridor.
9. The Geriatrics Department is next to / between the Dermatology
Department at / in / on the second floor.
10.I think that Mrs Adams is sitting over there, between / in front of the
vending machine.

8. Complete the sentences with the prepositions below.

.
at by in on next to outside over under
1. The toilets are _____ the ground floor, _____ reception.
2. I always keep a pen _____ my pocket.
3. Press the button _____ your bed if you need the nurse.
4. I’ll put your bag _____ your bed, out of the way.
5. The Neurology’s _____ the top of the building, so take the lift!
6. Reception is _____ the main entrance, _____ the left.
7. See that door over there? The car park is just _____ .
8. He’s _____ Ward 3, _____ the end of this corridor.
THERE IS/THERE ARE
We use there is/there are to say that somebody or something exists.
+ There’s a toilet in the + There are some patients in the
- ward. - waiting room.
? There isn’t a toilet in ? There aren’t any patients in the
the ward. waiting room.
Is there a toilet in the Are there any patients in the
ward? waiting room?

9. Complete these sentences with the correct form of there is / there are.
1.. _____ a conference room next to the physicians’ area. (+)
2. _____ two visitors’ toilets down the hall. (+)
3. _____ an X-ray machine in the physicians’ area?
4. _____ an utility room next to the patient room. (-)
15
5. _____ two beds in Mr Rabine’s room?
6. _____ any bandages in the clean supply room. (-)
7. _____ one private and twelve standard wards in this unit. (+)
8. _____ three doctors and one patient in the canteen. (+)

WRITING
10. Use the map and complete the spaces in the email to explain how
to. get to the City Hospital. Then write an email giving your friend
directions to where you work or study from the bus or railway station.
Dear Mr Keane,
Here are the directions you asked
for from the railway station to the
City Hospital Renal Unit.
Leave the railway station at the
main entrance. Turn (1) ____ and
walk along Station Street for about
100 metres. Go (1) ____ the road to
the number 45 bus stop. Take the
bus to the hospital.
Get off the bus opposite the
hospital. Walk (1) ____ Byron Avenue
and take the (1) ___ left. The door to
the Renal Unit is on your (1) ____.
11. Work in pairs. Take turns to ask and answer questions about the
.location of different places in the hospital. Use questions like these.
Excuse me, I’m Do you know Could you tell me
looking for the where how to get to...,
... the ... is/are? please?
READING EXTENSION
12. Choose the correct prepositions in the following sentences.
. A big hospital is like a small town; it needs thousands of/from people to
make it work. All these people are organized into/with teams and each person
in each team has their tasks. At/In the past, the health care team’s chain of
command was simple: doctors made decisions and gave senior nurses orders.
Senior nurses then instructed junior nurses, and so of/on. Things are changing.
In many countries nurses have much more responsibility than they once had.
One thing is not changing; it is still a doctor who is in/with charge of a
16
patient’s treatment. It is not only doctors and nurses who deliver treatment and
care for/towards people; there are many other specialists too.
For example, there are physiotherapists who specialize at/in exercises to
treat injury or dysfunction and occupational therapists who help patients
manage every-day living. There are also many people the patient does not
meet like lab technicians doing the tests and pharmacists dispensing
medicines. Like any town, a hospital has teams for/of office staff and auxiliary
workers such as porters, orderlies, technicians, drivers, cleaners, receptionists,
and cooks. There are also volunteers who, between/without pay, raise money
in/for the hospital and run shops, cinemas, libraries, and restaurants.

17
 Lesson 3
Emergency Medical Care

VOCABULARY

emergency [I'mE:Gqnsi] швидка (екстрена) медична

medical care допомога
victim ['vIktIm] жертва
road traffic [rqVd 'trxfIk дорожньо-транспортна
accident пригода
'xksdqnt]
violence ['vaIqlqns] насилля
poisoning ['pOIzqnIN] отруєння
burn [bE:n] опік
life-threatening ['laIf TretnIN] життєво небезпечний
unconscious [An'kPnSqs] непритомний
blood [blAd] кров
incident ['InsIdqnt] подія, випадок
train crash [krxS] залізнична катастрофа
triage ['trJRZ] тріаж, медичне сортування
surgery ['sE:Gqri] оперативне втручання
medical kit [kIt] медична аптечка
stretcher ['streCq] ноші
paramedic ["pxrq'medIk] парамедик
to assess [q'ses] оцінювати
to apply a splint [q'plaI] накладати шину
cardiopulmonary ["kRdiqV"pAlmqn серцево-легенева
resuscitation qri реанімація

rI"sAsI'teISn]
intubation ["Intju'beISn] інтубація
sore throat ["sL 'TrqVt] хворе горло
heart attack ['hRt qtxk] серцевий напад

LEAD-IN

 What are the most common emergencies?

18
 What are some injuries that first aid can help?
 What kind of patients should be treated before others?
READING
Emergency Medical Care
Every day of the year people come through the doors of A&E
departments. They may be victims of road traffic accidents, violence,
accidents at home, poisoning, burns, and so on. A&E is for people who are in
life-threatening situations: seriously injured, unconscious or losing a lot of
blood.
It is typical for an emergency department that the number of patients
varies, and situations are unpredictable; thus,
the emergency department is crowded, and it
may take a long time to get treatment. When
A&E departments have multiple casualties, after
a major incident like a train crash, they have to
decide who is a priority and who can wait. To do this they use a procedure
called triage. They sort patients into groups: those who need immediate
surgery, those who are stable but need hospital care, and those who only
need first aid. People who are going to die are not a priority for medical care.
Skilled medical practitioners work in teams of two per ambulance. Each
ambulance is furnished with a full medical kit, including the appropriate
medical equipment and medication, plus a stretcher. Before emergency
patients’ hospitalization it’s the duty of paramedics to respond to medical
emergencies outside a hospital setting. They must rapidly assess a patient and
the situation in order to provide appropriate care. Paramedics may perform
procedures to stabilize a patient’s condition, such as applying a splint or
stopping bleeding. In addition, lifesaving procedures may be needed, such as
cardio-pulmonary resuscitation, intubation and medication administration.
Nursing in A&E is fast moving and interesting. As an emergency nurse,
you’ll treat a variety of conditions from sore throats to heart attacks. The
practice of emergency medicine requires both a broad knowledge base and a
large range of skills; the ability to provide immediate care is fundamental.
1. Read the text and answer the following questions.
1. What are the duties of an emergency medical dispatcher?
2. Each ambulance is furnished with a full medical kit, isn’t it?
19
3. Who provides medical care in the prehospital environment?
4. What do emergency nurses do?
5. What is the emergency physician’s role?
2. Find in the text the terms for the following definitions. The first
letter is provided.
1. an unpleasant and unintended event that results in injury,
loss, damage, etc.; a
2. a device for transporting the ill, wounded, or dead; s
3. a set of materials and tools used for giving first aid; m k
4. physical damage to someone’s body caused by an
accident or an attack; i
5. a specially equipped vehicle used to transport the sick or
injured; a
6. the process of prioritizing patients who are taken to a
hospital; t
7. a person who is trained to do medical work, especially
emergency first aid, but is not a fully qualified doctor; p
8. a medical specialty that provides medical care to people
with life-threatening or urgent healthcare needs. e m

3. Choose the word or phrase from the list (a-f) which has the same
meaning as the underlined words in sentences (1–6).
1. The patient is conscious – you can talk to her a) awake and alert
now. b) critical
2. Remove the pads from his chest.
3. Make sure you keep his head still – you might c) immobilize
injure his spine. d) take off
4. He needs treatment immediately.
e) right now
5. If the procedure is not successful, you may have
to do it again. f) repeat
6. Her condition is serious, but not life-threatening.

4. Read how patients describe their problems and do the matching

exercise below.

20
1. Anyway, I cut myself really badly with a chopping
knife and I just can’t get the bleeding to stop. a) asthma
2. But it’s my eye that’s the worst - it’s so badly
bruised I can’t open it. Can I get it checked by the b) black eye
doctor?
3. My wrist doesn’t look right: I can’t move my fingers c) bleeding
- that means I’ve broken something doesn’t it?
4. I was getting out of the bath when I felt a sharp
d) broken wrist
stabbing pain in my chest and suddenly, I was very
breathless and started feeling very dizzy.
5. Aisha started having difficulty breathing. She was e) colic
coughing a lot and she said her chest felt tight.
6. It’s my little girl. Jasmine. She seems to have really f) heart
bad stomach pains – she keeps arching her back and
crying. problem

5. Odd one out.

1. a) accident b) burn c) poisoning d) polluting

2. a) awake b) responsive c) reactive d) unconscious
3. a) resuscitation b) intubation c) transfusion d) assessment
4. a) trembling b) shaking c) suffocating d) shivering
5. a) choking b) bleeding c) seizure d) earache
6. a) moody b) irritable c) cheerful d) unstable
21
 7. a) lose b) gain c) put on d) increase
8. a) invasive b) nauseous c) sick d) woozy

Lis
LISTENING
6. Listen to a conversation between a nurse and a patient in an
. emergency room (Track 4). Mark the following statements as true
(T) or (F) false.
1. The patient has a third-degree bum.
2. The nurse gives the patient medicine for his pain.
3. The patient’s cut must be cleaned and covered.

Listen again and complete the conversation.

Nurse: Hello, sir. Don’t worry, everything’s going to be okay. What
happened?
Patient: There was an (1) ____ at work. A machine caught fire behind
me.
Nurse: Okay. Where are you (2) ____?
Patient: My back hurts pretty badly. I think it’s (3) ____.
Nurse: I can see that. But I don’t think it’s too serious, though.
Patient: Really? How can you tell?
Nurse: Well, it’s blistering, and that’s a good sign. It means it’s
probably not a (4) ____-____ ____.
Patient: That’s good. It still hurts, though.
Nurse: Of course. I’ll get an icepack to (5) ____ ___ ____ . That
should make it feel a bit better.
Patient: Thanks. I also cut my hand as we were trying to put the fire
out.
Nurse: Okay, we just need to (6) ____ it and get a bandage over it.
Patient: All right. Thank you so much.

LANGUAGE PRACTICE
THE IMPERATIVE
We use imperatives to give clear, simple Help me.
instructions to a patient. Don’t stand up.
22
 We can use staging words, e.g. first, then, next, First, breathe out.
finally followed by a short pause to make it Then, show me your
easier for the patient to understand the throat.
instructions.
The first thing you have to do is... Oh, and by the way, don’t forget
After you’ve done that... to...
The next thing to do is... Make sure you remember to...
Oh, and be careful not to...

7. Match the beginnings and endings of the sentences to get

. imperatives.
1. Take these a) and then talk about your problem.
2. Do more b) any noise!
3. Be c) be afraid.
4. Please close d) careful!
5. Please don’t make e) exercise.
6. Sit here f) for five minutes.
7. Don’t forget g) here, please.
8. Wait h) medicines every day.
9. Don’t i) the window.
10. First, sit down, calm down, j) to buy a thermometre, Jane.

8. Select the appropriate expression to make polite requests in each

of the following situations.
1. Mr. Suarez is being prepared for an operation. The nurse asks him to
wear a sterile gown.
a) Take off your clothes and wear this gown.
b) Would you take off your clothes and wear this gown?
2. When inspecting the patient’s mouth, the nurse asked him to remove
his dentures.
a) Would you remove your dentures, please?
b) Take your dentures out.
3. Mr. Suarez is being taken to the OR. He will be transferred on a
stretcher. The nurse asks him to lie down on it.
a) Mr. Suarez, get out of bed now. Get on the stretcher.
b) Can you lie down on the stretcher, please?
23
 4. The day after the operation the nurse in charge is asking Mr. Suarez
to ambulate. Ambulating reduces complications of immobility.
a) Get up and try to walk!
b) It would be good for you to take a walk. Walking will help you to
feel better.
9. Use the words in brackets to make the instructions gentler. Add
additional words and change the punctuation where necessary.
1. Keep your leg still. (I’d like / for me / if you can)
2. Tilt your head forward. (could / slightly / for me)
3. Raise your arm a bit more. (now/ I’d like / for me / if you can)
4. Pop up on the couch. (can/ just /for me)
5. Roll up your sleeve. (could/ for me / please)
6. Bring your knees up further just / a bit / for me.)
7. Tell me what your date of birth is. (Can / please)
8. Lean forward (if you can/ just / slightly / for me)
9. Move more towards the edge of the trolley. (can / just / a little / for me /
please)
10.Stand up. (can / for me / please)


WRITING

10. Read this set of first aid instructions for bruises. Then, write first
. aid instructions for non-medical people for the treatment and care
of cuts and grazes including the information below.
How to treat bruises
• Apply ice to the bruise to reduce swelling.
• Raise the bruised area so that it is higher than the heart. This reduces
internal bleeding.
• Get medical advice if the bruise doesn’t get any better after 24 hours

 cleaning and hygiene  dressings

 how to stop bleeding  what to do if the bleeding
 antiseptics does not stop
SPEAKING
24
11. Match (1-4) to (a-d) and get ready to talk about emergency
. procedures for a person whose heart has stopped or is no longer
breathing.
1. mouth-to- a) Put your hand on his chest and your other hand on
mouth top of it, push down a little and release. Count up to
four after each push. Repeat the procedure fifteen
times.
2. chest b) Now set up IV and give him Lidocaine. The dosage
compressions is 100 ml over two minutes.
3. defibrillation c) Hold the patient’s nose closed, open his mouth and
give two full breaths into it.
4. medicating d) Set the charge on the defibrillator at 200, apply the
pads on each side above and below the heart. Make
sure you don’t touch him, press the button and hold
for two seconds.
READING EXTENSION
12. Read the first aid poster. Then, choose the correct answers.
. A seriously injured person needs immediate attention from
paramedics or other emergency medical personnel. However, you can help
the injured person before medical professionals arrive.
First, check for responsiveness. If an injured person is unresponsive,
check for breathing and a pulse. If these are missing, perform CPR
(cardiopulmonary resuscitation). CPR consists of chest compressions,
designed to restart the heart and circulate oxygenated blood, and rescue
breathing, designed to provide oxygen for someone who cannot breathe on
their own. If a defibrillator is available, this is an easier and more effective
way to reset an abnormal heartbeat.
Sterilize any open wounds that an injured person has and place a
bandage over them. Look for blisters that indicate a first- or second-degree
burn and cool them with cold running water. For those in shock, elevate
their feet, cover them with a blanket, and get help. People with serious
injuries such as third-degree burns require painkillers like morphine and
other treatments that you cannot provide. Wait with the injured person
until help arrives.
25
1. The poster is mostly about how to
a) perform CPR.
b) help injured people.
c) administer morphine.
d) identify third-degree burns.
2. What is the first thing a person should do to an unresponsive person?
a) administer CPR
b) check for breathing
c) sterilize his or her wounds
d) cover the person with a blanket
3. What can be inferred about first-degree burns?
a) They usually cause people to go into shock.
b) They are less painful than third-degree burns.
c) They occur more frequently than other burns.
d) They require more bandages than second-degree burns.

26
 Lesson 4
Types of Medications

VOCABULARY

medication ["medI'keISn] лікарський засіб

compound ['kPmpaVnd] сполука
to prevent [prI'vent] запобігати
disease [dI'zJz] захворювання
over-the-counter ["qVvq Dq 'kaVnt безрецептурні препарати
drugs q]
restriction [rI'strIkSn] заборона, обмеження
prescription [prI'skrIpSn] рецепт
to prescribe [prI'skraIb] призначати, приписувати
pain reliever [peIn rI'lJvq] знеболюючий препарат
cough suppressant [kPf sq'presnt] той, що пригнічує кашель
antihistamine ["xnti'hIstqmJn] антигістамінний препарат
to dispense [dI'spens] відпускати (ліки)
antibiotic ["xntibaI'PtIk] антибіотик
blood pressure ['blAd preSq] артеріальний тиск
solid ['sPlId] твердий
liquid ['lIkwId] рідина
to swallow ['swPlqV] ковтати
drops [drPps] краплі
to rub ointment ['OIntmqnt] втирати мазь
transdermal patch [trxns'dE:mql px нашкірний пластир
C]
lozenge ['lPzInG] пастилка, льодяник
sublingual ["sAb'lINgwql] під’язиковий
intravenous ['Intrq'vJnqs] внутрішньовенний
injection [In'GekSn] ін’єкція
LEAD-IN

 What are some common medications that people take?

 What are the benefits and disadvantages of medications?

27
 Why don’t some people seek medical treatment when ill?
READING
Types of Medications
Medications are chemicals or compounds used to cure, halt, or prevent
diseases; ease symptoms; or help in the diagnosis of illnesses. They are
generally divided into two groups:
 over-the-counter drugs (OTC or nonprescription
medications) are available in pharmacies and
supermarkets without special restrictions.
 prescription-only medicines (POM) must be prescribed
by a qualified healthcare professional.
OTC medications are generally considered to be safe and effective
when people follow the directions on the label. Popular examples include
pain relievers, cough suppressants and antihistamines. They are usually
located on shelves in pharmacies, grocery stores, and even in gas stations.
However, safe use of these drugs requires knowledge, common sense, and
responsibility.
Prescription-only medicines legally require a medical prescription to be
dispensed. They may be prescribed by a GP, hospital doctor, dentist, nurse,
pharmacist, optometrist, or physiotherapist. Examples of prescription
medicines include virtually all antibiotics, cancer drugs and medicines for
high blood pressure.
The following are examples of the common type of dosage forms used:
• solid dosage form (pills, tablets or capsules) to be taken orally,
• liquids that are swallowed,
• drops that are put into ears or eyes,
• creams, gels, or ointments that are rubbed onto the skin,
• inhalers (like nasal sprays or asthma inhalers),
• patches that are stuck to skin (called transdermal patches),
• lozenges and tablets that are placed under the tongue (sublingual
medicine),
• injections (shots) or intravenous (inserted into a vein) medicines.
•

1. Read the text and answer the following questions.

1. What are medications?
2. What two groups are medications generally divided into?
28
 3. Are OTC medications safe and effective?
4. What are the examples of POM?
5. What dosage forms are commonly used?
2. Match the term and its definition.
1. a small solid round mass of medicine that is a) capsule
swallowed.
2. a small soluble case of gelatin containing a dose of b) drops
medicine, swallowed whole.
c) inhalant
3. a medicated tablet, that is allowed to dissolve in the
mouth. d) lozenge
4. a medicine or drug that you breathe into your lungs.
5. a smooth oily preparation that is rubbed on the skin for e) ointments
medicinal purposes or as a cosmetic.
6. a solid medical preparation in a conical or cylindrical f) patch
shape, designed to be inserted into the rectum or vagina to g) spray
dissolve.
7. a piece of material that is worn on the skin and contains a h) suppository
medication that is absorbed gradually over time.
8. a sweet liquid that contains medicine. i) syrup
9. a liquid kept under pressure in a can or other container,
j) tablet
which you can force out in very small drops.
10. any liquid medication applied by means of a dropper.

3. Look at the illustrations and write the appropriate form of

medicine under each of them. Then, match these forms of
medication to the routes of administration.

29
 1. (into the) ear 5. (onto the) skin
2. (into the) eye 6. (under the) tongue
3. (into the) nose 7. (into the) lungs
4. (by) mouth 8. (into the) rectum

4. Read and correct each sentence to make it true.

.
1. Medicines are chemicals or compounds used to cause diseases.
2. A chemist’s, or pharmacy, is often the only place where you can buy
most kinds of furniture.
3. Pink eye is usually treated with antibiotic injection.
4. OTC medications are sold following the doctor’s orders.
5. POM do not require a prescription from a medical professional.
6. Patches are rubbed onto the skin.
7. Creams, gels, or ointments are usually stuck to skin.
8. Tablets and capsules can’t be swallowed whole.
9. Suppositories are inserted into eyes or ears.
10. Analgesics are designed to exacerbate pain.
5. Read the directions for the over-the-counter medications. Find
. phrases that mean the following.

30
 Don’t take this medicine
KOLD KARMA
more than four times in
Cold and flu capsules
Directions twenty-four hours.
How to take:
For oral use. Do not chew.
Swallow capsules with water.
How much to take:
Adults and children over 12:
To be taken every two to four hours as
required according to the severity of the
symptoms. Do not exceed eight capsules in 24
hours.
Children 6-12 years: One capsule every four
hours. Do not exceed four capsules in 24
hours.
Do not give to children under 6 years.
DANGER: May cause drowsiness.
Avoid driving or operating machinery when
taking this medicine.
_______________________
1. It can make you feel sleepy.
_______________________
2. Don’t drive when you are taking this medicine.
_______________________
3. Swallow whole.
_______________________
4. Take this medicine when you need it according to how bad you feel.
_______________________
5. Only take this medicine by mouth.
_______________________
Lis
LISTENING
6. Listen to two conversations between nurses and patients and
. complete the following extracts from the conversations.
Conversation 1
- This one is your antibiotic. (1) __ __ you take it on an empty stomach.
- This is your inhaler. (2) __ __ rinse your mouth with water after you use it.
- The last one is the lotion for your rash. (3) __ __ __ you shake the bottle,
so you mix the contents well.
Conversation 2
31
- Here are the eye drops. They only last a month so (4 ) __ __ discard the
contents after this date.
- (5) __ __ to keep the eye drops in the fridge.
- (6) __ __ avoid too much sun with these tablets. You could burn easily.
Listen again and find a word or a phrase with the following meanings.
1. Mix the contents _________
2. Clean the mouth with a mouthful of water_________
3. Do not stay out in the sun_________
4. Throw away what is left in the container________
5. Keep in the fridge between 2-8°C_________
6. Take before eating or drinking_________.

LANGUAGE PRACTICE
TELLING THE TIME
Nurses use the twelve-hour clock 12.00: twelve o’clock
when they talk to patients, visitors 8.45: quarter to nine
and colleagues. 3 p.m.
The 24-hour clock is often used for 14.00: two o’clock/fourteen hundred hours
schedules, documents and charts. 8.20: eight twenty/twenty past eight
PREPOSITIONS OF TIME
We use at with clock times. I start work at 7 a.m.
We use in with parts of the day in the morning/afternoon/evening
and longer periods of time. but: at night
We use on with days and dates. on Monday, on October 10th

7. Match pictures (a-h) with the ways of telling the time (1-8) and
. complete the gaps with appropriate prepositions.

32
 1. nine twenty ___ the morning
 2. eight o’clock ___ the evening
 3. midday
 4. quarter to three ___ the afternoon
 5. half past eleven ___ night
 6. three ___ the afternoon
 7. quarter past eight ___ the morning
 8. midnight

8. Say what time it is.

. 10.00 – It is ten o’clock (a.m.).
22.00 – It’s ten o’clock (p.m.).
14.10 – It’s ten minutes past two.
15.15 – It’s quarter past three.
16.30 – It’s half past four.
17.40 – It’s twenty to six.
21.45 – It is quarter to ten.
1) 8.30 6) 8.40
2) 20.5 7) 11.20
5
3) 15.1 8) 16.00
5
4) 12.4 9) 4.00
5
5) 17.0 10)12.35
5
ORDINAL NUMBERS
1st first 6th sixth 11th eleventh 22nd twenty-
2nd second 7th seventh 12th twelfth second
33
 3rd third 8th eighth 13th 23rd twenty-
4th fourth 9th ninth thirteenth third
5th fifth 10th tenth 20th 31st thirty-first
twentieth
21st twenty-
first
Ordinal numbers are 4th August 1914: the fourth of August,
used for dates. nineteen fourteen
31st March 2011: the thirty-first of March,
two thousand and eleven
Dates written on forms: 06.07.1975
day.month.year

9. Read and complete the sentences.

1.. Beth’s birthday is on the _____ of _____. 7/4

2. Tom’s birthday is ___ the _____ of _____. 31/7

3. My teacher’s birthday is ___ the _____ of _____. 12/9

4. My birthday is ___ the _____ of _____.

5. My mum’s birthday is ___ the _____ of _____.
6. My dad’s birthday is ___ the _____ of _____.
7. All students started their studies _____ the _____ of _____ September.
8. The faculty members attend a seminar _____ Saturday mornings.
9. Most doctors don’t like to be on call _____ night.
10. The nurse reported all emergency cases _____ the morning.
WRITING
10. In an experiment, a stimulant called Isoprenaline is given to a rat
to. see what happens to heart rate and blood pressure. Look at the data
and use the words and expressions below to complete the report.
dose intravenous infusion
the effect of returned
anaesthetized administered
dropped recorded
Experiment report
Aim To test ____ Isoprenaline on an ____ rat.
Method I ____ a small ____ of Isoprenaline by ____ to a rat and ____

34
 the rat’s heart rate and blood pressure.
Results The rat’s heart rate went up to 500 and then ____ slowly to
normal after three minutes. The rat’s blood pressure ____ after
one minute. After two minutes the rat’s blood pressure
returned to 130.

SPEAKING
. Match (1–7) to (a–g) to make sentences. Then, work in pairs and
11.
make short dialogues to practice these instructions.
1. You need to take three capsules a) cause drowsiness.
2. Apply this ointment to b) spray once a day.
3. Take this nasal c) the recommended dose.
4. Here is a cough d) twice a day at mealtimes.
5. Do not exceed e) the capsules with water.
6. Always swallow f) the rash and the area around it.
7. Be careful; this medication may g) syrup; take one tablespoon twice
a day.
READING EXTENSION

12. Read the text filling the gaps with the right word from the options
. given below.
Doctors usually prescribe (1) ___ to fight bacterial infections. They
work either by killing bacteria or halting their multiplication so that the
body’s (2) ___ system can fight off the infection.
People with insulin-dependent diabetes have a (3) ___ that can’t
produce enough insulin (a hormone that regulates glucose in the body).
Others have a low production of thyroid hormone, which helps control
how the body uses energy. In each case, doctors prescribe medicines to (4)
___ the missing hormone.
Medicines that relieve pain are called pain relievers, or (5) ___. They
don’t get rid of the source of the pain, but they block the pathways that
transmit pain (6) ___ from the injured or irritated body part to the brain
(in other words, they affect the way the brain reads the pain signal) so that
you don’t hurt as much while your body recovers.
35
 As people get older, they sometimes develop (7) ___, or long-term,
conditions. Medicines can help control things like high blood pressure, or
(8) ___, and high cholesterol. These drugs don’t cure the underlying
problem, but they can help prevent some of its body-damaging effects over
time.
1. a) antibiotics b) antivirals c) histamines d) vitamins
2. a) urinary b) immune c) circulatory d) endocrine
3. a) pancreas b) liver c) spleen d) gallbladder
4. a) reveal b) refuse c) remove d) replace
5. a) ointments b) analgesics c) lozenges d) antivirals
6. a) gestures b) rays c) signals d) actions
7. a) acute b) chronic c) minor d) slow
8. a) migraine b) perspiration c) hypertension d) hypotension

36
 Lesson 5
Communication Skills in Nursing

VOCABULARY
essential [I'senSl] суттєвий, неодмінний
skill [skIl] вміння, навик
treatment ['trJtmqnt] лікування
prevention [prI'venSn] профілактика, запобігання
rehabilitation ["rJq"bIlI'teISn] реабілітація
life-saving ['laIf seIvIN] рятівний
accurate ['xkjqrqt] точний, достовірний
health record ['helT rekLd] медична картка
condition [kqn'dISn] стан
confident ['kPnfIdqnt] впевнений
body language ['bPdi lxNgwIG мова тіла
]
facial expression ['feISl IkspreSn вираз обличчя
]
to nod [nPd] кивати (головою)
compassion [kqm'pxSn] співчуття
kindness ['kaIndnqs] доброта
frightening ['fraItnIN] жахливий, моторошний
procedure [prq'sJGq] процедура
rapport [rx'pL] взаєморозуміння
honest ['PnIst] чесний
test results ["test rI'zAlt] результати аналізів
to complete [kqm'plJt] завершувати, закінчувати
efficient [I'fISnt] доцільний, ефективний, дієвий
educator ['eGukeItq] інструктор, педагог
therapy ['Terqpi] терапія
LEAD-IN

 Why is clear communication between nurses and patients important?

 What 3 skills do you need for effective communication?
37
 What are some possible causes of misunderstanding with patients?
READING
Communication Skills in Nursing
Being able to communicate is an essential skill for all health
professionals and it is particularly important for
nurses who are with people and their families for
many hours a day. They tell patients about
diagnostics, treatments, prevention, prognosis and
rehabilitation. Nurses communicate important and
potentially life-saving information to doctors.
They also write accurate health records and descriptions of patients’
conditions.
Verbal communication is one of the most important communication
skills. Nurses should speak clearly, using complete sentences and a
professional tone. They also should demonstrate calm and confident body
language (facial expression, eye contact, smiling, nodding). Active listening
involves understanding, rather than just listening to, what someone is trying to
say.
It is important to show care and compassion when collecting and
giving information to patients. Kindness can help calm patients during
potentially stressful and frightening situations and procedures. Trust and
rapport can be gained by being compassionate and honest. Nurses should
tell the truth when discussing test results, procedures or prognoses and
they should avoid making promises simply to keep a patient calm.
Nurses use written communication skills to take notes about patients,
complete health records and share information with other nurses and
doctors. Their writing should be clear and efficient to ensure they
communicate important health information accurately.
Nurses should be effective educators when describing health
conditions, diagnostic test results, medications, therapies and at-home care
to patients and families. They need to explain complex health topics in
language anyone can understand.
1. Read the text and answer the following questions.
1. Why are communication skills essential for all health professionals?
2. What information do nurses communicate to doctors?
38
3. How should nurses speak to their patients?
4. How can nurses gain their patients’ trust?
5. What do nurses use their written communication skills for?

2. Match the words to make word-combinations. Use them in the

sentences of your own.
a) essential a) health records
b) life-saving b) body language
c) accurate c) skill
d) complete d) contact
e) professional e) information
f) confident f) situations
g) facial g) test results
h) eye h) expression
i) stressful and frightening i) sentences
j) diagnostic j) tone

3. Choose the word that is closest in meaning to the underlined part.

1. Gina asks her patient about his day to develop a connection.
A. preconception B. rapport C. anxiety
2. Some patients say music is helpful for healing.
A. therapeutic B. verbal C. non-verbal
3. The nurse is using too much specialized vocabulary.
A. jargon B. anxiety C. empathy
4. Hospitals can cause feelings of nervousness and worry.
A. rapport B. jargon C. anxiety
5. Frowning is a type of communication that is done without the use of
spoken language.
A. therapeutic B. empathy C. non-verbal
6. Ask more questions that require answers longer than one-word
responses.
A. cultural differences B. open-ended questions C. preconceptions

39
 4. Informal expressions are used to create a friendly and relaxed
. relationship with the patient. Match the expressions (1-7) to their
meanings (a-g).
1. have a chat a) monitor
2. a bit of a shock b) I’m going to sit down
3. a bit flushed c) take notice of
4. watch for d) discuss
5. I’ll just grab a chair e) tired of doing something
6. fed up with f) red complexion
7. keep an eye on g) unpleasant surprise

5. Decide if the following communication strategies are good or bad.

. Do Don’t
1. Speak normally ✓
2. Show empathy
3. Put up a barrier
4. Use only Yes/No questions
5. Use open-ended questions to encourage patients
6. Be impatient and rush patients
7. Be sincere
8. Use a lot of medical jargon
9. Humiliate patients when they are incontinent
10. Give patients privacy
11. Talk down to patients
12. Use inappropriate language, for example lovie or sweetie

Lis
LISTENING
6. Listen to a phone conversation between two nurses and choose
. the correct answers.
1. What is the main idea of the dialogue?
a) how cultural differences affect communication
b) why a nurse is having trouble talking with a patient
c) why it’s important to ask open-ended questions
d) how to improve patients’ health literacy
2. According to the dialogue, how can the nurse establish a good rapport?
40
 a) explain jargon when talking to the patient
b) focus on the patient’s medical history
c) ask why the patient feels nervous or anxious
d) start by asking non-medical or personal questions
Listen again and complete the conversation.
Nurse 1: … Well, she’s complaining of constant headaches. I asked
about her (1) ____ ____, but she didn’t say much.
Nurse 2: Is it just a (2) ____? Maybe she doesn’t know what you’re
asking for.
Nurse 1: It’s possible. But I can’t tell because she’s barely speaking
to me.
Nurse 2: She might just be anxious. It can be scary to feel terrible but
not know why.
Nurse 1: Yeah, she does seem (3) ____ ____.
Nurse 2: Did you use lots of jargon? In my experience, that (4) ____
____ ____.
Nurse 1: I might have. I mean, I asked her if she thought they might
be migraines or cluster (5) ____.
Nurse 2: See, if she has (6) ____ literacy, those terms might sound
scarier than they are. …
LANGUAGE PRACTICE
MODAL VERBS
ABILITY • He can speak medical English.
• She couldn’t see well without her glasses.
• I wasn’t able to visit her at the hospital.
PERMISSION • Can I use your phone?
• Could I have your number, please?
• May I feel your pulse?
• Might I have a word with you, doctor?
• The assistant was allowed to complete the operation.
NECESSITY  You must be careful when you take medicines.
 He has to stay in bed for two weeks.
 You need to devote particular attention to this patient.

41
 PROHIBITION  You mustn’t smoke here. It’s forbidden.
 You can’t enter the OR. It’s not allowed.
ADVICE  You should take this drug after meals.
 You ought to follow the doctor’s treatment.
 You’d better stay at home.

7. Complete the rules with a suitable modal verb to make them true
. for hospitals in your city. Avoid using the same words repeatedly.
FOR PATIENTS:
1. You ______ use all hospital property with due care.
2. You ______ keep any valuables and cash in the hospital.
3. You ______ talk or laugh loudly.
4. You ______ keep your phone on silent mode.
5. You ______ use plastic carry bags.
6. You ______ speak to the ward nurse if there is a problem.
FOR VISITORS:
1. You ______ stay overnight with their child
2. You ______ bring children under 5 to visit.
3. You ______ tip any hospital employee for their services.
4. You ______ bring flowers into the wards.
5. You ______ use the patients’ toilets.
6. You ______ bring your mask and wear it over your nose and mouth.
FOR NURSES:
1. You ______ wash your hands when you enter and leave the ward.
2. You ______ control your feelings.
3. You ______ gossip about your patients.
4. You ______ say the word "incurable".
5. You ______ hold in confidence all personal information entrusted to
you.
6. If you make a mistake in your work, you ______ tell the doctor about it.
EXPRESSING POSSIBILITY

42
 100% He must be in his ward. I saw him there a minute ago.
 You can buy all the necessary drugs here.
 I may be working next Friday.
 She could be allergic to penicillin.
 A new drug might work, and it might not.
 Can he be American? He speaks Ukrainian very well.
0%
 This can’t be true.

8. A man has walked into a London hospital and told the nurses that
. he has lost his memory. They are trying to find out who he is.
What conclusions would you draw from the following
information? Use the words in brackets to answer.
His breath smells of alcohol and he can’t walk straight. (must)
He must be drunk.
1. He speaks English with an accent. (Can…?)
2. He has some French francs in his wallet. (might)
3. He has a piece of paper with a London telephone number. (may)
4. The line is busy all the time. (must)
5. He is wearing a ring on the finger of his left hand. (must)
6. His clothes are really expensive. (can’t)
7. He has a photo of two girls in his pocket. (could)
8. His shoes are dirty and worn out. (could)

9. Rewrite the sentences, using the words in brackets, so that they

. keep the same meaning.
1. This doctor is able to read and write Japanese. (can)
This doctor _____ Japanese.
2. I’m certain this phone is broken because I can’t hear anything. (must)
This phone _____ because I can’t hear anything.
3. I managed to finish all my work. (able)
I _____ finish all my work.
4. It’s against the rules for patients to smoke in here. (allowed)
Patients _____ smoke in here.
5. The best thing for you to do is sit down. (better)
You _____ sit down.
43
6. The report must be on my desk tomorrow morning. (has)
The report _____ on my desk tomorrow morning.
7. It is likely that he will stay in hospital. (may)
He _____ in hospital.
8. It would be a good idea to avoid eating sweets. (should)
You _____ eating sweets.
9. It is necessary for you to do this exercise. (ought)
You ____ this exercise.
10.Would you mind if I used your pen? (might)
_____ your pen?

WRITING
10. Good communication with your patient is essential. Complete the
. description of good communication practice using the words from
the box.
eye ease open name friendly
sit smile quickly relaxed questions (x2)
1. Imagine the patient is a close family member or friend and treat him or
her as you wish to be treated yourself.
2. Always try to put your patient at ____ and make them feel ____.
3. If possible, ____ at the same level as the patient.
4. The expression on your face is important, so ____ and maintain ____
contact with your patient.
5. When you talk, don’t rush the patient or speak too ____ and always
use a ____, open tone of voice.
6. Take an interest in your patient, use their ____ and ask them general
____ about their life.
7. It is also important to use an ____ posture, i.e. don’t fold your arms, as
this can look aggressive.
8. Finally, check it is OK to ask ____ and tell them roughly how long the
interview will last.
SPEAKING
11. You need to make phone call to book an appointment for your
. patient. Match the stages (1–6) to the different parts of the
44
 conversation (a–f). Then, work in pairs and role-play the
dialogue.
1. greet person and identify a) The patient’s name is Milly Hanks –
yourself and department that’s H-A-N-K-S.
2. give reason for calling b) Good, so that’s 4.15 on 24th March.
3. confirm day and time c) Thank you for your help. Goodbye.
4. suggest day and time for d) Good morning, this is Monica from
appointment Paediatrics.
5. give patient details e) How about 25th March at 3.00 p.m.?
6. thank person and end call f) I’d like to make an appointment with the
practice nurse for one of our patients, please.
READING EXTENSION

12. Communication is a skill you can develop with practice and careful
. speaking techniques. Read the text and match choices (A-F) to (1-
6).
1. A. Study a foreign language
2. B. Speak to your audience
3. C. Practice speaking
4. D. Use body language
5. E. Introduce yourself
6. F. Confirm details
1. When you first meet a patient, immediately give them your name and
title. Explain why you are there and what you are going to do. Use
patient identifiers such as their full name, birthdate and address to
confirm you are speaking to the correct person.
2. Practice how you talk to your patients, either by yourself or with a friend
or colleague. Pronounce every word correctly and use familiar language
and explanations – rather than big words or industry jargon – for
medical terms.
3. Be aware of the signals your body might give patients. Before walking
into a room, take a deep breath and try to relax your expression and
posture. Your behavior can have a calming effect on a patient in a
stressful situation.
45
4. Adjust your communication style depending on who you are talking to.
The language and tone you use with a doctor or nurse might differ
significantly from what you say to a patient or their family. Adjust your
speech so it is positive and nonthreatening when talking to children.
5. Consider learning a new language, which can teach you new ways to use
words and speech. Learning another language can also help you
communicate with patients of different ethnicities. Communicating basic
information to patients in their own dialect can help calm them and earn
their trust.

46
 Lesson 6
Structure of the Human Body
VOCABULARY
cell [sel] клітина
tissue ['tISH] тканина
trunk [trANk] тулуб
extremity/limb [Ik'stremqti]/[lIm] кінцівка
skull [skAl] череп
brain [breIn] мозок
forehead ['fPrId] лоб
gum [gAm] ясна
tongue [tAN] язик
palate ['pxlqt] піднебіння
thorax/chest ['TLrxks]/[Cest] груди, грудна клітка
abdomen ['xbdqmqn] черевна порожнина
pelvis ['pelvIs] таз
ribcage ['rIbkeIG] грудна клітка
thoracic cavity [TL'rxsIk] грудна порожнина
stomach ['stAmqk] шлунок
spine/backbone [spaIn]/['bxkbqVn] спинний хребет
vertebra ['vE:tIbrq] хребець
elbow ['elbqV] лікоть
forearm ['fLrRm] передпліччя
wrist [rIs] зап’ястя
thigh/hip [TaI]/[hIp] стегно
shin [SIn] гомілка
ankle ['xNkl] щиколотка

LEAD-IN

 What do you like the most about your body?

 What would you like to change about your body if you could?
 What are the most critical organs in our body?

READING
47
 Structure of the Human Body
The human body a single structure but it is made up of billions of cells
which unite to form a tissue. Similar tissues come together to form an organ.
Many organs constitute an organ
system and thus an individual.
The human body can be divided
into three major areas: the head, the
trunk and the extremities (limbs). The
head consists of two parts: the skull
which contains the brain, and the face
which consists of the forehead, the
eyes, the nose, the mouth with the lips,
the cheeks, the ears and the chin. In the
mouth there are gums with teeth, a
tongue and a palate. The head is connected with the trunk by the neck.
The trunk can be divided into the thorax (chest), abdomen, and pelvis.
Ribs are the long curved bones, which form the rib cage protecting the
internal organs of the thoracic cavity. The abdomen is often subdivided
superficially into four quadrants: the upper right, upper left, lower right, and
lower left. One’s back is found on the opposite side of the stomach and is a
flat section of the body. The framework of bones called the skeleton supports
the soft parts of the body and protects the organs from injury. The spine
(backbone) is the central support for the body made of separate irregular
bones called vertebrae.
The upper extremity is connected with the chest by the shoulder. Each
arm consists of the upper arm, the elbow, the forearm, the wrist, and the
hand. We have four fingers and a thumb on each hand. At the end of the
fingers are fingernails. The lower extremity (the leg) includes the hip (the
thigh), the knee, the shin, the ankle and the foot with five toes.
1. Read the text and answer the following questions.
1. What is the human body made up of?
2. What does the head consist of?
3. What are the parts of the trunk?
4. What are the functions of the skeleton?
5. What does each arm consist of?
48
2. Label the parts of the human body.
head neck shoulders hair chest arm hand abdomen leg
knee foot buttocks ankle toes hip nose elbow eye ear

3. In the grid, find ordinary English names of the parts of the

human body for the anatomical terms used by doctors. ( )
1. mandible
2. axilla
3. thorax
4. abdomen
5. umbilicus
6. inguinal region
7. kneecap
8. torso
9. extremity
10. vertebral column

4. Odd one out.

. 49
 1. a) head b) trunk c) brain d) limbs
2. a) shin b) palm c) elbow d) wrist
3. a) heel b) neck c) knee d) ankle
4. a) mouth b) nose c) hip d) chin
5. a) calf b) forehead c) jaw d) cheek
6. a) chest b) abdomen c) navel d) toe

5. Read the sentence pairs. Choose where the words best fit the gaps.
1.. shoulder / ankle
A. I twisted my ____ when I was running.
B. Tom can’t move his arm due to his ____ injury.
2. toe / knee
A. The leg bends at the ____.
B. Breaking even your smallest ____ can make walking difficult.
3. foot / hand
A. This shoe barely fits on my ____.
B. Give me your _____ and I will help you up.
4. forehead / head
A. The patient suffered minor ____ trauma and may have a concussion.
B. There are several small scratches on the ____.
5. neck / back
A. If you cannot see Andy’s chest, you are looking at his ____.
B. The ____ attaches the head and torso.
6. cheek / lip
A. The nose is bruised and the upper ____ is bloody and swollen.
B. There are scrapes on her left ____ near the left ear.

Lis
LISTENING
6. Listen to two conversations between nurses and match the
. beginnings of the questions with the endings.
1.Ok, a) it hurt?
2.What b) Mrs Hales?
3.Where does c) are you?
50
4.What about d) broken?
5.Let’s have a look – swollen, e) happened to you?
6.You’ve had an x-ray, f) haven’t you?
7.Anything g) your shoulder
8.You aren’t on any other medication, h) isn’t it?
Listen again and write questions to go with these answers.
Nurse:
Patient: Not bad, thanks - a bit sore.
Nurse:
Patient: I fell off my bike
Nurse:
Patient: Here, around my wrist.
Nurse:
Patient: Yes, 1 can, slowly.
Nurse:
Patient: Yes, very! I’ve also got a cut on my leg – look.
Nurse:
Patient: Yes, it is deep. Will 1 need stitches?
Nurse:
Patient: No, never - and I don’t want any!
Nurse:
Patient: No, I haven’t seen him yet.

LANGUAGE PRACTICE
PLURAL OF NOUNS

eyes, ears, limbs, bones  classes, matches, dishes, boxes

days, boys, ways, keys  babies, ladies, cavities, extremities
tomatoes, potatoes, heroes  torsos, kilos, photos, pianos, radios,
zoos
shelf, life, shelves, lives  beliefs, chiefs, roofs, safes

 man men  child children  sheep sheep

 woman women  person people  deer deer
 foot feet  mouse mice  species species
51
  tooth teeth  louse lice
 diagnosis
diagnoses  datum data
 criterion
criteria  syllabus syllabi
Remember:
 news, money, hair, advice,  police, clothes, scissors, trousers,
knowledge, furniture, measles pyjamas, contents, scales, goods
7. Put the nouns in the brackets into plural if you’ve got more than
. one of them in your body.
The human body is made up of different parts: the (head), the (trunk)
and upper and lower (limb). The sense of vision is found in the (eye)
which are protected by (eyelid), (eyelash), and (eyebrow). (Muscle) allow
us to open and close the (eye). (Eyelash) are small hairs that protect the
(eye) from dust and dirt. (Eyebrow) are a group of small hairs that make a
curve above the (eye). The sense of smell is found in the (nose), and the
sense of taste is found in the (tongue). The (lip) go around the (mouth). We
can crush food with (tooth). The (hair) protects the (head), so that it
doesn’t get too cold. The (ear) are on both (side) of the (head).
The (arm) are connected to the (trunk) by the (shoulder). The (joint)
allow us to move the parts of the body. You can find (elbow), (wrist),
(hand), and (finger) on the (arm). The (nail) are the hard part that you can
find at the (fingertip). The (leg) are connected to the (trunk) by the (hip).
On the (leg) you can find (knee), (ankle), (foot) and (toe). We have five
(toe) just like the (finger) on our (hand) which help us keep our balance
when we walk.
The (trunk) is the central part of the body and here you can find the
(chest), (back), (abdomen) and (shoulder).

8. Use is/are in the sentences below.

. Economics ___ Tom’s favourite subject.
1.
2. Their information ___ not correct.
3. The news ___ very interesting.
4. Some people ___ coming today.
5. Your money ___ not enough to buy this textbook.
52
6. The furniture in our classroom ___ of good quality.
7. The police ___ looking for the thief.
8. Your progress ___ amazing.
9. My mother’s hair ___ turning grey.
10. Measles ___ dangerous for grown-ups.
POSSESSIVE CASE
• the nurse’s name • the nurses’ duties • the government’s
• my baby’s teeth • the patients’ rights decision
• Tom’s shoulders • the men’s bodies • Italy’s largest city
• Thomas’(s) hands • my children’s hair • the moon’s light
• my mother-in-law’s • Jack and Jill’s • fortune’s wheel
health child • yesterday’s newspaper

9. Complete the sentences with the correct possessive form of the

. nouns.
1. The doctor checked the (children) _____ teeth.
2. Ann is a (girl) _____ name.
3. (Mary and Sue) _____ mum has broken her arm.
4. (Denis) _____ toenails need a trim.
5. In this country teachers have (two months) _____ holiday.
6. This outstanding surgeon has saved many (people) _____ lives.
7. (Students) _____ lives are busy.
8. Do you know (Mr. Richards) _____ wife?
9. Have you seen my (brothers) _____ faces?
10.Her (mother-in-law) _____ hair is completely grey.

WRITING
10. Write a message to your roommate asking to meet your cousin
. who is visiting you for the first time and you are having classes
and can’t meet him/her. Describe your cousin’s physical
appearance in detail.
The body — height and build;
The head — hair colour and main features of their face;
The face — eyes, nose, mouth, complexion. Facial hair if they
have any!
53
Body language — what are their common gestures? What do they
always do with their hands or eyes?
The clothing — what do they usually wear?

SPEAKING
11. Get ready to describe one of your groupmates so that other
. students could guess the right person. Use the plan from Ex. 10.
READING EXTENSION

12. Read the text choosing the words that best complete the sentences.
.
What is Wonderful about the Brain?
Inside your head is a (remarkable/insignificant) organ, the brain. You
use it to understand and remember things that are happening around you. The
brain is soft and (soapy/spongy). It is made up of billions of tiny parts called
(cells/hormones). Three coats or membranes cover the brain.
The brain sometimes is called the busiest (phone/communication) centre
in the world. The brain controls your body functions and (prevents/keeps) all
parts of your body working together. Thousands of (messages/letters) from all
parts of the body are being sent to and from the brain. Messages are carried to
the brain by (sensory/motor) nerves. Special places, or centres, on the brain
receive these messages from all parts of the body. When messages are
received by centres, the brain (inhibits/interprets) them. All day long your
muscles and your brain are working. By the end of the day, they are tired.
Then your brain and your muscles start to (die/relax). Before long, you go to
sleep. As you sleep, the big muscles in your body relax.

Lesson 7
Infrastructure Body Systems
54
 VOCABULARY

infrastructure ['InfrqstrAkCq] інфраструктура

skeletal system ['skelqtl sIstqm] опорно-рухова система
framework ['freImwE:k] кістяк, основа
to protect [prq'tekt] захищати
internal [In'tE:nl] внутрішній
tissue ['tISH] тканина
red blood cell ["red 'blAd sel] еритроцит
to fuse [fjHz] зростатися
maturity [mq'CVqrqti] зрілість
skeleton ['skelItn] скелет
muscular system ['mAskjqlq sIstqm] м’язова система
to permit [pq'mIt] дозволяти
posture ['pPsCq] постава
voluntary muscle ['vPlqntri mAsl] довільний м’яз
conscious ['kPnSqs] свідомий
involuntary muscle [In'vPlqntri mAsl] мимовільний м’яз
esophagus [i'sPfqgqs] стравохід
cardiac muscle ['kRdixk mAsl] серцевий м’яз
circulatory ["sE:kjq'leItqri] кровоносний
cardiovascular ["kRdiqV'vxskjqlq] серцево-судинний
blood vessel ['blAd vesl] кровоносна судина
nervous system ['nE:vqs sIstqm] нервова система
spinal cord ['spaInl kLd] спинний мозок
cranial nerve ['kreIniql nE:v] черепний нерв
sense organ [sens 'Lgqn] орган чуття
taste bud ['teIst bAd] смаковий рецептор
LEAD-IN
 Have you ever fractured your bone?
 What helps blood move through the circulatory system?
 What specialists can treat the nervous system disorders?
READING
Infrastructure Body Systems

55
 The skeletal system is
the framework of the
body. It is what gives the
body its basic shape, while
protecting the internal
tissues and organs. A vital
role of this system is also
the production of red blood cells. Humans are born with over 300 bones;
however, many bones fuse together between birth and maturity. As a
result, an average adult skeleton consists of 206 bones.
The muscular system permits movement of the body, maintains posture,
and circulates blood throughout the body. Voluntary (skeletal) muscles allow
for conscious movement of body parts; involuntary (smooth) muscles are
located within certain internal organs such as the esophagus; and cardiac
muscles are found within the heart, whose movement is a constant pumping
action.
The circulatory (cardiovascular) system is composed of the heart,
blood vessels and approximately 5 litres of blood. The blood vessels of the
body (arteries, capillaries, and veins) make up a closed system of tubes
that carry blood from the heart to tissues all over the body and then back to
the heart. The cardiovascular system is powered by the body’s hardest-
working organ — the heart, which is only about the size of a closed fist.
The nervous system is a very complex system by which all parts of the
body are controlled. The nervous system has two distinct parts: the central
nervous system and the peripheral nervous system. The CNS consists of the
brain and spinal cord. The PNS consists of nerves including 12 pairs of
cranial nerves and 31 pairs of spinal nerves. The nervous system also
comprises special sense organs such as the eyes, ears and taste buds.
1. Read the text and answer the following questions.
1.

1. How many bones are there in the human body?

2. What are the main functions of the skeletal system?
3. What three types of muscles are found in the body?
4. What does the cardiovascular system consist of?
5. What are the parts of the nervous system?

56
2. Find in the text the terms for the following definitions. The first
letter is provided.
1. hard whitish tissue making up the skeleton b________
2. the framework of bones supporting the body s________
3. The position in which someone holds their body when
standing or sitting p________
4. the red liquid that flows around inside the body b________
5. A band of fibrous tissue in the body that can tighten and
relax to produce movement m________
6. organ made of cardiac muscle with four chambers
responsible for pumping blood h________
7. a blood vessel that carries blood away from the heart to the
body’s organs a________
8. a blood vessel that carries blood back to the heart v________
9. the smallest type of blood vessel that carries blood to and
from individual cells in the body c________
10.a fibre that transmits messages between the brain and other
parts of the body n________

3. Replace the words in bold type by their synonyms from the box.
.
automatic voluntary involuntary musculoskeletal
skeleton heart capillaries brain respiration
1. All of the bones, cartilages, muscles, joints, tendons and ligaments in a
person’s body compose what is known as the locomotor system.
2. An average bony framework of an adult has 206 bones.
3. There are three types of muscles: skeletal, smooth and cardiac.
4. About 2/3 of the muscular pumping organ in the thoracic region is
located on the body’s left side with the other 1/3 on right.
5. The thinnest of the blood vessels in the body carry blood very close
to the cells in order to exchange gases, nutrients, and waste products.
6. The nervous system regulates both voluntary activities, such as walking
and talking, and involuntary activities, such as breathing.
7. There are 12 pairs of nerves that branch from the coordinating centre
located in the skull and 31 pairs that branch from the spinal cord.

57
8. Some activity within the CNS is quite simple reflex activity but much
of its activity is complex and conscious.

4. Fill in the table.

. The Divisions of the Nervous System

o somatic nerves o brain o spinal cord o parasympathetic

o sympathetic o sensory input o motor output o nervous system
o peripheral o central nervous o autonomic
nervous system system nerves

5. Provide the name of the system according to its function.

.
1. __________ a) interprets information from sensory units and
controls body functions & systems;
2. __________ b) maintains the structure of the body, provides internal
support and protection;
3. __________ c) transports gases, nutrients, and wastes throughout the
body;
4. __________
d) enables the body to move.

Lis
LISTENING
6. Listen to the recording twice and then fill in the gaps in the
. summary with the correct words and phrases from the word
bank.
blood vessel heart defects risk factors most common
several prevented regularly inactivity weight
58
 In the US, the (1) ____ cause of deaths is heart disease There are
(2) ____ diseases that can be classified as heart disease. They include
(3) ____ disease, heart failure, and (4) ____ you’re born with. Many forms
of heart disease can be (5) ____ or treated with healthy lifestyle choices.
(6) ____ for heart problems include smoking, (7) ____ , poor diet, and
stress. In addition, excess (8) ____ is also associated to heart disease. An
important part of heart disease prevention is seeing your doctor (9) ____.

LANGUAGE PRACTICE

countable uncountable DETERMINERS

There are a lot of muscles in the
body.
a lot of / lots of
There is a lot of blood, and I can’t
stop it.
many much There aren’t many bones broken.
Does the heart need much energy?
a few = some, a little = some, A few students have passed the test.
enough enough We deserve a little rest.
few = not many, little = not much, Very few cells remain unchanged.
not enough not enough I have little time left.

7. Choose the correct option in italics to complete the sentences.

. Chris loves technology. (Few/A few/a little) years ago, he noticed that
he had very (little/a little/many) information about his habits, health and
lifestyle, and he wanted to lose (some/any/many) weight.
So, he bought (little/much/some) gadgets that could collect this
information and help him understand himself better. Now he is connected to
(lot/a lot/lots of) sensors that record every detail of his life. He monitors
what he eats and drinks, how long he sleeps, how (many/much/lot) money
he spends... (Little/Few/Much), if any, people collect as (many/much/little)
information about themselves as Chris.
(Many/Lot of/A little) of his gadgets are attached to him. Every one of
them sends data to his computer, and at the end of each day Chris spends
(few/a few/a little) time analyzing it. He doesn’t wear all his gadgets 24/7,
but he has so (much/many/a lot of) systems that automatically track his
59
activity that there aren’t (much/any/no) days when there is no monitoring at
all.
8. Fill in: many / much / few / a few / little / a little.
.
1. Too ____ people eat junk food and it’s hard to give up!
2. First, make sure that you always have ____ healthy snacks in your
fridge.
3. Eat ____ yoghurt or ____ raw vegetables when you feel hungry.
4. If you feel that you have ____ energy at work during the day, drink
____ green tea or eat ____ nuts, instead of going out for a burger.
5. ____ people realize how ____ sugar and salt is in frozen pizza, for
example.

9. Rewrite the sentences, using the words in brackets, so that they keep
. same meaning.
the
1. The human skeleton consists of many bones. (lots)
2. We don’t have much homework this weekend. (little)
3. Almost none of the patients could speak English. (few)
4. There aren’t any blood vessels in cartilage. (no)
5. I didn’t spend a lot of time on that translation. (much)
6. I have got some interesting facts about the heart. (few)
7. Not many of my friends have regular medical checkup. (few)
8. There was little fresh air in the room, so he had to open the window.
(much)

WRITING
10. Complete a short article for kids about the heart.
. Your heart is really ____. It’s located a little to the left of ____, and
it’s about the size of ____. The heart muscle is special because of what it
does. The heart sends ____ around your body. The blood provides your
body with _____ it needs. It also carries away _____. Your heart is sort of
like a pump, or two pumps in one. The right side of your heart receives
blood from the body and pumps it to ____. ____does the exact opposite: It
receives ____ from the lungs and pumps it out to the body.

SPEAKING
60
 11. Match the beginning and ending of the sentences. Then, add three
. more pieces of advice how to stay healthy.
1. If you do a lot of exercise a) an unhealthy way of living.
2. Not taking any exercise is b) for someone with back problems.
3. Reading in bad light can c) running every morning before
4. A hard bed is good breakfast to keep fit.
5. Bad posture can d) you develop strong muscles.
6. People with fair complexions e) burn easily in the sun.
7. You should get into the f) cause back pain.
habit of g) make the eyes ache.

READING EXTENSION

12. Read and discuss some interesting facts about the human body.
.
 Children grow faster in the springtime than any other season during the
year.
 The human head is a quarter of our total length at birth, but only a seventh
of our total length by the time we reach adulthood.
 Your eyes remain the same size after birth, but your nose and ears never
stop growing.
 Compared to its size, your tongue is the strongest muscle in your body.
 For every pound of fat or muscle gained, your body creates seven miles of
new blood vessels.
 Your blood vessels are 60,000 miles long and would go twice around the
world and still have some to spare!
 The cornea is the only living tissue in the human body that does not contain
any blood vessels.
 Women’s hearts beat faster than men’s.
 The brain is about 75-80% water.
 The human brain can read up to 1,000 words per minute.
 The human brain has the capacity to store as much information as 5
Encyclopedia Britannica.

61
 Lesson 8
Regulation Systems of the Body
VOCABULARY
urinary ['jVqrInqri] сечовидільний
renal ['rJnl] нирковий
to eliminate [I'lImIneIt] усувати, виключати
urine ['jVqrIn] сеча
waste [weIst] залишки, відходи
kidney ['kIdni] нирка
ureter [ju'rJtq] сечовід
bladder ['blxdq] сечовий міхур
urethra [jV'rJTrq] сечівник
lymphatic [lIm'fxtIk] лімфатичний
pathogen ['pxTqGqn] патоген
lymph node ['lImf nqVd] лімфовузол
spleen [splJn] селезінка
thymus gland ['TaImqs glxnd] вилочкова залоза
innate immunity [I"neIt I'mjHnqti] вроджений імунітет
acquired immunity [q"kwaIqd I'mjHnq набутий імунітет
ti]
interstitial fluid ["Intq'stISl flHId] інтерстиціальна рідина
absorption [qb'zLpSn] поглинання
endocrine ['endqVkraIn] ендокринний
hormone ['hLmqVn] гормон
reproductive ["rJprq'dAktIv] репродуктивний
ovary ['qVvqri] яєчник
fallopian tube [fq'lqVpiqn tjHb] фаллопієва труба
uterus ['jHtqrqs] матка
vagina [vq'GaInq] піхва
testis ['testIs] яєчко
LEAD-IN
 What is immunity?
 What vaccinations did you get as a child?
 What are some things used to help control reproduction?
62
 READING
Regulation Systems of the Body
The urinary system, also known as the renal system, produces, stores and
eliminates urine, the fluid waste excreted
by the kidneys. The kidneys make urine
by filtering wastes and extra water from
blood. Urine travels from the kidneys
through two thin tubes called ureters and
fills the bladder. When the bladder is full,
a person urinates through the urethra to
eliminate the waste.
The lymphatic and immune systems consist of a complex network of
specialized cells and organs designed to protect and defend the body against
attacks by pathogens. They share some of the same structures and functions.
Both the lymphatic and immune systems contain the lymph nodes, spleen,
thymus gland, and some of the disease-fighting immune cells. There are two
subsystems within the immune system, known as the innate immunity
and the adaptive (acquired) immunity. The lymphatic system has three
interrelated functions: removal of interstitial fluid from tissues; absorption and
transportation of fats to the circulatory system; and transportation of immune
cells to and from the lymph nodes, where the lymph is filtered.
The endocrine system is the collection of glands located all over your
body which create and secrete hormones. Metabolism, growth and
development, tissue function, sexual function, reproduction, sleep and mood
are all examples of body functions that are regulated by hormones.
The reproductive system is responsible for creating life. The primary
organs involved differ between the sexes with ovaries, fallopian tubes, the
uterus and vagina found in women and testes and a sperm channel found in
men. New life begins when an egg from a woman is fertilized by sperm from
a man.
1. Read the text and answer the following questions.
1.

1. What are the main functions of the urinary system?

2. What do the lymphatic and immune systems do?
3. What does the endocrine system include?
4. What are the branches of the immune system?
63
5. What is the reproductive system responsible for?

2. Match the words to make word-combinations. Use them in the

sentences of your own.
1. produce a) the bladder
2. travel b) an egg
3. fill c) urine
4. eliminate d) disease
5. secrete e) the body
6. fertilize f) through ureters
7. protect g) new life
8. contain h) hormones
9. fight i) the lymph nodes
10.create j) the waste

3. Find a word in the text for the following definitions. You will get
the term that can protect you against particular diseases.
1
2
3
4
5
6
7
8
1. One of the two organs in your body that clean your blood and remove
waste.
2. A regulatory substance produced in the body to stimulate specific cells
or tissues into action.
3. A clear liquid in the body that cleans the tissues and helps to remove
harmful bacteria from the blood.
4. The organ in the body of a woman in which a baby develops before
birth.

64
5. A watery, typically yellowish fluid stored in the bladder and discharged
through the urethra.
6. The muscular tube that connects woman’s outer sex organs to her
uterus.
7. The duct by which urine is conveyed out of the body from the bladder.
8. A gland in the neck of humans that produces T-cells.
4. Read the sentence pairs. Choose where the words best fit the gaps.
1.. endocrine / reproductive
A. The glands of the ____ system work together to control many bodily
functions.
B. The ____ system is the only system in which males and females have
very different parts.
2. gonads / hormones
A. Everything from hunger to childhood growth is regulated by the
____ of this system.
B. The ____ are the organs which produce sex cells.
3. bloodstream / intercourse
A. Each gland secretes one or more hormones into the ____.
B. When a sperm cell reaches an egg cell during ____, fertilization occurs.
4. pituitary / thyroid
A. The ____ gland, located at the base of the brain below the
hypothalamus, secretes nine hormones that control important functions.
B. The ____ gland, found in the neck below the Adam’s apple, controls
how quickly the body uses energy and makes proteins.
5. birth control / sexually active
A. Every ____ person should be aware of contraceptive use.
B. There are several safe and effective methods of ____.
6. immunity / infection
A. The swollen lymph nodes are one of the earliest warning signs of ____.
B. Building ____ by using a vaccine is called immunization.

5. Match the name of the system with the functions it performs.

.
1. Urinary system a) Production of a new individual.

65
2. Endocrine system b) Defense against bacteria, viruses and other
pathogens that may be harmful.

3. Lymphatic system c) Moving a clear fluid that contains white

blood cells and removing excess tissue fluid.

4. Immune system d) Elimination of a waste product called urea

from the body, control of water and salt
balance.

5. Reproductive system e) Production of hormones in order to regulate

a wide variety of bodily functions.

Lis
LISTENING
6.
Listen to a conversation between a doctor and a patient and
. choose the correct answers.
1. What are the speakers mainly talking about?
a) different types of STDs
b) how to use contraceptives
c) the results of a pregnancy test
d) the importance of contraceptives
2. What is true of the woman?
a) She is not sexually active.
b) She always uses contraceptives.
c) She recently contracted an STD.
d) She does not take birth control pills.

Listen again and complete the conversation.

Nurse: … Let’s see. First, are you (1) ____ ____?
Patient: Yes, I am.
Nurse: And do you (2) ____ ____?
Patient: Um, well, (3) ____ ____ ____.
Nurse: Try to?
Patient: Well, I use them (4) ____ ____ ____ ____.
Nurse: Ms. Ryan, it’s very important for you to use a contraceptive
every time. If you don’t, you could end up with an (5) ___ ___.

66
 LANGUAGE PRACTICE
PRONOUNS
Can you complete the table with the missing pronouns?
I mine
you your
his himself
she hers
it its -

we our
their themselves

7. Put in a personal (me, you, etc.) or possessive (my, your, etc. or mine,
yours, etc.) pronoun.
1. ____ is five o’clock.
2. Mr Randolph is coming this morning with ____ two assistants.
3. How far is ____ to the Radiology from here?
4. That X-ray machine has got something wrong with ____ generator.
5. Ann didn’t like _____ test results. We told ____ that ____ were fine but
____ didn’t believe ____.
6. Sam didn’t invite Mel and Simon to the ward. He didn’t want ____ to
see ____ like that.
7. They are expecting your answer. Why don’t ____ phone ____?
8. The doctor prescribed ____ an effective medication for my cough.
9. We met John yesterday. _____ told ____ about the accident. ____ was
. really terrible.
10. I think her job is more interesting than ____, but she thinks ____ job
is more interesting than ____.

8. Put in myself, yourself, etc. or me, you etc.

.
1. Don’t pay any attention to ____ – he always complains.
2. The patient cut ____ shaving this morning.
67
3. John fell and hurt ____ yesterday.
4. The ward ____ was nice, but perhaps the toilet might be better.
5. No one is going to help us. So, we’ll have to do it ____.
6. Robert ____ is quite friendly, hut the rest of his family are very cold.
7. Mark talked to a patient sitting next to ____.
8. I had a phone call from the President ____.
9. The computer will turn ____ off if you don’t use it.
10. This patient is 93, but she lives all by ____.
11. The streetlights switch ____ on at night.
12. June can’t afford to buy ____ a wheelchair, so her friends are going to
buy one for ____.

9. Correct the mistakes. If a sentence is correct, put a tick (✓).

.
1. I let they go home.
2. Your diagnosis is just the same as mine.
3. Was it your decision or her?
4. John and her mother are in the waiting room.
5. That’s not my chart – this is the mine.
6. That baby has got something wrong with it’s eye.
7. Alex is a good friend of mine.
8. Is that my medicine or his?
9. Which is Dr Packer? – That’s he at the door.
10.Somebody’s taken my crutches instead of theirs.
11.This is her pills, these are your pills and these two are mine
pills.
12.Those x-rays belong to Pete and Sue – at least, I think they are
theirs x-rays.

WRITING
10. Complete an opinion essay about immunization choosing the
. words that best complete the sentences.
Some parents are choosing not to (immunize/operate) their children
nowadays. The claim is that there have been reported
(disasters/incidences) of (diabetes/measles) and smallpox vaccines being

68
 administered to healthy children, and soon after that the child shows signs
of (autism/depression).
(Besides/Nevertheless), I have no empathy for that opinion
whatsoever. The fact that parents can choose whether or not to protect
their children from (life-threatening/life-saving) diseases and are not doing
so proves that this is a first-world problem. Just last week, there was (an
essay/a report) that 5 children in a private school were diagnosed with
polio. Just because their parents refused to immunize them against this
crippling illness, these young people face a life of difficulty due to
(impaired/increased) mobility.
(In sum/ In the beginning), I believe it is ludicrous to not vaccinate a
child. I (critically/sincerely) hope that the next president passes legislation
to require all young people to be immunized.

SPEAKING
11. You have to talk to teenagers about sexually transmitted diseases.
. Complete the sentences with the words from the box to get some
basic facts and risk factors of STD.
BASIC FACTS alcohol abuse
 Young people are ____ of becoming infected
with STDs. develop an immunity
 STDs often cause no____.
especially at risk
 People may ____ to their sex partners without
even knowing it. from a mother to her
 STDs can be passed ____ baby before, during,
or after the baby’s birth. immediate symptoms
 You never ____ to STDs.
 STDs can cause ____. multiple

RISK FACTORS pass diseases

 Your ____ an STD increases with:
 ____ sex partners risk of developing
 Unprotected sex
sterility and death.
 Drug or ____
READING EXTENSION

69
.
12. Read and discuss some interesting facts about the human body.
 In a lifetime, the kidneys clean more than 1 million gallons of water,
enough to fill a small lake.
 The bladder can store almost half a litre of urine for 2 to 5 hours without
causing discomfort.
 The average person passes 1.5 litres to 2 litres of urine in 24 hours.
 There are between 400 and 800 lymph nodes in the body.
 Swelling of the lymph nodes in your neck are an indication that the body is
fighting an infection.
 Far from being a useless, the appendix has recently been discovered to be
an important part of the lymphatic system.
 The largest cell in the body is the female egg and the smallest is the male
sperm.
 A man’s testicles manufacture 10 million new sperm cells each day –
enough that he could repopulate the entire planet in only 6 months!

Lesson 9
70
 Human Body Energy Systems
VOCABULARY
digestive system [daI'GestIv sIstqm] травна система
to break down ['breIk daVn] розщеплювати
bloodstream ['blAdstrJm] кровотік
indigestible ["IndI'Gestqbl] неперетравлюваний
alimentary ["xlImentqri] травний
gastrointestinal ["gxstrqVIn'testInl] шлунково-кишковий
pharynx ['fxrINks] глотка
esophagus [i'sPfqgqs] стравохід
small/large intestine [In'testIn] тонкий/товстий
кишечник
rectum ['rektqm] пряма кишка
anus ['eInqs] відхідник, анус
salivary gland [sq'laIvqri glxnd] слинна залоза
liver ['lIvq] печінка
gall bladder ['gLl blxdq] жовчний міхур
pancreas ['pxNkriqs] підшлункова залоза
respiratory system [rq'spIrqtri sIstqm] дихальна система
oxygen ['PksIGqn] кисень
carbon dioxide ["kRbqn daI'PksaId] вуглекислий газ
airways ['eqweIs] дихальні шляхи
lung [lAN] легеня
nasal cavity ['neIzl] носова порожнина
larynx ['lxrINks] гортань
trachea [trq'kJq] трахея
bronchus (bronchi) ['brPNkqs, brPNkaI] бронх
alveolus (alveoli) [x'lvJqlqs, x'lvJqlaI] альвеола
bronchiole ['brPNkiqVl] бронхіола
LEAD-IN
 What are some common ailments of the respiratory system?
 What diseases can affect the digestive system?
 Have you had any of these diseases?
READING
Human Body Energy Systems
71
 The digestive system is responsible for receiving food, breaking it down
into nutrients (a process called digestion),
absorbing the nutrients into the bloodstream,
and eliminating the indigestible parts of food
from the body. The digestive system can be
divided into two main parts: the alimentary
(gastrointestinal) tract and accessory organs.
The alimentary tract is like a long muscular
tube, up to 10 metres long, with digestive organs
attached along the way: mouth, pharynx,
esophagus, stomach, small and large intestines,
rectum and anus. The accessory organs include the teeth, tongue, salivary
glands, liver, gallbladder, and pancreas.
The respiratory system is a group of organs responsible for
carrying oxygen from the air to the blood stream and expelling the waste
product carbon dioxide. The main parts of this
system are the airways, the lungs and linked
blood vessels, and the muscles that enable
breathing. The airways are passages that carry
oxygen-rich air to the lungs and carbon dioxide
out of the lungs. The airways include the nose
and linked air passages called nasal cavities,
mouth, larynx (voice box), trachea (windpipe),
bronchial tubes or bronchi, and their branches, called bronchioles.
Thousands of small air sacs (alveoli) are at the end of each bronchiole.
The lungs are the principal organs of the respiration and one of the
largest organs of the body. The left lung is slightly smaller than the right
lung to allow room for the heart.

1. Read the text and answer the following questions.

1.

1. What is the reproductive system responsible for?

2. What organs does the alimentary tract include?
3. What are the functions of the respiratory system?
4. What are the main parts of this system?
5. Why is the left lung smaller than the right lung?
72
2. Label the diagrams using the words given below.

 alveoli  larynx
 nasal cavity  trachea  stomach
 liver  tongue  esophagus
 lungs  pancreas  gallbladder
 mouth  rectum  small intestine
 bronchi  pharynx  large intestine

3. Solve the crossword puzzle.

1 2 Across:
3 3. An organ producing bile.
4 6. The part of the throat that
5 leads from the mouth to
6 7 the esophagus.
9. Two main tubes coming
8 9 from the trachea that
carry air into the lungs.
10 10. Organs inside the chest
11 which fill with air when
12 breathing in.
12. An opening through
13 which food passes into
the body.
13. Tiny air sacs of the
14 lungs where gases are
exchanged.
14. A muscular tube that
connects the throat to the stomach.
73
Down:
1. The area of the throat that contains the vocal cords and produces vocal
sounds.
2. The exchange of oxygen and carbon dioxide between living cells and their
environment.
4. An organ where bile is stored.
5. A part of the body at the end of the large intestine where solid wastes are
stored until they leave the body.
7. A process by which the body changes food so it can be used to supply
energy.
8. A muscular sack that stores food and helps to digest it.
11. The tube that connects the larynx to the lungs.

4. Put the steps of digestion in the appropriate order.

 .It absorbs the nutrients.
 The food goes to the esophagus.
 The liquid goes to the small intestine.
 The saliva mixes the food.
 The stomach turns the food into a thick liquid.
 The teeth break the food.
 Then it goes to the stomach.

5. Match the medical terms (1-5) often used to describe respiration

. to their meanings (a-e).
1. respirations a) a slow breathing rate
2. respiratory rate b) breathing in
3. inspiration c) breathing out
4. expiration d) breaths (movement of air in and out of the lungs)
5. apnea e) difficulty in breathing, shortness of breath
6. bradypnea f) rapid breathing
7. tachypnea g) temporary stopping of breathing
8. dyspnea h) the rate at which a person breathes in and out

74
 LISTENING
6. Listen to a conversation between a nurse and a patient. Mark the
. following statements as true (T) or false (F).
1. The woman’s children have asthma.
2. Quitting heals lung damage caused by smoking.
3. The woman decides to quit smoking.

Listen again and complete the conversation.

Nurse Hi, Mrs. Blake. I have a few (1) ____ before the doctor
: sees you. Are you still (2) ____?
Patien Yes. but not very much.
t:
Nurse Still, you need to quit. You understand the risks, don’t
: you?
Patien Of course. I know it causes (3) ____ ____.
t:
Nurse Yes. Plus, people around you are at risk of (4) ____
: ____.
Patien I know. And I don’t want my kids getting it. But quitting
t: is really hard.
Nurse It also helps heal the damage to your lungs and (5) ___
: ___.
Patien Well, I’ll think about it.
t:

LANGUAGE PRACTICE
RELATIVE CLAUSES
who for people: The patient who was admitted yesterday is getting
better.
whose for possession: That’s the patient whose father is our chief
surgeon.
which for things: The article on the liver which you wrote is great.
when for time: It was six o’clock when the ambulance arrived.
where for place: That’s the hospital where I work.
why for reason: The reason why I can’t help you is that I’m sick.
75
 7. Complete the sentences with the correct relative pronoun (who,
. which, when, where, why).
whose,
1. The left lung, ____ allows room for the heart, is slightly smaller.
2. Mrs Jenkins, ____ you see sitting over there, is our new staff nurse.
3. My left ankle, ____ I broke last winter, is still giving me trouble.
4. This is the body system ____ job is digestion.
5. The laptops, two of ____ belonged to nurses, were taken from the office.
6. The A&E is a department ____ you go if you have an emergency.
7. What is the name of that famous surgeon ____ we saw the other day?
8. He didn’t tell us the reason ____ he resigned.
9. I don’ know anyone ____ lifestyle is really healthy.
10. The thermometer ____ I bought last week from your store isn’t
working.

8. Match the terms to their definitions filling the gaps with

. appropriate relative pronoun.
1. digestion a) a device ____ is used for examining of
the larynx;
2. cholecystectomy b) a surgical procedure ____ the gallbladder is
removed;
3. gastroscopy c) the stage of development ____ a child changes
physically into an adult;
4. laryngoscope d) a procedure ____ x-rays are used for visualization
of the internal organs;
5. liver e) the process ____ breaks down food into smaller
parts;
6. puberty f) a large organ in the body ____ cleans the blood
and produces bile;
7. radiography g) the upper part of the bowels ____ most nutrients
are absorbed;
8. small intestine h) a procedure ____ a tube is inserted into the
mouth, down the esophagus, and into the stomach
to view these organs.
PURPOSE AND REASON
for Plants are often used for relieving pain.
76
to You should have physiotherapy to improve coordination.
in order to I’ll prescribe you some tablets in order to ease the pain.
so I felt tired, so I bought some vitamins.
so that Many people take vitamins so that they can stay healthy.
because I’m here because I’ve got an appointment with my GP.
that’s why I’ve got an appointment with my GP – that’s why I’m here.

9. Choose the best option to complete the sentences.

.
1. ____ I was sick, I stayed home.
a) Because b) So that c) In order to
2. Our teacher arranged some extra tutorials ____ give her students more
opportunities to ask questions before the examination.
a) so b) to c) because
3. We were unable to carry out the experiment ____ the computer
malfunctioned.
a) for b) that’s why c) as
4. Would you like to go outside ____ a short walk?
a) as b) so c) for
5. Sarah had a stomachache, ____ she made an appointment with a
gastroenterologist.
a) so b) in order c) so that
6. He opened the window ____ let fresh air in.
a) Because b) in order to c) so
7. Jason’s dream was to help people, ____ entered medical college.
a) that’s why b)) so that c in order to
8. It’s important to keep a food diary ____ you can check your progress.
a) for b) so that c) in order to
WRITING
10. Write about a sandwich journey through a person’s alimentary
. canal completing the sentences with the parts of the digestive
system.
The sandwich you’ve just had for lunch begins its digestion in your
____. While you chew your sandwich, chemicals in your ____ help break

77
it down into forms the body can more easily absorb. After a few bites of
your sandwich are chewed, moistened, and broken down, the food moves
on to the ____, the food pipe connecting your mouth to your stomach.
Once your sandwich travels through your esophagus, its next
destination is your ____. Partially digested sandwich sits in your ____ for
about 2 to 4 hours and then goes into your ____. It continues breaking
down the food and works to absorb the nutrients. By the time the sandwich
reaches your ____, the remaining material consists of undigested food
particles, water, and secretions from your small intestine. The primary
duties of the ____ are to absorb water and electrolytes from what was your
food and to compact solid waste so that it can be eliminated from your
body. The function of the ____ is to store stool temporarily, until your
body is ready to eliminate it.
SPEAKING
11. Study the information in the chart and get ready to comment on
. findings. Use the expressions given below.
the

 The chart shows ______ .  As we can see in the chart ______ .

 This data is related to ____  According to______ .
 The biggest slice refers to__ .  Sectors 3 and 4 are evidence that ___.
 This indicates that ______.  In general ______ .
 The second sector  These results suggest that ___.
represents____.

78
 READING EXTENSION

12. Read and discuss some interesting facts about the human body.
.
 Unless food is mixed with saliva you cannot taste it.
 An average person eats 50 tonnes of food and drinks 50,000 litres of
liquid during his life.
 1.5 litres of saliva are produced each day. During lifetime, a person
produces enough saliva to fill two swimming pools.
 The acids present in our stomach are strong enough to digest zinc.
 From all the oxygen that a human breathes, twenty percent goes to the
brain.
 We lose half a litre of water a day through breathing. This is the water
vapour we see when we breathe onto glass.
 The breathing rate is faster in children and women than in men.
 The need to breathe so much is due to carbon dioxide build-up more than
the need for oxygen. If there was a different way to get rid of carbon
dioxide, we would only need to breathe at a rate of about once per minute.

79
 Lesson 10
Nurses’ Specialties
VOCABULARY

emergency room [I'mE:Gqnsi rH відділення невідкладної

m] допомоги
intensive care unit [In"tensIv 'keq] відділення інтенсивної
терапії
delivery [dI'lIvqri] пологи
obstetric [qb'stetrIk] акушерський
urgent ['E:Gqn] нагальний, терміновий
severity [sI'verqti] тяжкість
injury ['InGqri] травма, пошкодження
equipment [I'kwIpmqnt] устаткування, обладнання
critical care ["krItIkl 'keq] інтенсивна терапія
neonatal ["nJqV'neItl] неонатальний
premature born ['premqCq] передчасно народжений
newborn ['njHbLn] новонароджений
immediate [I'mJdiqt] негайний, терміновий
pediatric ["pJdi'xtrIk] дитячий
common cold ["kPmqn 'kqVld застуда
]
infant ['Infqnt] немовля
adolescent ["xdq'lesnt] підліток
valuable ['vxljuqbl] цінний
cancer ['kxnsq] онкологічне захворювання
psychiatric ["saIki'xtrIk] психіатричний
mental illness ["mentl 'Ilnqs] психічне захворювання
psychological ["saIkq'lPGIkl] психологічний
LEAD-IN
 How is treating children more difficult than adults?
 What nursing specialties are the most challenging?
 What specialty would you choose?

80
 READING
Nurses’ Specialties
You can find nurses anywhere: in the
emergency room, in the intensive care unit, or
helping with a delivery of a baby in the
obstetric department. As a result, there are
countless types of nursing specialties.
An emergency room (ER) nurse is one who
cares for patients with urgent medical concerns. This professional helps
physicians assess the severity of a patient’s injury or illness, prepares
diagnostic equipment, and provides post-treatment care and counseling.
Critical care nurses take care of patients in the Intensive Care Unit and
monitor critically ill patients while also providing their basic care. This
work is intense and may require helping family members to deal with the
loss of a loved one.
Neonatal nurses care for sick and/or premature newborn babies and are
responsible for providing immediate care for patients and aiding doctors in
diagnostic and treatment procedures. Pediatric nurses work with children of
all ages, from 28 days old to 18 years old. They deal with anything from a
common cold to broken bones. Providing care to infants, young children, and
adolescents is one of the most challenging jobs a nurse could experience.
Oncology nurses provide valuable services to cancer patients and their
families. They might be responsible for cancer screening, assisting doctors
in treatment sessions, discussing care options with patients, or providing
educational information to the public.
Psychiatric nurses work with patients who are experiencing some sort
of mental illness, psychological disorders, and emotional distress. They
work with both inpatients and outpatients to provide quality care.

1.
1. Read the text and answer the following questions.
1. What does an emergency room nurse do?
2. What specialists care for patients with life-threatening illnesses?
3. Do neonatal or pediatric nurses work with children?
4. What services does an oncology nurse provide to cancer patients?
81
 5. Who do psychiatric nurses work with?
2. Match the words to make word-combinations. Use them in the
sentences of your own.
1. emergency a) illness
2. diagnostic b) screening
3. post-treatment c) room
4. life-threatening d) services
5. premature e) newborn
6. challenging f) information
7. valuable g) equipment
8. cancer h) distress
9. educational i) job
10.emotional j) care

3. Read and correct each sentence to make it true.

1. ER nurses care for patients with urgent medical concerns in the ICU.
2. Acute care nurses work in the Intensive Care Unit and deal with life-
threatening illnesses.
3. Neonatal nurses are responsible for monitoring the health of infants
before birth.
4. Pediatric nurses focus on the medical care of elderly patients, from
infancy to the teenage years.
5. Oncology nurses might be responsible for dental screening and
monitoring patients’ well-being.
6. Psychiatric nurses care for and support patients with childhood
illnesses.

4. Read what nurses say about their career paths, goals and passions
. and choose the most suitable specialty for each of them.
1. I’m quite attracted to working with children. a) dental nurse
2. I’ve always been very interested in detailed
b) pediatric nurse
anatomy, and I’m good with my hands.
3. I fancy helping expectant mothers deliver their c) ICU nurse
babies naturally.
d) geriatric nurse
4. I really enjoy taking care of critically ill patients.
5. I certainly prefer to work with elderly patients e) obstetrical nurse
82
 than, say, children.
5. Odd one out.
.
1. a) anxious b) concerned c) relieved d) worried
2. a) tough b) simple c) tricky d) challenging
3. a) counseling b) advising c) suffering d) educating
4. a) urgent b) critical c) trivial d) vital
5. a) manage b) monitor c) indicate d) control
6. a) option b) benefit c) plus d) advantage
7. a) downside b) disadvantage c) drawback d) withdrawal
8. a) bother b) trouble c) disturb d) determine

LISTENING
6. Listen to a conversation between a psychiatric nurse and a radio
. interviewer. Check (✓) the things which the nurse does regularly.
1.  work in a hospital
2.  work in people’s homes
3.  work with former prisoners
4.  use psychotherapy
5.  use electroconvulsive therapy
Listen again and complete the conversation.
Interviewer …Penny, what exactly is (1) ____ ____?
:
Nurse: Psychiatric nurses care for people with mental illnesses,
such as (2) ____ ____, ____ and so forth
Interviewer Are you based (3) ____ ____ ____?
:
Nurse: Personally no. I do most of my work at people’s homes.
Interviewer Really?
:
Nurse: Yes, my work involves the (5) ____ of people back into
society.
Interviewer People who have been previously hospitalized because
: of (6) ____ ____ ____, you mean?
Nurse: Yes, and also people with mental illnesses who have
83
 been imprisoned.
Interviewer Fascinating. And what does your work involve?
:
Nurse: I’m trained in a range of (7) ____.
Interviewer And is electricity still used in psychiatric treatment?
:
Nurse: (8) ____ ____? No, that s only used in a small number
of cases. I’ve never used it myself…

LANGUAGE PRACTICE
PRESENT CONTINUOUS
 actions in progress,  he is smiling
temporary or changing situations  he is not smiling
? is he smiling?

am/is/are verb+ing
+ I’m working hard.
- She isn’t working here.
? What are you working on?

7. Look at these sentences that a nurse or patient might say. Use the
. verb in brackets in the present continuous.
1. The phone _____ (ring). Can you get it, please?
2. I’m afraid she _____ (speak) with the doctor at the moment.
3. My hands _____ (hurt) worse and worse lately.
4. Mrs Jones _____ (feel) much better today.
5. You _____ (have) your surgery next Monday, aren’t you?
6. ____ the pain _____ (get) worse?
7. My husband _____ (not / cope) well with my illness.
8. I’m very worried about her. She _____ (not / eat) anything these days.
9. You _____ (take) any medications. Is that correct?
10. This buzzer _____ (not / work). Can you fix it for me, please?

8. Complete these conversations with the correct present continuous

. form of the verbs in brackets.
– Lisa, I need some help. (1)_________ (you / do) anything important?
84
– Yes, I’m sorry. I (2) ________ (change) Ms Bandine’s IV. Is it urgent?
– No, I can wait five minutes.
– What (5) ________ (the nursing assistants / do)?
– They’re with Ms Davis. I think they ________ (6) (take) her temperature.
– Mr Halpert’s call light is on.
– He (3) ________ (probably / complain) about pain again.
– The poor guy (4) ________ (have) trouble sleeping. I’ll go and
give him some pain medication.
PRESENT CONTINUOUS FOR FUTURE ARRANGEMENTS
I’m meeting a consultant tomorrow.
What are you doing tonight?
We’re having a meeting later today.

9. Complete these conversations with the correct present continuous

. Read this email and fill in the gaps with the suitable word from
the box. Use the correct form of the verb.
check feed have look meet phone see
Hi Karen,
How’s life? I’m just sooo busy! I have a 12-hour day today.
I _____ with the geriatric consultant at 9 a.m. to discuss treatment for one
of my patients. Then I _____ my supervisor to write an order for supplies
in the clean supply room. After that I _____ patients in rooms 10 to 30. I
only have 15 minutes for my lunch, so Stefan and I _____ a quick
sandwich in the nurses’ lounge. In the afternoon I _____ through medical
records with the receptionist and then I _____ an insurance company about
a patient in room 12. That always takes a long time. After that I _____ IV
fluids in all the rooms. It’s nonstop!
Anyway, that’s all for now! Off to work!
Lisa

WRITING
10. Read this profile of a student nurse and write a similar one about
. yourself, explaining
85
• why you decided to become a nurse;
• what you are doing now;
• your career plans.
I’m Tina and I’m nineteen years old. Now I’m studying for a
diploma in nursing at medical college. I have exams next month,
so at the moment I’m studying hard. I want to be a nurse because I
like working with people and I’m interested in science, but I really
don’t like doing paperwork.
I haven’t decided what to specialize in yet. I need more
experience before I decide, but I’m quite attracted to the idea of
pediatrics because I like working with children. I’m good at talking
to kids and making them feel comfortable, and I’m very organized.
I’ve worked on a children’s ward for three months in summer and I
really enjoyed it. One day, I hope to work in the children’s hospital,
which I saw on television.

SPEAKING
11. Give short explanations of the following nurses’ specialties.
. obstetrical nurse –
An
a cardiac nurse –
a surgical nurse –
a geriatric nurse –
a dental nurse –
READING EXTENSION

12. Read the text about Florence Nightingale choosing from (A-G) the
. one which fits each gap (1-7).
A. to be cleaned and had organized food and medical supplies.
B. Florence secretly studied nursing.
C. made sure they were taught basic skills of firs aid and hygiene.
D. in those days nurses had little or no medical training.
E. the soldiers loved her.
F. especially India.
G. each night she walked through the dark wards with her lamp,
bringing comfort to the sick.

86
 Florence Nightingale was born in 1820. She was named after the city of
Florence in Italy, where her parents went after they got married in 1818. Rich
families in England did not send girls to school in those days, but her father
made sure that she and were educated at home. When she was eighteen,
Florence became convinced that her aim in life was to care for the sick. This
idea horrified her parents, because (1) ____ . But in spite of her parents’
objections, (2) ____ .
In 1854 Florence Nightingale was asked to lead a group of nurses to care
for British soldiers wounded in the bloody battles of the Crimean War. When
she arrived, Nightingale found the soldiers in terrible conditions. Within a few
weeks she had arranged for the hospital (3) ____ . As a result, the sick and
wounded were far more comfortable. She was devoted to the care of her
patients and (4) ____ . They called her the “Lady of the Lamp” because (5)
____ .
After the war, Florence Nightingale worked on improving army
hospitals in England. She also concerned herself with health problems in
British colonies overseas, (6) ____ . In 1860 Florence Nightingale established
the first training school nurses at St Thomas’s Hospital in London. She laid
down strict rules for the behaviour of nurses and (7) ____ . The nurses brought
her ideas to other countries; her methods form the basis of nursing training
today.

87
 Lesson 11
Qualities of a Professional Nurse
VOCABULARY
knowledge ['nPlIG] знання
degree program [dI'grJ prqVgrxm] дипломна програма
quality ['kwPlqti] якість
to contribute to [kqn'trIbjHt] сприяти
success [sqk'ses] успіх
caring ['keqrIN] турботливий
compassionate [kqm'pxSqnqt] співчутливий
point of view ["pOInt qv 'vjH] точка зору
respectful [rI'spektfl] шанобливий, ввічливий
crucial ['krHSl] вирішальний, критичний
to provide care [prq"vaId 'keq] забезпечувати догляд
medical record ['rekLd] медична картка
severe consequence [sI"vIq 'kPnsIkwqn серйозний наслідок
s]
skill [skIl] вміння, навик
critical thinking ["krItIkl 'TINkIN] критичне мислення
problem solving ['prPblqm sPlvIN] вирішення проблем
patience ['peISns] терплячість
to overcome ["qVvq'kAm] здолати, перебороти
anxiety [xN'zaIqti] тривожність
to be eager ['Jgq] прагнути
workshops ['wE:kSPp] семінар
time management ['taIm mxnIGmqnt керування часом
]
emotional stability [I"mqVSqnl stq'bIl емоційна стійкість
qti]
flexibility ["fleksq'bIlqti] гнучкість
attitude ['xtItjHd] ставлення, відношення
passion ['pxSn] пристрасть
unique [ju'nJk] унікальний
LEAD-IN
 How do nurses become qualified in our country?
88
 Why do medical students need lifelong education?
 What three qualities do you have to be a good nurse?
READING
Qualities of a Professional Nurse
Good nurses not only possess knowledge
acquired through a nursing degree program, but they
also have other qualities that greatly contribute to
their professional success and wellbeing of their
patients.
The number one quality of a good nurse is
caring. When you show patients you care about them, they’re more likely
to open up to you. Being compassionate, thinking about things from the
person’s point of view and being respectful are all important.
When it comes to providing medical care, attention to detail is crucial.
From keeping medical records to developing a care plan, a nurse must avoid
making errors at all costs. In this field, mistakes can have severe
consequences.
Nursing requires strong analytical and problem-solving skills.
Problem solving is defined as a response given in a difficult situation,
where critical thinking is required for a solution. As a nurse, one thing
you’re going to need a lot of is patience. It’s essential to be patient
educating people on their health and helping them overcome anxiety, stress
and fear.
Medical knowledge and technology are advancing very rapidly, so it
is important for nurses to be eager to learn and keep working on
improving their skills and learning new things. This professional growth
can be achieved through lifelong learning such as reading, attending
workshops, conferences and courses.
Some other qualities of a great nurse include strong communication
skills, time management, emotional stability flexibility, optimistic attitude
to their job, passion and desire to help others. While each nurse brings
their own unique qualities to their work, the qualities that make a great
nurse can be learnt, encouraged and grown.
1. Read the text and answer the following questions.
1. What does a nurse need to become a good professional?
89
 2. When are patients more likely to open up to the nurse?
3. Why is attention to detail crucial?
4. How can professional growth be achieved?
5. What other qualities are important to be a great nurse?
2. Match the synonyms.
1. characteristics a) good
2. crucial b) greatly
3. enthusiasm c) qualities
4. excellent d) important
5. fast e) errors
6. mistakes f) consequences
7. nervousness g) anxiety
8. outcomes h) rapidly
9. significantly i) passion
10.sympathetic j) compassionate

3. Fill in the gaps with the most appropriate verb from the box and
you will get 10 strategies to be professional in the workplace.

Attend Be Bring Collaborate

Communicate Deliver Dress Follow Keep
Take
1. ____ effectively
2. ____ time to listen to patients
3. ____ a positive – and realistic – attitude to every shift
4. ____ to patients with compassion
5. ____ accountable for your actions
6. ____ your nursing knowledge up-to-date
7. ____ top-quality care
8. ____ with coworkers
9. ____ strong ethical practices when making nursing decisions
10. ____ and style yourself professionally

4. Reorder the words to make expressions that nurses use to improve

. communication with patients.
Showing empathy
90
1. how you / feeling / I understand / must be
2. for you / it’s difficult / I can see
Reassuring
3. clean you up / much better / Let me / and you’ll feel
Please
4. be embarrassed, Sheila; / happen to anyone / it can / Don’t
5. of my job / I’m used / it’s part / to it;
Respecting the patient’s privacy
6. come back / Do you / later? / want me to
7. a screen / a little privacy / have / to put round the bed, / I’ll bring / so you
can

5. Read these comments that patients made about their nurses. Are
. they positive (P) or negative (N)?\
1. She never listens. I want a nurse who is attentive.

2. The nurses in Central Hospital are always caring and patient.

They take time to sit and talk to us, even when it’s really busy.
3. He’s really well-informed about medicine. I think that’s important
– you know you’re in good hands.
4. One of the nurses is just so unfriendly. He never smiles and he’s
not very polite either. He often shouts at the patients.
5. Nurse Kepner is very flexible and she changes her routine when
her patients need her.
Lis
LISTENING
6. Listen to a conversation between a job interviewer and a nurse.
. the following statements as true (T) or false (F).
Mark
1. The woman has no experience as nurse.
2. One of the job duties is to give vaccines.
3. The woman prefers the fast patient flow of hospitals.

Listen again and complete the conversation.

Interviewer Jane, I’m Richard Jenson. I’ll be interviewing you for
: the RN (1) ____.
Nurse: Nice to meet you, Mr. Jenson.
91
Interviewer So, what kind of experience do you have?
:
Nurse: Well, I started volunteering in hospitals as a teenager.
I’ve worked as an RN for the past (2) ____ ____.
Interviewer And why did you go into nursing?
:
Nurse: I love (3) ____ ____ of people. It brings me a lot of joy.
Interviewer Excellent. Now, this is a general practice. You’ll be
: giving (4) ____ ____ ____ and assisting with annual
physicals.
Nurse: Everyday tasks. I understand.
Interviewer Is that appealing to you?
:
Nurse: Yes, because there’s more interaction with patients.
(5) ____ are too fast-paced.
Interviewer Right, it’s definitely slower here. But we still have to
: maintain patient flow.
Nurse: Of course.
Interviewer Now, have you worked with (6) ____ ____ ____?
:
Nurse: Yes, we switched to them several years ago.

LANGUAGE PRACTICE

PRESENT SIMPLE OR PRESENT CONTINUOUS

She works on the children’s ward. I’m working on an interesting project.
You have all the qualities to be a great nurse. He’s having dinner with his friend.

7. A Senior Staff Nurse is explaining the layout of the hospital. Choose

. correct prepositions in italics to complete the explanations 1-6.
the
Brian _____ (be) a nurse. He _____ (look) after sick people. He usually
_____ (get) up at 6.00 o’clock. Today he is late, it is 6.30 and he _____
(be) still in bed. He usually _____ (go) to work by train but today he
_____ (drive). He _____ (arrive) at work at 6.30 every morning but it is
7.00 now and he _____ (still drive).
92
 It’s 12.00 o’clock. He always _____ (have) his lunch at midday but
right now, he _____ (not have) lunch, he _____ (look after) his sick
patients.
It is half past seven now, Brian _____ (watch) TV. He usually _____
(watch) TV at half past seven because his favorite programme _____
(start) at that time.
It is 11.30 now Brian _____ (go) to bed. He always _____ (go) to bed
around midnight.

STATIVE VERBS IN ENGLISH

POSSESSION SENSE EMOTION MENTAL STATE OTHERS

belong feel care agree be

have hear hate believe consist
own see like forget contain
possess smell love know cost
sound need remember include
taste prefer think seem
touch want understand weigh
8. Read this student nurse’s email home to her friend. Choose the
. correct verb forms to complete it.
Hi Eve,
I (write/’m writing) to say thank you for the birthday card, and to tell you
how I (get on /’m getting) on. The course is hard work, but I (enjoy / am
enjoying) it so far. We usually (have /are having) classes every morning,
but this week I (work / ‘m working) in Geriatrics all day. It’s interesting,
although of course I (want /’m wanting) to work as a scrub nurse.
On the geriatric ward I (make / ‘m making) beds and (check
/checking) patients’ blood pressure and temperature. I (learn / ‘m
learning) a lot, and the experience (is / is being) very useful.
I (go out /’m going out) most Saturday nights but stay in and study
on other days. Tomorrow, I (go/’m going) to a restaurant for my birthday!
I (make/’m making) a lot of friends, but I wish you were here too. Write to
me!
Love,
Maria Carmen

93
 9. Complete these sentences with the present simple or present
. continuous of the verbs in brackets.
1. I ________ (look after) Mrs Watson today.
2. This month Lisa, a student nurse, ________ (work) with me.
3. I’m a triage nurse and I ________ (work) in the emergency room of a
large hospital in Melbourne.
4. My colleagues and I _______ (deal with) new patients as they arrive in
ER.
5. We also ________ (assist) the doctor and decide on the order of priority
for treatment.
6. I ________ (not / understand) why I have to lie down all the time.
7. I like working with old people and I ________ (want) to specialise in
geriatrics.
8. Don’t you think the pain ________ (get) better with your treatment?
9. Mrs Royle ________ (not / like) talking about her illness.
10.________ your back ________ (hurt) when you lie down?

WRITING

10. Read some rules for nurses. Make up your own rules of effective
. work.
1. Read the order of the doctor before you give medicines.
2. If you make a mistake in your work, you must tell the doctor about it.
3. Do not be rude when you speak with patients.
4. Learn to control your feelings. When you are angry – count up to hundred.
5. Don’t gossip about your patients.
6. Never say the word "incurable".
SPEAKING
11. Read the profile of a nurse and get ready to talk about your
.
personal qualities that will make you a great nurse.
I chose nursing career as I decided to dedicate my life to the care of
others. I’ve always been very caring and compassionate, and I’m ready to put
my own health at risk to help the sick to become better. I like to work

94
directly with people, despite the many challenges a job like this can present.
Helping those people, who are in pain, gives the spiritual satisfaction.
The most important strength of mine is that I am soft-hearted, and I can
feel the pain of others. I hope to give not only my book knowledge, but a
piece of my heart to every patient I will care for. I’m communicative,
initiative, emotionally stable, patient and dedicated.
I believe that the study at the medical college will help me to gain
professional knowledge so that along with my professional skills and with
my passion to help people, I will become a very good nurse.
READING EXTENSION

12. Read the text below. Use the word given in capitals at the end of
. some of the lines to form a word that fits in the gap in the same
line.
To be a good nurse, a nursing (1) ____ is not all you QUALIFY
need. As a nurse, your (2) ____ plays a huge part in how PERSONAL
(3) ____ you are in your work. Therefore, it’s very SUCCESS
important to make an honest (4) ____ of your own ANALYSE
character before you start a career in nursing. You should ESTIMATE
certainly not (5) ____ the challenges involved in the (6) OCCUPY
____. ABLE
As a nurse, you need to have the (7) ____ to care for
patients on both a medical and a personal level. For TOLERANT
example, (8) ____ of difficult patients is a very important ENJOY
quality. All in all, nursing may not always be (9) ____, but ACHIEVE
very few other jobs give such a wonderful sense of (10)
____ each day.

95
 Lesson 12
A Working Day of a Nurse
VOCABULARY

healthcare facility ['helTkeq fq'sIlqt медична установа

i]
to assist [q'sIst] допомагати
to be on staff [stRf] працювати
illness ['Ilnqs] захворювання
ailment ['eIlmqnt] нездужання
condition [kqn'dISn] стан
injury ['InGqri] травма, пошкодження
shift [SIft] зміна, чергування
handover ['hxndqVvq] передача чергування
doctor’s office ["dPktq PfIs] кабінет лікаря
vital signs ['vaItl saInz] життєво важливі ознаки
to administer [qd'mInIstq] призначати
dressing ['dresIN] перев’язка
bloodwork ['blAdwE:k] аналіз крові
glucose ['glHkqVs] глюкоза
diabetic ["daIq'betIk] діабетичний
procedure [prq'sJGq] процедура
to monitor ['mPnItq] наглядати, спостерігати
treatment ['trJtmqnt] лікування
to examine [Ig'zxmIn] оглядати, обстежувати
ward [wLd] палата
round [raVnd] лікарняний обхід
duty ['djHti] обов’язок
promptly ['prPmptli] швидко
to handle paperwork ['hxndl] працювати з документам
case history ['keIs hIstri] історія хвороби
to compile [kqm'paIl] упорядковувати
LEAD-IN
 Why do some nurses work long hours?
 What are the dangers of nurses working too much?

96
  What’s the starting salary for a qualified in our country?
READING
A Working Day of a Nurse
Healthcare facilities typically require nurses to be on staff 24/7 to
assist patients with illnesses, ailments, medical
conditions, and injuries. A nurse’s working day varies
from facility to facility and is usually eight or twelve
hours long. You might work a day, night or evening
shift. A shift starts with a handover by the nurse of the
previous shift which includes an update on the
condition of each patient.
Each nurse will have a number of patients; the time spent with each
will vary, but, in general, it will be around 30 minutes for nurses in a
hospital and a little less for nurses in a doctor’s office. In this time, a
nurse’s tasks include checking the patient’s vital signs, administering
necessary medication, and changing dressings as appropriate. It’s common
to do bloodwork in the morning, do glucose tests for diabetic patients,
prepare patients for procedures, etc. The patients are closely monitored
throughout their treatment to ensure they remain as healthy, comfortable
and pain-free as possible. When doctors come and begin to examine their
patients, every ward nurse tells the doctor about the condition of her
patients.
The ward round is one area where teamwork is essential. It is the
time when patients are reviewed by as many as possible of the
professionals involved in the care and treatment of the patient. In most
of hospitals, doctors make their rounds at about 9 a.m. It is generally the
nurse’s work to prepare the patients needed for examination. For nurses,
morning round is one of the opportunities for receiving clinical
instructions. Each nurse should be ready to attend to her duty promptly.
At least some portion of a nurse’s day will be spent handling
paperwork. This is necessary as there are patient case histories that need
compiling. The nurse must make sure that the appropriate paperwork has
been completed.
1. Read the text and answer the following questions.
1. How long is a typical nurse’s working day?
97
 2. How much time do nurses spend with each patient?
3. What are common nurse’s tasks in the morning?
4. What is the ward round?
5. Why is it necessary to complete the appropriate paperwork?

2. Match the opposites.

1. eight hours a) shift
2. night b) round
3. doctor’s c) patients
4. vital d) long
5. changing e) instructions
6. diabetic f) office
7. morning g) dressings
8. clinical h) paperwork
9. handling i) histories
10.case j) signs

3. During the day a nurse uses a lot of the instruments and devices.
How many of them can you find in the picture? Match each one
with its corresponding usage.

Devices and instruments Use

1. Syringe a) to check a temperature
2. Stethoscope b) to cover cuts, blisters, etc.
3. Scissors c) to inject patients
4. Adhesive tape d) to cut bandages
5. Thermometer e) to check blood pressure
6. Adhesive plasters f) to fix dressing to wounds

98
 4. Match (1-5) to (a-e) to make expressions you can use to calm a
. patient.
1. It’s OK, I’m a) good hands.
2. Please try b) care of you.
3. You’re in c) here.
4. The doctor d) to relax.
5. We’re taking e) is coming in a few minutes.
5. Can you guess which word on the left matches the definition on
. the right?
1. Nurse’s lounge a) the ward area where nurses keep the patients’
records and other documents
2. Nurse’s station b) the room where dirty towels, bedclothes are
collected before taking them to the laundry
3. Lift c) the room where nurses rest during coffee/tea
breaks
4. Clean-linen room d) the room where the clean bedclothes, towels,
etc. are kept
5. Dirty-linen room e) the equipment used to take people to upper
floors

Lis
LISTENING
6. Listen to a conversation between a nurse and his supervisor and
. choose the correct answers.
1. What is the dialogue mostly about?
a) the length of the man’s shifts
b) overtime pay that the man earned
c) a nurse asking to work fewer hours
d) problems caused by an overworked nurse
2. According to the dialogue, what will the supervisor try to do?
a) offer some of the other nurses overtime
b) get someone else to take over the man’s shifts
c) try to lighten the man’s daily workload a bit
d) give the man more breaks while he is at work

Listen again and complete the conversation.

99
Nurse: Excuse me, Janet. Can I talk to you?
Supervisor Sure. What’s (1) ____ ____ ____?
:
Nurse: I was wondering if another nurse could take over a
couple (2) ____ ____ ____.
Supervisor Why? Is everything okay?
:
Nurse: Yeah, I’m fine. But I leave work feeling (3) ____ ____on
most days. And the exhaustion is starting to get to me.
Supervisor So, you’re feeling (4) ____?
:
Nurse: A bit. My workload is a little heavy,
Supervisor I’m sorry to hear that. But unfortunately, I’m not sure I
: can do much.
Nurse: Oh. May I ask why?
Supervisor Well, it’s not that I don’t want to help, but we’re already
: (5) ____ ____ nurses.
Nurse: So, there’s no way to cut my hours?
Supervisor Not really. It would mean giving the other nurses
: (6) ____. And that’s just not in the budget.
Nurse: It’s okay. I understand.
Supervisor I can look into possibly getting you (7) ____ ____ ____
: more breaks during shifts. Would that help?
Nurse: Yes. Even that would be great.
Supervisor Alright. I can’t make any (8) ___. But I’ll see what I can
: do.

LANGUAGE PRACTICE
PRESENT PERFECT CONTINUOUS
 recent continuing activities  he has been waiting
  he has not been waiting
? has he been waiting?

have/has been verb+ing

+ She has been working since 6:00 this morning.
100
 - I haven’t been waiting for long.
? How long have you been sleeping?

7. Fill in the blanks with ‘for’ or ‘since’.

.
1. She has been staying in our hospital ______ three weeks.
2. Rita has been answering emails ______ she returned from the meeting.
3. James has been visiting his cardiologist ______ he was a child.
4. Alice has been administering medication ______ morning.
5. They have been revising the material for the exam _____ three days.
6. It has been snowing heavily ______ Monday.
7. Ann has been practising nursing ______ three years.
8. The new doctor has been working here ______ April.
9. John has been working here ______ January.
11. David has been changing dressings ______ two hours.

8. Five nurses have just finished some jobs. Look at the table and
. complete short dialogues below using the present perfect
continuous.
NURSES ACTIVITY
Carol prepare patients for procedures
Rachel update relatives on patients’ condition
Neil check patients’ temperature
Paul carry a patient
Tim fill in case histories
1. – Paul, you’re sweating. – I have been carrying a patient.
2. – Neil, why is there a thermometer in your pocket?
3. – Carol, you look tired.
4. – Rachel, why are you late for the meeting?
5. – Tim, what have you been doing since the morning round?

9. Complete the sentences by writing the verb in brackets in the present

. simple, present continuous or present perfect continuous.
1. The coffee ______ (smell) good.
2. The patient in ward 6 is ______ (get) better every day.
3. You ______ (write) an essay for two hours.
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 4. He ______ (go) to the physiotherapy clinic three times a week.
5. The doctor ______ (operate) on your sister since the very morning.
6. I’m exhausted. I ______ (train) my stomach muscles all morning.
7. We _____ (have) a conference next Friday. Will you come?
8. Right now, the nurse _______ (talk) on the phone.
9. I ______ (look) for your case history for an hour.
10. Could you close the window? I ______ (freeze).
11. Mike ______ (compile) paperwork for an hour already.
12. Our clinic is private and it always ______ (close) for Easter
holidays.
WRITING
10. Night shift vs morning shift. Read two nurses’ posts about
. working shifts and write a similar one giving your personal
opinion.

Day shift is obviously better. It

does not impact our sleep Well, I honestly think night shift
schedule. Nature wants us to work is the best. Generations of my
in daytime and sleep at night. family work nights. Here's my
Working night shifts completely reasons:
changes the schedule. I used to 1) less people. I like people but
spend entire day in sleeping and I working around a lot of people
used to forget about my lunch. makes me nervous.
Sometimes I could not even get 2) less superiors. Nothing worse
time to speak with my family, it than big bosses staring you
affects the social life as well. down as you work.
During the daytime you need to 3) It's more fun and less
sleep and you miss most of the stressful. Work can be
social gathering, I also used to miss productive and fun at the same
dinner with friends and night time.
movies too. 4) It’s easier for me to stay
I think working night shifts awake then to wake up and
drag myself out of bed at 6 am.
continuously is harmful for health.

102
 SPEAKING
11. Describe the working day of a nurse using the words and word-
. combinations from the box. You can use the beginning below.
 to prepare a bed;  to administer medication as
 to check the equipment prescribed;
attached to the patient;  to assist the doctor with
 to observe patient’s vital procedures;
signs;  to take blood tests;
 to assess the patient’s  to record patients’ blood pressure;
condition;  to communicate with families;

Nurses are highly trained, licensed members of medical staff who use their
knowledge and skill sets to support patients through operations and various
procedures, develop treatment plans and offer advice on outpatient care. In
hospitals most nurses can work shifts to provide 24-hour care to patients
suffering from serious and acute conditions. A day in the life of a nurse
can include a wide range of duties…

READING EXTENSION

12. Read the article from The Daily Post. Then, mark the following
. statements as true (T) or false (F).
The findings of the latest Daily Post survey are startling: over fifty
percent of Springfield County nurses feel overworked. The survey asked
three hundred full-time and part-time nurses to rate their work experiences.
The results reveal that the majority of nurses work long shifts with few
breaks in between. Most reported feelings of fatigue and lack of energy.
Nurses cited several reasons for this exhaustion. Low pay drives
nurses to work longer hours to earn overtime pay. Furthermore, high stress
on the job leads many nurses to retire early. And although demand for
nurses is high, few hospitals have the budget to hire more. The dangers of
such strain are obvious. Low energy and tiredness can negatively affect job
performance and put patients at risk.

103
 But the surveyed nurses also offered solutions to these issues.
Among their suggestions was an increase in part-time positions to reduce
stress on nurses working long hours. Finally, a majority of nurses
requested shorter shifts with lighter workloads to prevent exhaustion and
on-the-job errors. And they want these changes soon. According to the
nurses, delaying these improvements threatens the well-being not only of
medical providers, but that of patients, too.
4. The Post survey interviewed half of Springfield County nurses.
5. Hospitals are not hiring new nurses for financial reasons.
6. The nurses also suggested reducing part-time positions.

104
 Lesson 13
Infection Prevention
VOCABULARY
infection [In'fekSn] інфекція
prevention [prI'venSn] профілактика
health facility ['helT fq'sIlqti] медична установа
avoidable [q'vOIdqbl] той, якого можна уникнути
healthcare ['helTkeq prqvaIdq] медичний працівник
provider
germs [GE:m] бактерії, мікроби
staff [stRf] персонал
to contaminate [kqn'txmIneIt] заражати
droplet ['drPplqt] крапелька
equipment [I'kwIpmqnt] устаткування
sterile ['steraIl] стерильний
microorganism ["maIkrqV'LgqnIzq мікроорганізм
m]
precaution [prI'kLSn] запобіжний захід
skin surface ['skIn sE:fIs] поверхня шкіри
blood [blAd] кров
to destroy [dI'strOI] руйнувати
surgical ['sE:GIkl] хірургічний
asepsis [eI'sepsIs] асептика
procedure [prq'sJGq] процедура
to isolate ['aIsqleIt] ізолювати
disease [dI'zJz] захворювання
contagious [kqn'teIGqs] заразний
virulent ['vIrqlqnt] хвороботворний
resistant [rI'zIstqnt] стійкий
antibiotic ["xntibaI'PtIk] антибіотик

LEAD-IN
 Why is cleanliness important in a hospital?
 How do infections spread?

105
  Can you name any deadly infectious diseases that have spread around
the world?
READING
Infection Prevention
Infections that patients get while receiving care in a health facility harm
millions of people each year. It is important to prevent and control avoidable
infections – for the sake of patients and healthcare providers.
Germs are a part of everyday life and are found everywhere including
our bodies. They are carried by staff who have not
properly washed their hands or whose uniforms are
contaminated, by dust or droplets of air, by visitors, by
other patients, or by equipment that is not sterile. An
infection occurs when germs enter the body, increase in
number, and cause a reaction of the body. These microorganisms may cause
macroproblems.
Preventing the spread of infections is extremely important nurse’s
responsibility in hospitals. The most universal precaution is handwashing.
You should immediately wash your hands and any other skin surfaces that are
contaminated with blood or other potentially infectious body fluids. The
easiest way to prevent the spread of infection is to destroy the germs when
they are on hands, equipment and furniture.
To prevent the spread of infection in hospitals, nurses and other health
care providers follow the practices of medical and surgical asepsis. Clean
technique (medical asepsis) reduces the number of germs present and prevents
them from being passed on to patients. Surgical technique (surgical asepsis)
involves keeping objects and areas free of germs to make sure that procedures
are sterile.
You may sometimes need to isolate a patient to prevent the spread of
infection. This can happen when a patient has a disease which is easily caught
by others (a highly contagious or highly virulent disease) or an infection that is
resistant to standard antibiotics. The aim of isolation is to protect other
patients, visitors and staff, while also giving the right care to the infected
patient.
1. Read the text and answer the following questions.
1. Whose responsibility is to prevent the spread of infection in hospitals?
106
 2. Who can carry infections in hospitals?
3. What is the easiest way to prevent the spread of infection?
4. Does medical or surgical asepsis involve keeping procedures
sterile?
5. When can a patient be isolated?
2. Find in the text the terms for the following definitions. The first
letter is provided.
1. a condition in which bacteria or viruses that cause disease
have entered the body i
2. a very small organism that spreads disease g
3. a particular set of clothes that has to be worn by the
members of the same organization or group of people u
4. an action that is done to prevent something unpleasant or
dangerous happening p
5. The action or process of washing one’s hands h
6. The exclusion of bacteria and other microorganisms,
typically during surgery a
7. a medicine that can destroy harmful bacteria in the body or
inhibit their growth a
8. the state of being separated from other people i

3. Personal protective equipment (PPE) is especially important due

to frequent contact between nurses and patients. Look at the
pictures and put the appropriate numbers below.

107
 gown head cover goggles
gloves shoe cover apron
face mask
4. Complete the sentences with the words from Ex. 3.
.
1. I hardly recognized my friend, wearing a surgical … .
2. I don’t think we need to routinely wear glasses, … or face shields like
we need to wear masks.
3. She stressed that using … should not been seen as a replacement for
good hand hygiene.
4. Wearing a … is a major issue in the fight against the spread of the
COVID-19 pandemic.
5. The nurse’s uniform was a full-length dress with long sleeves and an
….
6. Head covers should be removed from behind the head – taking care to
refrain from touching the head.

5. Match five main routes of disease transmission with their

. explanations.
1. Airborne a) direct (contact with body fluids)
2. Droplet or indirect (touching an item that has germs on it)
b) by air or dust and can be carried long distances
108
3. Contact c) by water, milk, food
d) by droplets from coughing, sneezing, laughing, or
4. Vector borne
talking that only travel about one meter
5. Vehicle e) by insects & animals
LISTENING
6. Listen to a conversation between a doctor and a patient. Mark the
. following statements as true (T) or false (F).
1. The man’s illness is not contagious.
2. The man will recover in a few days.
3. The doctor will send the man home with antibacterial soap.

Listen again and complete the conversation.

Doctor: Well, Mr. Larson, you have (1) ____. It’s a fairly common
strain. You should (2) ____ in a day or two.
Patient: Okay. I hope I don’t give it to my granddaughter.
Doctor: It is a (3) ____ ____ ____. Do you live in the same house?
Patient: Yes. She’s visiting for the holidays.
Doctor: Well, make sure to (4) ____ ____ ____ regularly. And use
(5) ____ soap.
Patient: I will. Is there anything else I can do?
Doctor: You could (6) ____ ____ ____ for a few days. I’ll give you a
few to take home.

LANGUAGE PRACTICE

PAST SIMPLE
 finished actions  he came
in the past  he did not come
? did he come?

+ V2 / V+ed I cleaned this ward a minute ago.

- did not + V You didn’t clean_ the door
handles.

109
 ? did … + V? Did you wash your hands?

7. Circle the 12 past simple forms in the wordsearch puzzle, then

. write their infinitive-without-to forms.
h e a r d t y r t u hear-heard
a o p a w s q d o k
d a w t s f g h o n
j k l h x b r o k e
z s p o k e w e c w
l m b u s f u d n j
m w e g d a y g m l
w e f h i e m a d e
a n h t k c g k i f
s t i k c a m e i t

8. Make these sentences positive.

. Nurses weren’t responsible for ward hygiene.
1.
2. Cleaners didn’t wash the floors four times a day.
3. Doctors didn’t see their patients.
4. Visitors didn’t wear their masks.
5. They didn’t know much about infection prevention.
Make these sentences negative
6. Nurses’ knowledge of universal precautions was poor.
7. We discussed new hygiene standards.
8. She had to use a sterile swab.
9. I wrote a hygiene report last week.
10.He went to the bathroom to wash his hands.

9. Read the text about what I usually do when I have a cold. Rewrite
. the text changing it to the past and underline the changes.
I call to the registry and make an appointment with my district
doctor. When I arrive at the polyclinic, the registering clerk finds my
patient’s card and directs me to consulting room 5.

110
 I don’t have to wait long. Soon the nurse invites me to come in. She
gives me a thermometre to keep it in the armpit for several minutes. The
doctor asks me what is wrong with me. I tell her my complaints, namely
dry cough and a bad headache. After that she begins to examine me.
First, she feels my pulse and measures my blood pressure. Then she
examines my throat and listens to my lungs. The doctor doesn’t think there
is anything wrong with me, just a common cold. So, she writes out a
prescription for some medicine to make me feel better. She also
recommends me to stay in bed for several days.
Yesterday I felt sick, so I decided to consult a doctor. I
called to the registry and made an appointment with … .

WRITING
10. Following the hygiene inspection, you were asked to make a
. notice reminding nurses about good hygiene practice. Complete
the list of rules and instructions for the nurses.
HYGIENE REMINDER!
1. Wet your hands with clean —
preferably running — … .
2. Apply enough … to cover all
surfaces of your hands and wrists.
3. … your hands and wrists for at
least 20 seconds. Make sure to
scrub all surfaces of your …, …,
…, and wrists.
4. … your hands and wrists under
clean — preferably running — … .
5. … your hands and wrists with a
clean towel or let them air-dry.
6. Use a … to turn off the faucet.

SPEAKING

111
11. A patient who does not understand that the precautions are
. routine may feel anxious. Match the reassurance and explanations
below to your actions to calm them down.
What you do What you say to the patient.
1. Changing a) We’ll be moving you to a single room Mrs. Brookes,
a gown just until this infection clears up. It’ll be quieter in
there. I hope you don’t mind
2. Using b) Do you think you could wash your hands before
sterile you help him eat? Your father is very vulnerable to
gloves infections at the moment
3. Asking c) I’ll just change my gown, we need a new one very
relatives to often to stop the chance of us spreading any germs
wash their
hands
4. Changing d) I’ll just rinse my hands again
a gown
5. Wards e) We use gloves with all patients to stop infection
cleaning spreading
6. Putting on f) I need to clean this urine up straight away. We like
rubber to keep the ward as clean as possible to help stop
gloves infection
7. Isolating a g) I need to take special care when doing your
patient dressing to make sure that your wound doesn’t
become infected

READING EXTENSION

12. Fill in the gaps with the right word from the options given below.
. I wear a blue uniform because I am a ward sister, and I am
responsible (1) ____ ward hygiene and the quality of patients’ food.
My job is to do everything necessary to (2) ____ and control
infection. Because a lot of infections spread by hand, I make (3) ____ that
everyone follows the cleanliness procedures. (4) ____ example, hands
must be washed before and after patient contact, before and after taking
off gloves, and after helping a patient use the toilet.
I am in charge of ward budgets, and controlling the money means I
have real (5) ____. Sometimes I (6) ____ to pay cleaning and catering
112
companies if I’m not happy with standards. But I don’t like to be (7) ____
all the time. I like to (8) ____ staff to think about infection and the spread
of disease, and to lead by setting a good example.
1. a) on b) of c) for d) with
2. a) produce b) prevent c) carry d) cause
3. a) sure b) mistakes c) an excuse d) a noise
4. a) With b) In c) At d) For
5. a) fuel b) power c) energy d) ability
6. a) secure b) deny c) save d) refuse
7. a) expensive b) strict c) mad d) angry
8. a) observe b) encourage c) use d) preserve

113
 Lesson 14
Patient Admission
VOCABULARY

admission [qd'mISn] прийом, поступлення

ward [wLd] палата
observation ["Pbzq'veISn] спостереження
outpatient ['aVtpeISnt] амбулаторний хворий
appointment [q'pOIntmqnt] прийом у лікаря
minor surgery ['sE:Gqri] незначна операція
dialysis ["daI'xlqsIs] діаліз
chemotherapy ["kJmqV'Terqpi] хіміотерапія
inpatient ['InpeISnt] стаціонарний хворий
treatment ['trJtmqnt] лікування
hypertension ["haIpq'tenSn] гіпертензія
diabetes ["daIq'bJtJz] діабет
bronchitis [brPN'kaItIs] бронхіт
condition [kqn'dISn] стан
poisoning ['pOIzqnIN] отруєння
burn [bE:n] опік
heart attack ['hRt qtxk] серцевий напад
informed consent [In"fLmd kqn'sen інформована згода
t]
complaint [kqm'pleInt] скарга
vital signs ['vaItl saInz] життєво важливі ознаки
medical history ["medIkl 'hIstri] анамнез
allergy [xlqGi] алергія
height [haIt] зріст
weight [weIt] вага
blood test ['blAd test] аналіз крові
LEAD-IN

 What do hospitals need to know about patients when admitting them?

 How do nurses help doctors learn about their patients?
 Have you ever been admitted to a hospital?

114
 READING
PATIENT ADMISSION
Admission of a patient means allowing a patient to stay in the
hospital unit or ward for observation, investigation,
treatment and care. There are three ways to be
admitted to hospital: either as an outpatient (for tests
or an appointment), a day patient (for minor surgery,
dialysis, or chemotherapy) or an inpatient (for
medical treatment or surgery).
Routine admission means that patients are admitted for
investigations and planned treatments or surgeries, e.g., patients with
hypertension, diabetes, or bronchitis. Emergency admission usually
happens when a patient is admitted in a critical condition requiring
immediate treatment, e.g., patients with accidents poisoning, burns, or
heart attack.
At the time of admission, the patient completes admission paperwork
and signs an informed consent document. The registered nurse performs
complete assessment of the patient. She enters the patient’s name, date and
time of admission, chief complaints, and medical diagnosis in the
admission file. At this time physical examination is performed, vital signs
are checked, medical history is taken, etc. The patient’s height and weight
are recorded. The patient is asked questions about the medications they are
taking and if they have any known allergies. Blood tests or other
investigations, such as an ECG, may also be taken, if required. Once this is
done, the patient may be asked to either walk or will be taken to the
treatment area.
A unit is a place where the patient is kept during hospital stay. The
admitting department notifies the unit prior to the patient’s arrival so that
room/bed can be prepared. At the time of arrival to the unit or ward the
patient and family will be given orientation regarding the visiting hours,
patient rights and responsibilities.
1. Read the text and answer the following questions.
1. What does admission of a patient mean?
2. What three ways to be admitted to hospital are there?
3. What patients undergo emergency admission?
115
 4. What does the nurse do at the time of admission?
5. Where is the patient kept during hospital stay?
2. Find the words in the admissions form which have the same
meaning as the words given below.

Patient Details
Title: First name(s): Surname:
……………………… ………………. …………….
….
Gender: □M Marital status:
……………..
□F
DOB: Country of origin:
……………………… …………
….
Occupation: ……………….
Address:
……………………………………………………………………………
………
Tel: (home) (work) (mobile)
……………….. ………………………… ……………….
.
GP: Tel:
……………………… …………………………
……. ……
Next of kin: Relationship to patient:
………………………….. ……………………….
Tel: (home) (mobile) ……………………….
………………..
Smoking intake: Allergies:
………… ……………………
Reason for admission:
116
…………………………………………………………………………...

1. family name
2. job
3. Mr / Mrs / Ms / Dr
4. family doctor
5. the name the patient wants the medical staff to use
6. closest relative
7. country where patient was born
8. male or female
9. married / single / divorced / widowed
10. why the patient is visiting hospital
11. date of birth
12. the amount of something you consume regularly
13. a bad reaction to, for example, food or medicine

3. Read the “Order of Care”. Look at the medical problems (a-c)

and match them to (1-3) according to the priority of care.
Order of Care
a) problems with breathing, a
1. Emergency (life-threatening) conditions broken bone
2. Urgent problems b) earache, sore throat
3. Non-urgent problems c) heart attack, stopped breathing

4. Match the sentences halves to make six nurse’s requests when

. admitting a patient.
1. Could you take a seat in a) lie back and try to relax.
2. Could you fill in b) your head?
3. Could you c) a few questions, please?
4. Could you tell me d) this form, please?
5. Could you show me e) the waiting room, please?
6. Could I just ask you f) what happened?

5. Read the extract from a patient information leaflet at the Central

. Hospital. Complete the gaps (1-7) with the words from the box.
117
 When you arrive, this is usually what happens: doctor
a) You check in at the ____.
cubicle
b) You give your name, address and ____, etc.
c) You wait in a ____. priority
d) A ___ carries out some basic tests (pulse, heart
rate). assessment
e) He/She asks you some questions and makes an date of birth
initial ____ of your condition.
f) He/She decides the ____ of care of all the patients triage nurse
in his / her charge. reception desk
g) The ____ visits you as soon as he/she is available.

Lis
LISTENING
6. You are going to hear the nurse interview a patient. Listen and
. complete the nurse’s questions.
1. Can you give me your ____ ____ please?
2. Can you ____that, please?
3. What would you like us_____ ____ you?
4. What is your date of ____?
5. Who is your ____ ____ ____?
6. Do you have any ____?
Listen again and fill in the admissions form for the patient.

Patient Admission
Surname
First name
Gender  M  F
DOB
Place of birth Catagne, Sicily
Occupation
Marital status
Next of kin
Contact no.
Allergies

118
 LANGUAGE PRACTICE
QUESTIONS

Who is fine
You are fine
Who felt sick
? He felt sick
Who complains of pain .
She complains of pain
Who speaks English
They speak English
Are you fine
Did he feel sick
?
Does she complain of pain
7. Choose the Do they speak English or French
. correct
How are you
words in
When did he feel sick
bold to get ?
What does she complain of
nurse’s
Where do they speak English
questions
when admitting a patient.
1. How / What is your family name?
2. Who / What is your GP?
3. How / Where do you live?
4. Why / When were you born?
5. What / Where is your date of birth?
6. Who / What is your next of kin?
7. How / What is your phone number?
8. Who / When does the pain start?
9. Why / Who helped you?
10. How / Where do you feel?

8. Put these words in the correct order to make questions. Then,

. match these questions to the responses in the box.
1. answer / you / me / my / can / questions? a) Yes, it does.

2. in / you / pain / any / are / ? b) Yes, I can.

119
3. you / where / you / know / do / are / ? c) Yes, I do. I’m in hospital.

4. feel / do / you / nauseous / ? d) No, I am not

5. symptoms / are / your / what / ? e) No, I don’t.

6. other / do / any / you / have / symptoms / ? f) I have a fever.

7. itchy / does / feel / it / ? g) I also feel dizzy.

8. you / glands / have / do / swollen / ? h) I have a rash on my chest.

9. Correct the mistakes in the following nurse’s questions.

.
1. What your problem? - What is your problem?
2. What can I for you do?
3. You can tell me your full name, please?
4. Where live you?
5. You have any allergies?
6. Why wrote you this letter?
7. You ready to see the doctor?
8. Where did the doctor went?
9. I can look at your ears, please?
10.Your daughter has eight years?
11.What her name is?
12.Understand you the question?
WRITING
10. Read the example summary of an admission and use the
. information in the box to write a similar summary.
Example Summary
Jim Grady is a 58-year-old man. He is a retired farmer. His wife is dead
and his son is his next of kin. Mr Grady was bitten by a snake while
walking with his dog and admitted to hospital as a day patient. He has a
medical history of high blood pressure and he smokes 20 cigarettes per
day.

120
 Patient Admission
Surname Thomas
First name Jim
Gender  M  F
DOB 1.9.80 ✓
Place of birth London
Next of kin son Richard
Contact no. 0771 805 6890
Smoking n/a
intake
Alcohol intake 30 units per week
Reason for Snake bite
admission
Medical High blood pressure
history
Family history Asthma and allergies
Allergies None

11. Nurse Lea is admitting a patient. Match her questions to patient’s

. answers.
1. Can you tell me your full name, a) Not that I know of.
please? b) No, I’m very lucky. I never
have.
2. Can you tell me why you’re here
c) It’s my son, Jeremy. Jeremy
today?
Chad.
3. Have you had any serious illnesses d) Yes, I had a mild heart
in the past? attack last year
4. Have you ever had any operations? e) Yes, it’s Doreen Mary Chad.
5. Now, are you taking any f) Yes, my doctor put me on
medications at the moment? some blood pressure tablets
6. Do you have any allergies to any after my heart attack.
medications? g) Well, I’ve got high blood
pressure, and I’m here for
7. Can you tell me the name of your
some tests.
next of kin?
READING EXTENSION
121
 . Complete the extract from an information leaflet for outpatients.
12.
GP’s department admitted treatment
tests appointment referred waiting
1. When you arrive at the clinic, please tell the receptionist who will
welcome you, check your details, and direct you to the ____ area.
2. The length of your visit will depend on the ____ you’re going to have.
3. You may need to have some ____, such as an X-ray, which could mean
going to another ____.
4. Or you may be ____ to other professionals, such as a physiotherapist or
dietician.
5. If staff at the clinic want to see you again, another ____ will be
arranged for you.
6. If you need to be ____ to hospital for more treatment, either as an
inpatient or for day surgery, you will be told when this is likely to
happen.
7. If you do not need further treatment, you will be discharged to your
____ care.

122
 Lesson 15
Daily Care of the Patient
VOCABULARY

to give birth [bE:T] народжувати

elderly ['eldqli] похилого віку
wheelchair ['wJlCeq] інвалідне крісло
helpless ['helplqs] безпомічний
vulnerable state ['vAlnqrqbl] вразливий стан
illness ['Ilnqs] захворювання
skin [skIn] шкіра
nail [neIl] ніготь
tissue ['tISH] тканина
injury ['InGqri] травма, пошкодження
germs [GE:m] бактерії, мікроби
massage ['mxsRZ] масаж
gums [gAm] ясна
to rinse out [rIns] полоскати
hygiene ['haIGJn] гігієна
aging ['eIGiN] старіння
infection [In'fekSn] інфекція
chemotherapeutic ["kJmqV'TerqpjHtI хіміотерапевтичний
k]
drug [drAg] лікарський препарат
dandruff ['dxndrAf] лупа
pediculosis ['pedIkjVlqVsIs] педикульоз
earwax build-up ['Iqwxks] накопичення вушної сірки
123
inflammation ["Inflq'meISn] запалення
unconscious [An'kPnSqs] непритомний
terminal patient ["tE:mInl 'peISnt] невиліковно хворий
hospice care ['hPspIs] хоспісна допомога
LEAD-IN
 What are the basic activities of daily life?
 Why is proper personal hygiene important?
 What does it include?
READING
Daily Care of the Patient
Nurses see patients more often than other specialists and are in the best
position to monitor them. Patients, whether this is a
young mother who has just given birth or an elderly
gentleman who is confined to a wheelchair, can feel a bit
helpless when hospitalized. They are in a vulnerable
state, due to illness, general health or a recent change in
their lives and their care is in the hands of medical
professionals.
It is therefore important to help the patients to stay clean and to take
care of their skin, mouth, hair, eyes, ears, and nails. Healthy smooth skin
protects the tissues from injury by preventing germs from entering the body.
Patients may be bathed every day in the hospital. The nurse may need to help
the patient walk to the shower and go back. Sometimes patients cannot wash
themselves and the nurse or family member washes them in bed.
All patients should have basic mouth care. It requires daily toothbrushing,
massage of the gums and rinsing out the mouth. Nurses can help if a patient is
too ill to take care of his or her mouth. Care of the hair is also a part of daily
hygiene. Hormonal changes, emotional and physical stress, aging, infection,
disease conditions and taking chemo therapeutic drugs affect the character of
hair. Dandruff and pediculosis are the common hair and scalp problems.
When caring for the patients, it is also important to check their ears for
build-up of earwax or inflammation. Some patients (e.g., unconscious
patients) may need special care of the eyes. Often patients may need help in
cleaning or cutting fingernails and toenails.

124
 Whether a nurse is taking care of post-operative patients in a hospital
or tending to terminal patients in hospice care, she will provide not only
physical necessities and comfort - she will also provide emotional stability
and support.
1. Read the text and answer the following questions.
1. Why are nurses in the best position to monitor patients?
2. How can patients feel when hospitalized?
3. What is the function of the skin?
4. What does good mouth care require?
5. Is any special care required for the patients’ eyes and ears?
2. Nurses often have to help patients with washing and grooming.
Label the objects with the words from the box.
brush comb deodorant dressing gown kidney basin
pyjamas razor shampoo shaving cream soap
swab toothbrush toothpaste towel washbowl

3. Now put the objects in the correct column in the table. Some items
may go in more than one column.
Washing Grooming Oral Hygiene Clothing
125
 washbowl

4. Read some nurse’s notes and choose the word that is closest in
. meaning to the underlined part.
1. A combination of arthritis and her recent radiotherapy has rendered the
patient not able to move.
A. unable B. immobile C. inattentive

2. Consequently, the patient has poor skin and may soon get ulcers of the
skin and soft tissue, usually over a bony prominence, occurring in an
immobile patients.
A. pressure sores B. acne C. skin spots
3. Therefore, it is important to change the patient’s the way that
someone’s body is placed every two hours.
A. attitude B. position C. mood
4. Her skin should be kept clean and dry, and the patient should have a
wash that you give to someone who cannot leave their bed every day.
A. swim B. shower C. bedbath
5. Remember to clean her hair and hard parts that grow at the ends of
your fingers and toes .
A. thumbs B. fingertips C. nails
6. She should be encouraged to eat a nourishing the kinds of food that a
person regularly eats containing adequate protein and to drink at least
2 litres of fluid every day.
A. liquid B. sandwich C. diet

5. People use different formal and informal expressions to talk about

. elimination. Complete the sentences with the words from the box.
bathroom bowel constipation defecate diarrhea incontinent
pooh runs urinate urine wee waterworks
1. In the USA, they say ‘go to the b____, but British people say ‘go to the
toilet’.
2. ‘Mummy, can I go to the toilet? I need a w____!’.

126
 3. U____ is the medical word for wee or pee. The verb is to u____. We
can also use the term ‘to pass water’.
4. Mr Jones complains of trouble with his w____. He can’t always control
his bladder and is sometimes i____.
5. ‘Have you had a b____ movement today, Mrs Davis?’
6. A stool or a motion is the medical word for a p____. The verb is to d____.
7. A patient with a loose stool has d___; but a patient with very hard
stools could have c____.
8. ‘I’ve got the r____, nurse. I have to go to the toilet all the time.’

Lis
LISTENING
6. Listen and complete the ADL assessment for patients 1-4 in the
. table. Check (✓) the activities which patients can do
independently and write “help” for the activities they need nurse’s
assistance with.

ADLs 1 Mr Karam 2 Elaine 3 Samson 4 Mr Bates

washing
dressing
oral hygiene
grooming
toileting

Listen again and answer the questions. Use the -ing form in your
answers.
1. Why does Mr Karam have problems with shaving?
Because his hands are shaky ...
2. Why is it difficult for Elaine to put her tights on by herself?
Because her back hurts and ...
3. What else does Elaine need help with?
She needs a hand with ...
4. What doesn’t Samson want help with?
5. What does Mr Bates hate using?

LANGUAGE PRACTICE
127
 PRESENT PERFECT
 news, life experiences,  he has learnt
present result of a past action  he has not learnt
? has he learnt?

have/has V3
+ I’ve done it.
- She hasn’t seen her patient today.
? Have you filled in his case history?

7. Write the past participle of each verb. Then, complete the

.
sentences using six verbs from the table.
be bring do eat go have lose take write

1. How many tablets have you _______ this afternoon?

2. How long have you _______ your headaches?
3. I’m very worried about Mr Vermont. He has ______ a lot of weight.
4. Has Mr Kransky _______ his exercises today?
5. I haven’t _______ the report yet, but I’m going to do it now.
6. Why haven’t you _______ your soup? Aren’t you hungry?

8. Look at this checklist of things that nurse Helen needs to do today.

. It’s 11 o’clock. What has she done? What hasn’t she done yet?
To-do list:
1. change patients’ dressings✓
2. check patients’ temperature✓
3. measure Mrs Erikson’s blood pressure
4. speak to Doctor Hansford about Mrs Grey
5. help Mr Barret’s with shaving✓
6. take Mrs Ashton to the shower
7. cut Mr Oliver’s nails ✓

128
 8. wash Mrs Vega’s hair
9. ask charge nurse for some report forms✓
10. write report on Mr Oliver’s progress

9. Write a suitable sentence using PRESENT PERFECT or PRESENT

. PERFECT CONTINUOUS:
1. Ann’s hair was dirty. Now it’s clean. (wash) Ann has washed her
hair.
2. Mr. Hill was 90 kg. Now he’s 80. (lose weight)
3. Mrs. Jenkins is very tired. (clean / all the wards)
4. My patient can’t find her glasses. (look for / since morning)
5. I can’t eat anything now. (eat too much)
6. Mrs Steel was admitted to our hospital a month ago. (stay)
7. Look! Mrs. Smith has got a lot of packages. (buy/ all her medicines)
8. The doctor is on holiday in France. (go)
9. I need a holiday. (work / hard / this year)
10. This patient can’t walk to the bathroom; his leg is in plaster. (break)
WRITING
10. Look at the training brochure for moving and handling patients
. put the stages in the correct order.
and
MOVING AND HANDLING PROCEDURE

 Encourage the patient to co-operate.

 Adjust the height of the bed and/or loosen bed linen, if necessary.
 Give clear instructions to the patient at each stage.
 Explain what you are going to do and the reason for the move.
 Check if the patient is comfortable after the move.
 Explain your actions as you are performing them.
 Check that the patient agrees.
 Check the patient’s level of independence.

SPEAKING

. 129
 11. Work in pairs. Write a short dialogue based on one of the
following scenarios.
1. Mrs Carter is very independent. The nurse offers to help with dressing
and washing, but Mrs Carter wants to do everything by herself. She asks
the nurse to fetch her walking frame so she can get to the bathroom.

130
2. Jared asks the nurse for help with shaving; his hands are shaking after
his operation. The nurse offers to help him take a shower, but he
refuses; he wants to do it by himself. He asks her for a shower chair.
3. The nurse brings Mr Altman the urinal bottle, but he tells her that he
hates using it. He asks her to help him get to the toilet.
READING EXTENSION

12. Read the text below. Use the word given in capitals at the end of
. some of the lines to form a word that fits in the gap in the same
line.
Some patients need help with daily (1) ____ such as ACTIVE
showering or going to the toilet. Some things can be
embarrassing for patients. A patient who is incontinent of
urine may feel (2) ____ and not want to ring the call bell SHAME
for the nurse, it is always important to help patients in a
EMBARRASS
sensitive way so that patients do not feel (3) ____ at all.
PRIVATE
Nurses should make sure that patients have (4) ____
when they are on the toilet. When nurses speak to patients,
particularly elderly patients, they should never talk down to ACCEPT
patients, it is not (5) ____ to humiliate patients if they have
been incontinent. Above all, it’s important to give patients PATIENT
enough time and not be (6) ____.

131
 Lesson 16
Nursing Care Records
VOCABULARY

to record [rI'kLd] записувати

health record ['helT rekLd] медична картка
chart [CRt] медична картка
legal ['lJgl] законний, юридичний
evidence ['evIdqns] свідчення, доказ
reporting [rI'pLtIN] звіт, повідомлення даних
digital ['dIGItl] цифровий
electronic [I"lek'trPnIk] електронний
medical history ["medIkl 'hIstri] анамнез
examination [Ig"zxmI'neISn] огляд, обстеження
illness ['Ilnqs] захворювання
family history ["fxmqli 'hIstri] сімейний анамнез
immunization ["ImjunaI'zeISn] імунізація
allergy [xlqGi] алергія
radiology image ["reIdi'PlqGi ImIG рентгенівський знімок
]
X-rays ['eks reI] рентгенівські промені
CT ["sJ'tJ] КТ
MRI ["em Rr 'aI] МРТ
side effect ['saId Ifekt] побічна дія
interaction ["Intqr'xkSn] взаємодія
insurance [In'SVqrqns] страхування
research ['rJsE:C] наукове дослідження
response [rI'spPns] відповідь, реакція
to assess [q'ses] оцінювати
LEAD-IN
 How important are accurate patient records?
 Why do medical professionals use abbreviations?
 What are some common medical abbreviations?

132
 READING
Nursing Care Records
The recording patient’s status, care and other information for a patient is
called the health record or chart. It is a legal document
that serves as evidence of care provided. Oral
communication about a patient’s status is called
reporting. Sometimes referred to as digital health records,
Electronic Health Records (EHR) are copies of a patient’s
medical history stored as electronic data. With EHRs,
information is available whenever and wherever it is needed.
The patient’s health record might include:
 contact information;  laboratory test results;
 medical history, examination and  radiology images (X-rays, CTs,
progress reports of health and MRIs, etc.);
illnesses;  medication information, including
 family history; side-effects and interactions;
 immunization status;  records of hospitalization;
 allergies;  insurance information.
Recording information is an essential part of nursing care. Research
shows that nurses routinely spend 15% to 25% (up to 2 hr) of their
workday documenting the care they give, and in some cases considerably
more. They need to note three types of information:
• important information about the patient status;
• the care provided;
• the patient’s response to that care.
The patient’s status should be assessed every time the nurse gives
care. The observations and the information they gather from the patient
help them decide whether the patient is getting better or is experiencing
problems that need attention.
1. Read the text and answer the following questions.
1. What legal document serves as evidence of care provided to the patient?
2. What is electronic health record?
3. What information does the patient’s health record usually include?
4. How much time do nurses spend documenting the care they give?
5. What three types of information are important to be noted by nurses?
133
2. Match the words to make word-combinations. Use them in the
sentences of your own.
1. digital health 1. data
2. electronic 2. document
3. legal 3. history
4. medical 4. images
5. contact 5. information
6. progress 6. of hospitalization
7. immunization 7. records
8. laboratory 8. reports
9. radiology 9. status
10.records 10. test results

3. Read these patient details and answer the questions below.

Mr Kyle
Wilson Patient Details

Title: First name(s): single

Surname:
12.09.1989 ……………….
……………………… …………….
…. construction worker
Gender: □ M5 Davis Close,
Marital Nottingham 9B
status:
4779 023 5491
……………..
□F
[email protected]
DOB: Occupation:
Dr. Tara Millet
……………………………… 4773 882 6495
……………………………..…………
……. Suzanne Wilson
mother
Address:
……………………………………………………………………………
……..……………
Tel: (mobile) Email
………………………………. ……………………………………
….…..
GP: Tel:
134
……………………… …………………………
……. ……
Next of kin: Relationship to patient:
………………………….. ……………………….
1. Is the patient a man or a woman?
2. When is the patient’s birthday?
3. Where does the patient live?
4. What is the patient’s job?
5. Is the patient married?
6. Who is the patient’s family doctor?
7. Who is Suzanne Wilson?

4. Abbreviations are often used in both patient records and verbal

. handovers. Match the abbreviations (1-14) to their meanings (a-n).
1. Pt a) activities of daily living
2. T b) electrocardiogram
3. P c) myocardial infarction, or heart attack
4. BP d) blood pressure
5. RR e) complain of
6. 02 f) observations
7. Wt g) patient
8. obs. h) pulse
9. c/o i) oxygen
10. Dx j) temperature
11. ADLs k) weight
12. ECG l) respiratory rate
13. MI m) bed rest
14. B/R n) diagnosis
5. Here are extracts from patient data protection legislation. Which
. of a, b and c means the same as each extract.
1. “Entries in records must be frequent”
a) make entries often b) make long entries c) read the records
regularly
135
 2. “Medical negligence”
a) careless practice b) neglected staff c) attacks on patients
3. “Professional misconduct”
a) a mistake b) an accident c) bad behaviour
4. “Confidentiality”
a) mistake b) privacy c) certainty
5. “Anyone making an entry must be easily identifiable”
a) all entries must be signed
b) you only have access to your own entries
c) identify yourself in order to get access to the records
6. “Patients do have the right to limit access to their records”
a) a patient has limited rights of access to their records
b) a patient can say who can read their records and who can’t
c) patients are wrong to limit access to their records

Lis
LISTENING
6. Look at the chart containing personal details of Mr Karlson.
. Then listen and correct any details (1-8) that may be wrong. Tick
(✓) items that are correct.
Surname: Johnson Karlson 1

First name(s): Dave Ian

Sex: M
2
Address: 3 Park View Mansions, Castlefield Manchester
M6 7DE
Admission details: Duncan Ward at 4 p.m. on 9 3

November 2008
Hospital: No 19736045 4

DOB: 27 10 53 5

Telephone number: 0166 405 7001

Marital Status: Single 6

Occupation: Sportsman 7

GP: Dr Khan 8

C/o: pain in right arm

136
 LANGUAGE PRACTICE
PRESENT PERFECT AND PAST SIMPLE
already
yesterday just
2 days ago yet
ever
last week
up to now
in l991 today/this week
in the past recently/lately

?- have
V2(ed) did has
V3(ed)

7. Complete each sentence with a time word from the box.

.
before ever for how long just last
year
never since today when yet
yesterday
1. Have you _____lost a patient’s records?
2. Have you taken a patient’s family history_______?
3. I had to stay in hospital for two months _______.
4. I have ______ had an allergy.
5. Miss Ellis has ______ been to her X-ray appointment.
6. Can you wait a moment? I haven’t finished ______.
7. How many patients did you have ______?
8. How are you, Mrs Sloan? I haven’t seen you ______ a year.
9. She says she’s felt sick all day ______.
10. I didn’t get all the vaccinations ______ I was a child.
11. I can’t remember _______ I’ve had this rash.
12. Mr Weber has been in Cardiology department _______ January.

8. Choose the correct option to complete the sentences.

.
1. I went for a wee two hours ______.
a) ago b) already c) since
137
 2. I ______ to the toilet since Monday.
a) didn’t go b) haven’t been c) didn’t went
3. Mr Roberts ______ bloated since her operation.
a) felt b) has felt c) have felt
4. We ______ blood in her stools last night and we are worried.
a) noticed b) have noticed c) have been noticing
5. The patient hasn’t had anything to eat ______ this morning.
a) for b) during c) since
6. ______ have you had this diarrhea exactly?
a) How long b) How far c) When
7. When ______ your GP?
a) did you last see b) have you last seen c) have you last been seeing
8. The patient ______ at 15.35 with abdominal pain.
a) presented b) is presenting c) has presented
9. Mrs Kitano ______ a baby girl.
a) has had b) have c) has had
10.He ______ to treatment yet.
a) didn’t respond b) hasn’t responded c) isn’t respond

9. Look at this email between two nurses, Irina and Eriko, about a
. patient, Mrs Keen. Complete the email using the words in the
brackets in PRESENT PERFECT or PAST SIMPLE.
Hi Erika,
I (1) ‘ve just visited (visit) Mrs Keen, a 62-year-old lady who (2) _______
(have) a stroke last month. I’m worried about her because she (3) _______
(lose) a lot of weight in that time, and she now looks very thin and weak.
She (4) _______ (have) a little soup while I (5) _______ (be) there, but it’s
difficult to say how much food she eats most days. She says she finds it
very difficult to eat with ordinary utensils. I was surprised the OT still (6)
_______ (bring) any modified utensils. I (7) _______ (phone) him a few
minutes ago to find out what’s happening, and he (8) _______ (tell) me
that he (9) _______ (already order) them but they (10) _______ (arrive)
yet. How many days do they usually take? Could you speak to the OT to
see if there’s anything he can do? I’m not sure how long Mrs Keen can
wait.
Thanks a lot
Ada
138
 WRITING
10. 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. Use information from the Patient Record to
complete what was said.
U/N: 732910
Surname: Smith
PATIENT Given names: Lea
DOB: 10.12.61 Sex: Female
RECORD

DATE & TIME Add signature, printed name, staff category, date and time to all entries
MAKE ALL NOTES CONCISE AND RELEVANT
Leave no gaps between entries
18.5.2018 Mrs Smith c/o chest pain at 22.00 hrs. Doctor
22.30 hrs informed. Oz administered via a mask. BP 220/100,
P 120 at 22.00hrs. Doctor ordered ECG, attended
by nursing staff. Glyceryl trinitrate administered at
22.05hrs, chest pain relieved within 2 minutes.
J Keene (RN) KEENE

Mrs Smits complained of chest pain at ____. The ____ was informed.
____ was administered via a mask. Her blood pressure was ____ and her
____ was ____at ____. The ____ordered an ____ which was done by
nursing staff. Glyceryl trinitrate ____ was given with good effect. The
chest pain was relieved within a couple of minutes.
SPEAKING
11. Invent an identity for your patient and take turns playing the role
. a patient and of a nurse. Interview your patient and write down
of
their details.
Patient Record
Surname
First name
Gender  M  F
139
 DOB
Place of birth
Occupation
Marital status
Next of kin
Contact no.
Smoking intake
GP
Alcohol intake
Reason for
admission
Family history
 mental  turberculosis
illness
 diabetes  HIV/AIDS

READING EXTENSION

12. Read the text choosing the words that best complete the sentences.
. As a medical professional, you should be prepared to take thorough
medical (stories/histories). The data you (collect/pick up) reveal
important details about a patient. Doctors use these details to uncover
likely reasons/causes of medical conditions and establish diagnoses.
First, get as many details as possible about a patient’s
(complaint/protest). Find out if the patient has a history of the condition.
Ask when the patient experienced the (set/onset) of symptoms. Check
what makes it worse and what makes it better.
Then find out about the patient’s (past/gone) medical history.
Record any previous (personal/medical) problems, especially those that
could relate to the current condition. Other details can also
(contribute/help) to a useful medical history. A good (society/social)
history includes information about the patient’s personal habits and
lifestyle. A (family/private) medical history reveals conditions that are
more likely to occur in a particular family.

140
 (After/Before) any medical procedure, make sure you have an
updated record of the patient’s allergies. This way, you avoid exposing
patients to medications or substances that might (harm/cure) them.

141
 Lesson 17
Administering Medication
VOCABULARY

medicine ['medsn] лікарський препарат

administration [qd'mInI'streISn] введення
core [kL] основний
healthcare setting ['helTkeq setIN] медична установа
advantage [qd'vRntIG] перевага
limitation ["lImI'teISn] обмеження
to prescribe [prI'skraIb] призначати, приписувати
route [rHt] шлях, курс
indication ["IndI'keISn] показання
contraindication ["kPntrq"IndI'keISn протипоказання
]
side effect ['saId Ifekt] побічна дія
medication ["medI'keISn] лікарський засіб
drug [drAg] лікарський препарат
self-evident ["self 'evIdqnt] очевидний
identifier [aI'dentIfaIq] ідентифікатор
generic name [Gq'nerIk] загальна назва
rate of absorption [qb'zLpSn] швидкість всмоктування
onset ['Pnset] початок
to adhere to [qd'hIq] дотримуватися
schedule ['SedjHl] режим, графік
to deviate from ['dJvieIt] ухилятися, відступати
safety ['seIfti] безпека
dose range ['reInG] діапазон дозування
abbreviation [q"brJvi'eISn] абревіатура
decimal point ["desIml 'pOInt] десяткова кома
condition [kqn'dISn] стан

LEAD-IN

 Why are there different ways of administering medicine?

 Why is it important to double check doctors’ orders?
 Were you afraid of injections when you were a little kid?
142
 READING
Administering Medication
Medicines administration is a core responsibility of nurses in
healthcare settings. Before administering any
medicine, nurses must be familiar with the
advantages and limitations of the prescribed
route and know the indications,
contraindications, and side-effects of the
medicine they intend to give. Most nurses are
familiar with the five rights of medication administration: the right patient,
drug, dose, route and time.
Right patient. This right is self-evident: the medication must be
administered to the patient for whom it is prescribed. It is important to use
two patient identifiers (e.g., name and date of birth)
Right drug. A possible reason that the wrong medication may be
administered is that many medications have similar names. To avoid
confusion, generic names should be used when medications are prescribed.
Right route. Nurses are only allowed to administer medications by
the route prescribed, though sometimes the prescriber may give a choice
(IV/PO). The nurse must understand the differences between these routes
such as the rate of absorption or onset of action.
Right time. It is important to adhere to the prescribed schedule. If a
medication is ordered to be given at particular time intervals, the nurse
should never deviate from this time by more than half an hour.
Right dose. As nurses are responsible for ensuring patient safety,
they must make sure that the prescribed dose is within the known dose
range. Abbreviations and inappropriate use of decimal points are factors
that commonly contribute to prescribing errors. The dose should make
sense for the age, size, and condition of the patient.
1. Read the text and answer the following questions.
1. What is a core responsibility of nurses in healthcare settings?
2. What are the five rights of medication administration?
3. Should brand or generic names be used when prescribing
medications?
4. Are nurses allowed to choose the route of drug administration?
143
 5. What factors contribute to errors in prescribed doses?

2. Label the 5Rs (five rules) of safe drug administration. Then, match
these rules to nurse’s guidelines given below.

 Check the route of administration on the Prescription Chart and

1. always obey the prescribed route of administration. Oral
administration and intramuscular administration are not equal.
2.  Always check the scheduled times for administration of
medication to avoid accidental overdose.
 Crosscheck the name of the medication on the Prescription Chart
3. and the medication label. Have the head nurse countersign the
medication order when administering high risk medicine.
4.  Always double-check the dosage of the medication as well as the
expiration date. Warn patients of any possible side effects.
 Check the patient’s full name by checking the hospital label on the
5. Prescription Chart and by checking the patient’s identity bracelet;
also check the patient’s date of birth if necessary.

3. Complete the sentences 1–7 with words from the box.

1. You give ____ medicine to fight a virus. analgesic
2. This ____ will make you immune. antibiotic
3. Use an ____ to treat a bacterial infection.
antidepressant
4. She has bipolar disorder and is on a powerful ____.
5. A ____ will make you relax and sleepy. antihistamine
6. Your diet is deficient in essential vitamins – you antiviral
need to take a ____.
inoculation
7. This is a powerful ____ – it should block the pain
immediately. sedative

144
8. ____ drugs are for allergies. supplement

4. The following abbreviations(1-16) are all commonly used on

. Prescription Charts. Can you match them to their meanings (a-p).
1. ac a) with meals
2. pc b) before meals
3. cc c) at bedtime
4. qd / daily d) after meals
5. qod e) by mouth
6. bid / bd f) every day
7. tid /tds g) every other day
8. qds h) every six hours
9. 6/24 i) four times a day
10. hs j) infusion
11. prn k) intravenous
12. po l) subcutaneous
13. sc m) sublingual
14. sl n) three times a day
15. iv o) twice a day
16. infus p) as required

5. Read the sentence pairs. Choose where the words best fit the gaps.
1.. loss of appetite / side effects
A. As you know, some patients suffer ____ and others don’t.
B. Anti-allergy drugs can lead to stomachaches, as well as ____ and
constipation.
2.pain / rash
A. Let’s consider ibuprofen, for example, a very common ____ medication.
B. Patients who take valium may experience drowsiness; others may get a
skin ____.
3.headache / pressure
A. Theoretically, this can cause low blood ____, but you probably won’t have
a problem.
B. In some people, it can cause a fleeting ____, but it doesn’t mean you
will get one.
4. stomach / vision
A. Some people get blurred ____, and others might feel nauseous.
145
 B. There’s a strong possibility that this will upset your ____.
5. diarrhea / injection
A. Injecting drugs intravenously may cause swelling at the ____ site for
some patients.
B. It’s also possible to have ____, vomiting, even headaches with this type
of pain medication.
6. swelling / tremors
A. ____ of the ankle is not common, but it is possible – it may happen.
B. This can make you feel dizzy, and ____ are another side effect of this
drug.
is
LISTENING
6. Listen to a conversation between a nurse and Doris, a patient,
. and complete (1-6) in Doris’ medication record.

Personal medication record Patient: Doris MacDonald

Medication Reason for use Form Route How much & when? Side effects
one drop, headaches,
right +
three times a itchy, red
(1)_____ glaucoma left
day eyes –
(6)_____ eye
temporary
six units, Itching,
every six redness and
injectio stomac hours swelling at
insulin (3)_____ n h the
injection
site
15 mg,
mouth
(2)_____ (4)_____ syrup three times a diarrhea
day
75 mg, two a
capsul nausea,
Tamiflu (5)_____ mouth day,
vomiting
es for five days
(2)_____ general
health
tablets (7)_____ 1 mg a day nausea

LANGUAGE PRACTICE
PAST PERFECT
 past before past  he had left
 he had not left
? had he left?
146
 had V3
+ He’d taken his medicine by 10 a.m
- She said that she hadn’t taken any medication.
? Had he left before you arrived?
7. Doctors started making their morning round about 9 a.m. Look
. at the things nurses had/hadn’t done before that hour and make
sentences as in example.
take patients to the canteen 
remove the dust from floor, beds, and furniture 
write up the patients’ daily records 
put the ward in perfect order 
receive clinical instructions 
take electrocardiograms 
make laboratory analyses of blood, urine and gastric 
juice
prepare the patients needed for examination 
Before the morning round began nurses had
taken patients to the canteen.

8. Which action comes first in each sentence? Write 1 or 2 after the

. verbs.
1. When the patient woke up [2], the doctor had left [1] the ward.
2. When the patient woke up [ ], the doctor left [ ] the ward.
3. When I got [ ] to the canteen, everyone ordered [ ] their meals.
4. When I got [ ] to the canteen, everyone had ordered [ ] their meals.
5. The nurse consultant didn’t go [ ] to the canteen with us. He had
already had [ ] lunch.
6. Students hadn’t understood [ ] the problem, so the teacher explained [ ]
it.
7. The teacher had given [ ] a quiz when I got [ ] to class.
8. I had saved [ ] my document when the computer crashed[ ].

9. Open the brackets using the verbs in Past Simple or Past Perfect.
.
147
1. She didn’t understand that she _____ (be) very rude with her doctor.
2. He felt sleepy after he _____ (have) his medication.
3. As I approached the ward, I understood that I _____ (lose) the patient’s
prescription.
4. I _____ (tell) him six times to take his medicine, but he forgot to take it.
5. I _____ (not recognize) old Mr Jarvis as he _____ (change) a lot.
6. It _____ (be) a medicine that I _____ (never hear) of.
7. The ward round _____ (already start) when I _____ (arrive).
8. The patient _____ (feel) a little better after he _____ (take) the pills.
9. The pediatric nurse _____ (read) the instructions carefully before she
_____ (give) an injection.
10.We _____ (not disturb) the professor until he _____ (finish) his report
on antibiotics.
WRITING
10. Look at prescriptions and find abbreviations or symbols that
. match these meanings. Then, complete the sentences below.
a) after meals – a) milligrams –
b) at bedtime – b) number –
c) before meals – c) tablets –
d) capsules – d) twice a day –

GCH GCH GCH

General Central Hospital General Central Hospital General Central Hospital
Pt: Sally Taylor Pt: Edna Lambert Pt: Max Khan
Zocor 10 mg Diovan 40 mg (tabs) Fluvastatin 20 mg (caps)
one po daily hs one po daily (pc/ac) 1 bd x 7 days
Dispense #90
Dispense #50 Dispense #14

1. You need to give Sally Taylor ten ____ of Zocor once a day by ____,
at bedtime for ____ days.
2. Diovan is for your blood pressure, Edna ____ for ____.
3. For your cholesterol, your doctor has prescribed Fluvastatin, Mr Khan.
You need to take ____.

148
 SPEAKING

11. Read the prescription label and work in pairs asking and
. answering the questions given below.
1. When was the
prescription issued?
2. What is the name of the
medicine?
3. What is the name of the
patient?
4. How old is the patient?
5. Who has prescribed the
medicine?
6. What is the dosage
indicated?
7. How many refills has DO NOT DRINK
ALCOHOLIC
the doctor prescribed? BEVERAGES WHEN
TAKING THIS
8. Can you drink alcoholic
beverages while taking
this medicine?

READING EXTENSION

12. Read the text below. Fill in the gaps with the words from the box.
.
Medication, administration, suppository, mouth, syringe,
skin, desired, stomach, muscle, vein, lungs, rectum
Depending on the drug and its (1) ____ effect, there is a variety of
(2) ____ methods. Most drugs are administered orally – that is, through the
(3) ____ Only drugs that will not be destroyed by the digestive processes of
the (4) ____ or intestines can be given orally.
Drugs can also be administered by injection into a (5) ____
(intravenously). Syringe is used when drugs need to be administered through
a vein or (6) ____ The (7) ____ consists of a needle attached to a hollow

149
cylinder marked with precise measurements so that the exact amount of
(8) ____ can be given.
Inhaled drugs are designed to act in the nose or (9) ____. General
anesthetics may be given through inhalation. Drugs may be administered
topically — that is, applied directly to the (10) ____; or rectally – absorbed
through an enema (an injection of liquid into the (11) ____) or a rectal
(12) ____ (medication that melts when inserted in the rectum).

150
 Lesson 18
Hospital Discharge
VOCABULARY

discharge [dIs'CRG] виписка

hospital ['hPspItl] лікарня
to return [rI'tE:n] повертатись
to transfer [trxns'fE:] перевозити
rehabilitation ["rJq"bIlI'teISn] реабілітація
nursing home ['nE:sIN hqVm] будинок престарілих
healthcare team ['helTkeq tJm] медична команда
to determine [dI'tE:mIn] визначати
treatment ['trjtmqnt] лікування
setting ['setIN] установа
attending physician [fI'zISn] лікуючий лікар
healthcare facility ['helt keq fq'silqt медична установа
i]
advice [qd'vaIs] порада
death [deT] смерть
procedure [prq'sjgq] процедура
written order ['rItn Ldq] письмове розпорядження
valuables ['vxljuqblz] цінні речі
admission [qd'mISn] прийом, поступлення
property ['prPpqti] власність
medication ["medi'keisn] лікарський засіб
follow-up visit ['fPlqV Ap] повторний огляд
chart [CRt] медична картка
sick note ['sIk nqVt] лікарняний лист
insurance company [In'SVqrqns] страхова компанія
wheelchair ['wJlCeq] інвалідне крісло
stretcher ['streCq] ноші

LEAD-IN

 What information is important to provide the patient for discharge?

 What kind of patients need assistance at home?
 When might patients need a referral?
151
 READING
Hospital Discharge
Discharge from the hospital is the point at which the patient leaves the
hospital and either returns home or is
transferred to rehabilitation facility or a
nursing home. When it has been decided that
a patient is medically ready for discharge, the
health care team must determine the most
appropriate setting for ongoing care.
Main reasons for patient discharge:
o planned discharge: the patient’s treatment is over, and the attending
physician has discharged the patient;
o transfer: the patient is transferred to another health care facility;
o LAMA/DAMA (left against medical advice/ discharged against medical
advice): the patient chooses to leave the hospital before the physician
recommends discharge;
o death: after the patient’s death, the dead body is handed over to the
relatives after completing the discharge procedure.
No patient should be discharged without doctor’s written order. The
nurse’s responsibility is to explain the discharge procedure to the patient.
Clothing, jewelry, or other valuables that were entrusted with hospital at
the time of admission should be returned to the patient. Any of the hospital
property that was given to patients for their use should be checked and
received back before they leave.
The patient is provided with instructions regarding medication,
follow-up visits, etc. The nurse should check that all the charts and files
are completed. If required, the patient is given a sick note or information
for insurance company. If the patient is not able to walk, then the nurse
should see that he/she is transferred either on a wheelchair or stretcher.
1. Read the text and answer the following questions.
1. What is hospital discharge?
2. What are the main reasons for patient discharge?
3. What is the nurse’s responsibility during the discharge?
4. What instructions is the patient provided with?
5. Is every patient given a sick note?
152
2. Find in the text the terms for the following definitions. The first
letter is provided.
1. official permission to leave a hospital d
2. a facility that focuses on treating people recovering from
injuries, surgeries and chronic medical conditions r f
3. a facility that provides long-term personal and/or nursing care
for those who can no longer care properly for themselves n h
4. the movement of someone from one place/position to another t
5. things, especially valuable, that are owned by someone p
6. the act of making contact with a doctor to check on the
patient’s progress after the treatment f v
7. an official note signed by a doctor which states that
someone is ill and needs to stay off work s n
8. an agreement in which you pay a company money, and
they pay your costs if you have an accident, injury, etc. i
9. a chair with large wheels used for moving around w
10.a bed/frame used for carrying someone who is ill or injured s

3. Decide if the following statements are true or false. Correct the false
ones.
1. Hospital discharge describes the point at which inpatient hospital care
begins.
2. Once a person is getting better and does not need a high level of care, a
hospital stay is essential.
3. Discharge against medical advice means that a patient chooses to leave
the hospital after the treating physician recommends discharge.
4. There is no need in carrying out the discharge procedure in case of
patient’s death.
5. If patients require some level of further care and are not yet ready to go
home, they may go to a skilled nursing or rehab facility.
6. All the hospital property that was given to patients for their use must go
with them as part of the discharge process.
7. Patients’ personal property brought into the hospital should be handed
over to the ward nurse after the patients’ discharge.

153
8. If you were off work due to a hospital stay, a sick note can be issued by
the hospital.
4. Look at the pictures of mobility aids patients can use at home and
. label them with the words from the box. Then, read about four
patients recently discharged from the hospital and fill in the gaps
with the most suitable words.
crutches commode chair leg brace non-slip mat raised toilet
seat grab bar shower chair walking stick walking frame
wheelchair

1. Jim broke his leg in two places. He was unable to cover the distance to
the bathroom, so he used a ____. Now his leg is still in plaster and it’s
not easy for him to walk. He’s using ____ to help get around.
2. Elin fell off a ladder and was completely paralyzed for a while. She’s
had a lot of physiotherapy and she needs to wear a ____ to stabilize
parts of her right leg which was badly damaged.
3. Mrs Ridley has had a hip operation. ____ allows her to take a shower
sitting down, and ____ helps her pull herself up. When she goes out, she
uses a ____. Her husband is strong enough to push her.
4. Mr Edwards who has arthritis in his legs has been in hospital for some
drug treatment, to which he responded well. However, his knees are still
154
 quite painful, so he uses a ____ to give him some support when he’s out
by himself. He has a ____ in the bathroom to prevent him from
slipping.
5. The Healthcare Team includes different specialists who are
. involved in a patient’s care after the discharge from hospital.
Match the job titles with their job descriptions.
a) a specialist who works with individuals or families
1. Physiotherapist who have problems relating to illness or
(Physio) hospitalization
2. Occupational b) a specialist who helps people recover their ability
Therapist (OT) to do ADLs
c) a specialist who supervises the preparation and
3. Speech and service of food and develops modified diets for
Language patients with specific needs
Therapist d) a specialist in restoring and maintaining maximum
movement in the body
4. Social Worker e) a specialist who dispenses medication and checks
5. Dietitian prescriptions for accuracy
f) a specialist who assists in the rehabilitation of
6. Pharmacist patients with speech and swallowing disorders
Lis
LISTENING
6. Listen to a conversation between a nurse and a patient. Choose
. the correct answers.
1. What is the dialogue mostly about?
a) how to correctly use a nebulizer
b) a review of the discharge process
c) when the patient should pay the bill
d) the steps a patient takes to be discharged
2. What can you infer about the patient?
a) He has never used a nebulizer.
b) He has not set up a way to get home.
c) He is unsure of his insurance coverage.
d) He must pay for the entire visit himself.

Listen again and complete the conversation.

Nurse: Hi, Matt. How are you feeling today?
155
Patient: Much better. I’m looking forward to (1) ____ ____.
Nurse: That’s good to hear! I just need to discuss some details of
the (2) ____ ____with you.
Patient: Sure.
Nurse: We’re sending you home with a nebulizer. Do you know
(3) ____ ____ ____ it?
Patient: No. Is it tricky?
Nurse: Not at all. I’ll show you before you leave. Now, let’s
discuss your coverage.
Patient: My (4) ____ ____ will cover the whole visit, right?
Nurse: Yes. However, the coverage for the hospital aids is 80%.
You should (5) ____ ____ ____ for the remainder in a week
or so.
Patient: Okay. I’ll look out for that in the mail.
Nurse: Great. And your (6) ____ plans are all set, right?
Patient: Yes. My daughter is picking me up in the afternoon.

LANGUAGE PRACTICE
FUTURE SIMPLE
 future facts, promises, requests,  he will come
predictions and spontaneous decision  he will not come
? will he come?
will V1
She’ll be here in a few minutes.
I promise I won’t be late.
One day, scientists will find cure for cancer.
OK, I’ll stay with you, then.

7. Ana is a patient on the Cardiology Ward. Complete what the

. nurse says to Ana as she takes her blood pressure. Use will and the
correct form of the verbs in the box.
be feel hold put roll see take
wrap
I 1______ just ______ your sleeve up a little. That’s good. We 2______
a pillow on your lap. 3______ you ______ your arm out straight for me?
You can rest it on the pillow. I 4______ the cuff round your arm. Just relax,
156
that’s right. You 5______ any pain; it 6______ just ______ a bit tight
around your arm. OK? That’s 130 / 85. I 7______ just ______ the cuff off
now and then you can eat your breakfast in peace! I’ll 8______ you later.

8. Look at the sentences (a–j) in the box that a nurse or patient

. might say. Complete the second part of the dialogues below with a
sentence (a–i).
a) Oh dear. I’ll get you another blanket if you like.
b) Hmmm – I won’t wake her up. I’ll tell him to call back later.
c) Oh, sorry. I’ll switch it off.
d) Yes, and then she’ll have an appointment with Doctor Hanford.
e) OK, so we won’t make you walk too far today.
f) I promise we’ll be very gentle, Mr Brown.
g) Don’t worry. I’ll pass it to you.
h) OK, Helen, I’ll change it for him.
1 – Sue, Mr Gimlet’s IV is going to finish in half an hour, but I need to go
to the OT now.
– h – OK, Helen, I’ll change it for him.
2 – Can you help me, Rachel? I’m afraid I’ve dropped my walking stick.
– ______________________________________________________
3 – Please don’t be rough when you lift me up.
– ______________________________________________________
4 – I’m afraid you can’t use your mobile phone in this ward, Mrs Miller.
– ______________________________________________________
5 – I’ve got Mrs Booker’s husband on the phone, but she’s still asleep.
– ______________________________________________________
6 – I’m sorry, Louise. I’m feeling very weak after my operation.
– ______________________________________________________
7– Sorry, Mike. What time will I be able to go home?
– ______________________________________________________
8 – Will Mrs Mann have the injections for six months?
– ______________________________________________________
BE GOING TO
We often use be going to for We’re going to discuss this on Monday.
First, I’m going to examine you.
157
explaining future plans and intentions The sky is dark - it’s going to rain.
or for predictions when it is clear that The meeting starts in five minutes -
something is certain to happen soon. you’re going to be late again!
9. Look at these sentences that a nurse might say. Complete the
. sentences with the correct form of be going to or will and the
verbs in brackets.
1. Next, I ______ (give) you an injection.
2. I promise the injection _______ (not hurt).
3. Her tests results have improved. She _______ (get) better soon.
4. Watch out! Mr Howard _______ (fall).
5. Bob _______ (probably need) his wheelchair for another six months.
6. Mr Adams _______ (have) his operation today.
7. Your Dad _______ (visit) you this afternoon, Julia.
8. I’m sure Mrs Spencer _______ (be) able to use the crutches.
9. Wait a minute. I _______ (bring) the wheelchair closer to make it
easier for you.
10. It is Sharon’s discharge from the hospital next week. Her parents
______ (make) a surprise for her.
WRITING
10. Mrs Davis’s doctor has referred her to an endocrinologist. Read
. the letter of referral replacing the words in bold by the words that
have the similar meaning given in the box. Then, write an email
referring your patient for district nursing services.
fine tremor heat intolerance overactive palpitations

Dear Mr Shepherd,
I would be grateful if you would see this 50-year-old woman
who has lost 20 kilos in weight in spite of eating more than usual.
She describes herself as more active than usual and at first,
she thought the weight loss was due to this. But more recently
she has developed irregular heartbeat, diarrhea, and inability
to cope with high temperatures. She has noticed that her
hands have a tendency to shake.

Her symptoms suggested hyperthyroidism, and this was

confirmed by my examination which revealed an enlarged
thyroid, red sweaty palms and 158
a very slight involuntary
movements of the hands.
 SPEAKING
11. Read the hospital discharge form and make a short summary.
.
HOSPITAL DISCHARGE FORM
Patient Name: Matt Clark
Dale of admittance 2/15/10
Date of discharge 2/18/10
Reason for asthma attack
admittance:
Received treatment: oral medication and a chest x-ray
Home care: Bed rest for one full day, avoid heavy
physical activity for one week
Aids: an inhaler and a nebulizer in case of more
severe asthma attacks.
Follow-up: an appointment with primary care doctor in
two weeks
Existing services: physical therapy for a previous knee injury
Additional notes:
Insurance: coverage for hospital stay – 100%, coverage
for hospital aids – 30%
Transportation: patient’s daughter (Sarah Clark) will pick up
patient at 4:15 pm
Matt Clark was admitted to hospital on February 15th with a
severe asthma …
READING EXTENSION

12. Read the patient information about patient discharge. Match

. choices (A-F) to the paragraphs (1-6).
A. Family support
B. Follow-up appointments
C. Taking medication
D. Post-discharge care
E. Helping with special tasks
F. Contacting your healthcare provider

159
1. After you are discharged you may be living at home or in another
setting. It is important to know where to find care and also to know
who will help you after your discharge from hospital.
2. You should understand your prescription drugs – when to take them
and what side effects you might experience. Ask for the name and
number of the person to call in case you have any questions.
3. How do you feel about using medical equipment, giving a shot or
changing a bandage? If you are unsure, ask a nurse to show you. Then,
demonstrate to the nurse that you can also do it.
4. Maybe you are worried about how you and your family are going to
deal with your illness. Ask your nurse about support groups in your
area. If necessary, ask to talk to a therapist before you leave hospital.
5. Write down the name and telephone number of the doctor or
healthcare provider you should contact if you have problems or
questions.
6. It is important to find out which tests and/or appointments you need in
the weeks that follow your discharge from hospital.

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 Lesson 19
Nursing Assessment
VOCABULARY

health assessment ['helT qsesmqnt] оцінка стану здоров’я

nausea ['nLziq] нудота
pain [peIn] біль
fatigue [fq'tJg] втома
inspection [In'spekSn] огляд
technique [tek'nJk] техніка, метод
indication ["IndI'keISn] показання
lesion ['lJZn] ураження
bruise [brHz] синець
rash [rxS] висип
odour ['qVdq] запах
auscultation ["Lskql'teISn] аускультація
lungs [lAN] легені
heart [hRt] серце
bowel ['baVql] кишечник
stethoscope ['steTqskqVp] стетоскоп
gown [gaVn] халат
abdomen ['xbdqmqn] черевна порожнина
percussion [pq'kASn] перкусія
palpation [pxl'peISn] пальпація
pressure ['preSq] тиск
tenderness ['tendqnqs] болючість
moisture ['mOIsCq] волога
solid ['sPlId] твердий
LEAD-IN

 What skills does a nurse need?

 What do you think is a nurse’s most important responsibility?
 What does the nursing process include?

161
 READING
Nursing Assessment
Health assessment is the process of gathering information about
patient’s health status, analyzing
information, and identifying problems.
When performing an assessment, the nurse
gathers subjective and objective data.
Subjective data are the verbal statements
provided by the patient. Statements about
nausea and descriptions of pain and fatigue
are examples of subjective data. Objective
data can be seen, heard, felt, or smelt, and they are obtained by physical
examination.
Inspection is the most frequently used assessment technique. Nurses
look for indications of a health problem by using their eyes, ears and nose.
They may inspect skin color, lesions, bruises or rashes as well as pay
attention to abnormal sounds and odors. Inspection is a critical observation
that should always occur first during an assessment.
Auscultation involves listening for lungs, heart, and bowel sounds
with a stethoscope. Auscultation should never be performed over patient
clothing or a gown, as it can produce false sounds or diminish true sounds.
The abdomen should be auscultated before percussion or palpation to
prevent production of false bowel sounds.
Palpation requires the nurse to apply varying degrees of pressure on
the patient with different parts of their hands. Light palpation allows nurses
to assess for texture, tenderness, temperature, moisture, pulsations, and
masses. Deep palpation is performed to assess for masses and internal
organs.
Percussion involves tapping fingers or hands quickly and sharply
against parts of the patient’s body to locate organ borders, identify organ
shape and position, and determine if an organ is solid or filled with fluid or
gas.
1. Read the text and answer the following questions.
1. What is the definition of health assessment?
2. What is the difference between subjective and objective data?
3. What is the most frequently used assessment technique?
162
 4. What does auscultation involve?
5. Is tapping fingers against parts of the body called palpation or
percussion?
2. Match the words to make word-combinations. Use them in the
sentences of your own.
1. physical a) borders
2. gathering b) data
3. identifying c) examination
4. objective d) information
5. assessment e) observation
6. bowel f) organs
7. critical g) palpation
8. deep h) problems
9. internal i) sounds
10.organ j) technique

3. Read the instructions for conducting a physical exam and

substitute the words in bold type by the words that have similar
meaning given in the box.
1. Introduce yourself and obtain verbal permission to age
perform the exam.
2. Collect demographic data. This includes the number appearance
of years lived and the characteristic of being either
male or female. auscultation
3. Collect information about the patient’s general look.
consent
Assess body build and physical fitness.
4. Perform a careful examination of skin, hair and body. inspection
Check for any abnormal spots.
5. Perform touching of skin and abdomen. Check for palpation
pain or tender areas.
6. Perform listening to the patient’s heart and lungs. percussion
Check for any irregular sounds.
7. Perform tapping of the patient’s abdomen and chest. sex

4. SOAP note is an acronym representing a widely used method of

. documentation for healthcare providers. Match four parts of a
163
 SOAP note with their explanations. Then, find the words or
abbreviations in the SOAP note which mean the same as the
expressions below.
a) the nurse’s summary of what the patient’s immediate
Subjective
medical problems are.
b) what the nurse plans to do to treat the patient’s
Objective
symptoms and help with the problem.
c) what the nurse sees or observes at the time. It is the
Assessment signs that the nurse can see, feel, hear, touch and
measure.
d) what the patient says about his or her problem. It is the
Plan
symptoms the patient (or the patient’s family) describes.

Patient Name: Kyle Jenkins

DOB: 06.04.2001
Record No: TT-581-133
Subjective: ‘My chest feels all tight.’ NKDA
Objective: Wt 75 kg, Ht 1 m 67, normal ROM
RR 28, wheezing, SOB, abdominal
exertion
Assessment: breathing pattern r/t asthma, R/O
COPD
Plan: administer meds via nebulizer

1. chronic obstructive pulmonary disease

2. medication
3. patient
4. related to
5. short of breath
6. rule out
7. abdomen is working hard because of breathing problems
8. give
9. respiratory rate
10. a device used for inhaling a medicinal drug
11. no known drug allergy
164
 12. range of motion

5. Match the nurse’s instructions with the phrases which should

. follow them.
1. I’d like to examine you. a) Stick your tongue out for me.
2. Give me your wrist. b) Look up for me, please.
3. Let’s take your BP. c) Would you take off your clothes.
4. Let’s have a look at your d) Breathe out quietly.
eyes.
5. Turn your head. e) I’m going to take your pulse.
6. Open your mouth. f) I want to check the pulse in your neck.
7. I want to listen to your heart. g) Will you straighten your arm for
me, please.
Lis
LISTENING
6. Listen to a conversation between a nurse and a patient. Mark the
. following statements as true (T) or false (F).
1. The man suspects that the woman has stomach problems.
2. The man conducts percussion tests.
3. The woman has excess abdominal fluid.

Listen again and complete the conversation.

Nurse: Okay, Sheryl, I’m going to ask that you lie down on the
table. I have to do (1) ____ ____ of your abdomen.
Patient: All right. Like this?
Nurse: Yes. Just put your arms (2) ____ ____ ____ and relax.
Patient: Do you think something is wrong with my stomach?
Nurse: No. I just want to do some (3) ____ ____ ____ tests to make
sure. Take a deep breath.
Patient: (inhales)
Nurse: I’m just checking that nothing feels swollen. (4) ____.
Patient: (exhales)
Nurse: Okay, next I’m going to tap right here on your (5) ____.
Patient: Why do you do that?
Nurse: This is a test to detect excess (6) ____ ____.
Patient: Is there any?
Nurse: Nope. It all looks normal.
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 LANGUAGE PRACTICE
PAST CONTINUOUS
 actions in progress  he was sleeping
 he was not sleeping
at a particular time in the past
? was he sleeping?

was/were verb+ing
+ I was working the whole morning yesterday.
- She was writing a report when I called her.
? While the doctor was examining the patient, the
nurse was filling in the patient’s card.

7. When Nurse Becky entered the ward at 4 pm her patients were in

. the
. middle of an action. Write positive sentences in Past
Continuous.
1. Alice / read / a book.
2. Kim and Sam / sleep.
3. Caron / listen / to music.
4.. Alex / take / the temperature.
5. Linda / look for / her medications.
6. Ben and Jake / discuss / the latest news.
7. Tessa / talk / to her husband.

8. Look at these sentences that a nurse or patient might say.

. Complete the sentences with the correct form of the verb in
brackets.
1. My son ______ (play) soccer in the park with his dad and he ______
(fall over) and ______ (pull) a muscle in his leg.
2. My wife______ (cough) all night so I ______ (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 in.
4. The patient ______ (present) to ER at 11pm. He ______ (suffer)
from serious vomiting.

166
 5. Can you tell me what ______ (you do) when your asthma attack
(start)?
6. My father ______ (have) a walk when he ______ (trip) and ______
(fall) in the street.
7. I ______ (give) him the wrong dose of aspirin last night. He’s only
three. What should I do? I’m really worried.
8. Last night when I ______ (sleep) I ______ (feel) a sharp pain in the
right side.

9. Choose the correct answer: A, B or C.

1..After years as a nursing assistant, Alicia finally ___ a nurse practitioner.
A become B became C did became
2. ‘I know about the schedule changes.’ ‘Oh, when ___ you?’
A they told B did they told C did they tell
3. These patients were ___ in China at the time of the pandemic.
A living B live C liveing
4. Lucy called us with the news when we ___ dinner.
A had B were having C have
5. The patient ___ to shout while we were discussing his discharge.
A was starting B was started C started
6. Jeff was working for a medical company ___ I was studying at college.
A before B while C after
7. Central Hospital offered Neela a job when she ___ her degree.
A finish B had finished C was finishing
8. I had breakfast quite early, then I ___ to the bus stop and caught the bus.
A had gone B had went C went
9. We missed part of the meeting because it ___ when we got to the hall.
A started B had started C hadn’t started
10. Sorry I shouted at you. I was stressed because my son ___ a panic attack.
A had B was having C had having
WRITING
10. Write a case presentation. Use these prompts to help you.
.
Case presentation: Ms Aziza Yang, 25th May 2011
1 Ms Aziza Yang / 36 yrs / present ER / 13.20 / abdominal pain
_________________________________________________________
2 suffer / constipation / about a week
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 _________________________________________________________
3 abdominal pains / severe / 7/10 / pain scale
_________________________________________________________
4 give / birth / son / 17th May
_________________________________________________________
5 before pregnancy / bowel movements / regular
_________________________________________________________
6 Dr Torres / prescribe / laxative syrup / three days
_________________________________________________________

SPEAKING
11. To interview a patient, you need to know the appropriate
. expressions. Match the useful questions (a-z) to choices (1-10).
QUESTIONS TO ASK A PATIENT
a) Are you married?
1. NAME b) Do you have any academic title?
c) Do you have any health insurance?
2. AGE d) Do you have insurance coverage from your work?
e) Does it cover a hospital stay?
3. ADDRESS f) Have you ever been immunized against polio?
g) Have you got married?
4. PHONE h) How old are you?
i) May I have your name?
5. MARITAL j) May I have your phone number?
STATUS k) What brings you in this hospital?
l) What do you do?
6. HEALTH m)What is your address?
INSURANCE n) What is your current job?
o) What is your name?
7. OCCUPATION p) What is your occupation?
AND TITLE
q) What is your phone number?
r) What is your surname?
8. NEXT OF KIN
s) What is your title?
t) What makes you come to this hospital?
9. REASON FOR u) Where do you live?
CONTACT
v) Who is your closest living blood relative?
w)Who is your next of kin?
10. IMMUNIZATION
x) Who sends you to this hospital?

168
 y) Why do you decide to go to this hospital?
z) Your age, please.

READING EXTENSION

12. Analysis of the collected data leads the nurse to make different
. types of diagnoses. Read the text and match choices (A-D) to the
paragraphs (1-4).
A. Actual nursing diagnosis
B. Risk nursing diagnosis
C. Possible nursing diagnosis
D. Wellness nursing diagnosis
1. This diagnosis indicates that a problem exists, and is composed of the
diagnostic label, related factors, and signs and symptoms. An example is
Impaired Skin Integrity related to prolonged pressure on bony
prominence as manifested by (AMB) Stage II pressure ulcer over
coccyx, 3 cm in diameter.
2. This diagnosis (potential problem) indicates that a problem does not yet
exist, but special risk factors are present. An example is Risk for
Impaired Skin Integrity related to inability to turn self from side to side
in bed.
3. This diagnosis indicates a situation in which a problem could arise
unless preventive action is taken. In addition, a possible diagnosis may
state an intuition by the nurse that cannot be confirmed or eliminated
until more data have been collected. An example is Possible Imbalanced
Nutrition related to insufficient oral intake.
4. This diagnosis indicates the patient’s expression of a desire to attain a
higher level of wellness in some area of function. For example, a patient
who is neither overweight nor underweight tells the nurse that she
knows she could improve her diet in some ways. She expresses a desire
to know more about how to improve her diet.

169
 Lesson 20
Signs and Symptoms
VOCABULARY

sign [saIn] ознака

symptom ['sImptqm] симптом
diagnosis ["daiqg'nqvsis] діагноз
health issue ['helT ISH] проблема зі здоров’ям
skin rash [rxS] висип на шкірі
eczema ['eksmq] екзема
dermatitis ["dE:mq'taItIs] дерматит
to measure ['meZq] вимірювати
vital signs ['vaitl sainz] життєво важливі ознаки
to rub [rAb] терти
temples ['templ] скроні
pain [pein] біль
headache ['hedeIk] головний біль
pregnant woman ['pregnqnt] вагітна жінка
to vomit ['vPmIt] блювати
nausea ['nLziq] нудота
sickness ['sIknqs] нездужання
stomach ['stAmqk] шлунок
cramps [krxmp] судоми
throbbing [`TrPbIN] пульсуючий
overwhelming ["qVvq'welmIN] нездоланний
fatigue [fq'tJg] втома
mild [maIld] незначний
illness ['ilnqs] захворювання
chronic ['krPnIk] хронічний
acute [q'kjHt] гострий
mental disorder ['mentl dIs'Ldq] психічний розлад
LEAD-IN
 Why is it important to recognize symptoms early?
 What are some common symptoms of colds and the flu?
 Have you ever had symptoms with an unknown cause?

170
 READING
Signs and Symptoms
In the medical world, signs and symptoms are the tools for making a
diagnosis. A sign is a health issue
that can be observed. This might
be a skin rash that indicates
eczema or red rings around the
eyes brought on by dermatitis.
Signs can be identified by anyone,
but should be professionally
diagnosed by doctors, who have
the training and experience to
identify their possible cause. Many signs are able to be measured, which is an
important part of the diagnosis. The most important medical signs are called
vital signs.
Signs can indicate symptoms. If a person is rubbing their temples, this
could be a sign that they’re experiencing symptoms of pain from a headache.
If a pregnant woman wakes up and flies to the bathroom, her vomiting is
probably a sign of nausea symptoms, as a result of morning sickness.
Symptoms are the things which a patient experiences that usually
cannot be observed by others. Examples include stomach cramps as a
result of eating undercooked meat, a throbbing headache brought on by
stress, or an overwhelming feeling of fatigue. The nurses cannot see, hear,
feel, or smell any of these issues, which makes them symptoms, not signs.
If you’re having symptoms, you’re the only person who can describe them.
The symptoms which make a patient seek medical help in the first place
are called the presenting symptoms. They are described in terms of being
either strong, mild or weak. Many illnesses have the same symptoms. These
symptoms are called non-specific. Fatigue is an example of this. It’s a
symptom of many kinds of illness, both chronic and acute, and of both
physical and mental disorders.
1. Read the text and answer the following questions.
1. What are examples of signs?
2. Can nurses measure patients’ signs?
3. Who can describe patients’ symptoms?
4. What are the presenting symptoms?
171
 5. What symptoms are called non-specific?
2. Match pictures (a-n) to symptoms (1-14).

1. cough 10. dizzy

2. fever 6. runny nose 11. itchy
3. earache 7. skin rash 12. nauseous
4. headache 8. sore throat 13. sweaty
5. stomachache 9. swollen glands 14. tired

3. Replace each of the medical terms for common symptoms in bold

type with a term which might use from Ex. 2.
1. Allergic symptoms could include watery eyes, hives, swelling, and
difficulty breathing.
2. Her migraines may be accompanied by dizziness, nausea or vomiting
as well as sensitivity to light and sound
3. This virus usually causes rhinorrhea and pneumonia, spreading from
person to person through direct contact with body fluids

172
 4. Initially she had a slight fever and complained of pharyngitis.
5. With lymphadenopathy, it is more important to diagnose and treat the
source of infection.
6. Babies cry for many reasons, but prolonged crying could mean they
are suffering from colic.

4. Complete the sentences using the words from the box.

.
1. She suffered ____ and vomiting. rash
2. He had a ____ abdomen. spots
3. ____ are typical symptom of chicken pox. lump
4. A deep cut needs ____ to heal properly. nausea
5. A ____ often causes itching. stitches
6. He found a ____ above his ankle. bloated
7. Her extreme ____ are difficult to live with. bruising
8. Ted was seen with black eyes and extensive ____. mood swings

5. Put the phrases patients usually use to talk about their symptoms in
. the proper box below.
I feel I have got a I sprained my I suffer from
a) b) c) d)
cold dizzy cancer ankle
rash unwell heartburn collarbone
fever tired diarrhea leg
headache exhausted constipation arm
stomachache rundown insomnia
backache anxious chest pains
sore throat nauseous low back pain
bad cough confused difficulty breathing

Lis
LISTENING
6. Listen and circle the most appropriate response to the patient in
. each case.
1 a) What kind of pain is it?
b) What’s your appetite like?
c) And has it been getting worse?

173
2 a) Have you taken anything for it?
b) How long have you had the runny nose for?
c) If it’s not a cold, what do you think it might be?
3 a) It’s the nature of life these days. We just have to get on with it.
b) It sounds as if you don’t need any help.
c) It sounds as if you are under a lot of pressure and need some help.
4 a) When did it start?
b) So, you’ve started smoking again recently?
c) Have you taken anything to relieve it?
5 a) Have you had a headache like this before?
b) So, you ve had a headache like this before?
c) I’ll just get you a few painkillers.

LANGUAGE PRACTICE
GERUND [-ING FORM)
Coughing is one of the most common symptoms.
the subject of a sentence
Do you need help with dressing?
after prepositions
after certain verbs: admit, She finished examining the patient.
avoid, enjoy, consider,
finish, suggest, etc.

7. Form gerunds from the words in the box. Then, use them in the
. sentences below.
arrive breathe establish go hear know itch make take
vomit
1. Please keep ____ these tablets until they all are finished.
2. I hate ____ to the dentist.
3. She suffered nausea and ____.
4. A rash can cause ____.
5. After ____ the diagnosis the doctor will prescribe treatment.
6. Fast _____ can also be a symptom of pneumonia.
7. Can you move it without ____ the pain worse?
8. ____ the difference between flu and cold saves life.
174
9. I apologize for ____ late.
10. I’m looking forward to ____ your ideas.

8. Complete the sentences with gerunds making them true about

. yourself.
1. I like ______.
2. I feel like ______.
3. I gave up ______.
4. I’d suggest ______.
5. I will never consider ______.
6. I can’t live without ______.
7. I’m looking forward to _____.
8. I would never forgive ______.

9. Fill in the gaps with gerund or infinitive forms of the verbs in the
. brackets.
1. ____ (see) a doctor isn’t people’s most favourite activity.
2. You need ____ (make) an appointment ____ (see) your doctor.
3. The patient refused ____ (leave) the emergency room.
4. He promised ____ (exercise) regularly.
5. I enjoyed ____ (talk) to patients while I was in the ward.
6. I don’t mind ____ (wait).
7. The resident admitted ____ (forget) ____ change Mr. Smith’s
treatment.
8. The patient agreed ____ (give) up ____ (smoke).
9. Please stop ____ (make) that noise.
10. I was happy ____ (help) you.
WRITING

10. Read the example report about the fatal symptoms of one patient.
. Use the notes in the box to write a similar report about a patient
with symptoms of an angina attack.
Example Report
The patient was a 60-year-old man. Two days ago, he complained of a
bad cough and said he felt nauseous. Yesterday his ankles and feet were
swollen, and he told his wife that his fingers were numb. At two o’clock
175
in the afternoon he felt dizzy, fell over and lost consciousness. He died of
heart failure in the ambulance.
NOTES
Patient: 55-year-old woman
Admitted to hospital: Monday 13th June 18.35
Presenting symptoms: burning pain in the centre of chest,
nausea, numbness in fingers

Diagnosis: angina attack

Treatment: rest & glyceryl trinitrate
Follow-up: Tuesday 11.00: No symptoms, vital signs
normal 14.00: discharged

SPEAKING
11. Match patients’ symptoms and your advice.
.
1. I’ve got a constant backache a) Unlikely, but you can have some
and a stiff neck. My shoulder cough mixture to relieve the
hurts as well. symptoms.
2. I feel tired all the time. b) Well, I don’t think it’s serious, but
Sometimes I feel sick you should take more exercise, go
because of very bad for a long walk every day and get
headaches. I have stayed some fresh air.
indoors most of the time c) I think, it’s allergy. You should get
lately. a prescription for antihistamine
3. I keep getting short of breath. preparation.
Is there any way I could be d) The doctor has prescribed a diet to
suffering from asthma? her, and apart from that I’m going
4. My daughter has been pale to give her these vitamin pills.
and anemic lately. e) You should use some ointment.
5. I just can’t sleep at night Just rub it in twice a day.
anymore. I don’t know what f) You should try to relax before you
to do. I feel so tired all the go to bed. Make a hot drink, have a
time. bath. But you shouldn’t drink tea
6. It’s every year about the or coffee late at night. They both
same time. Stuffed-up nose, contain caffeine and it keeps you
176
 my eyes itch, especially awake.
when I am in the garden.

READING EXTENSION

12. Read the doctor’s notes on the patient’s symptoms. Then, choose
. the correct answers.
Patient: Linda Thomas DOB: 11/06/79
Patient presented today with discomfort in her head and body. She
said she was treated for a cold last month by another doctor, and she was
worried it might have returned. Once again, she has a runny nose and is
coughing. She’s experiencing severe fatigue and difficulty concentrating,
also as before. However, she is now also wheezing and having trouble
breathing. She also reports muscle aches all over her body and a headache
that throbs. The pain and laboured breathing are preventing the patient
from sleeping comfortably. A temperature reading indicated a fever of 102
degrees.
I advised the patient that her symptoms suggest flu rather than a cold.
I recommended an over-the-counter analgesic to relieve pain and reduce
the fever, I also advised the patient to stay home for 2-3 days. She should
also drink plenty of fluids until she feels stronger. The patient will return
in 7-10 days if the symptoms do not improve.
1. When was Linda Thomas born?
a) March 11, 1999 c)July 7, 1979
b) June 11, 1979 d)November 7, 1999
2. What is the purpose of the doctor’s notes?
a) to explain a patient’s test results
b)to confirm another doctor’s diagnosis
c) to describe symptoms and the likely cause
d)to inform a patient about a common illness
3. Which of the following is a new symptom?
a) runny nose c) trouble breathing
b)fatigue d) coughing
4. What does the doctor recommend for the patient?
a) rest for a few days
177
b)returning if symptoms improve
c) a medication to stop the wheezing
d)a second doctor’s opinion in 7-10 days

Lesson 21
178
 Vital Signs
VOCABULARY

vital signs ['vaItl saInz] життєво важливі ознаки

skill [skIl] вміння, навик
measurement ['meZqmqnt] вимірювання
temperature ['temprqCq] температура
respiratory rate [rq'spIrqtri reI частота дихання
t]
heart rate ['hRt reIt] частота серцебиття
pulse [pAls] пульс
blood pressure ['blAd preSq] артеріальний тиск
oxygen ['PksIGqn] кисень
saturation ["sxCq'reISn] насичення
disease [dI'zJz] захворювання
treatment ['trJtmqnt] лікування
thermometer [Tq'mPmItq] термометр
stethoscope ['steTqskqVp] стетоскоп
cuff [kAf] манжета
stopwatch ['stPpwPC] секундомір
sequence ['sJkwqns] послідовність
weight [weIt] вага
frequency ['frJkwqnsi] частота
condition [kqn'dISn] стан
severity [sI'verqti] тяжкість
disorder [dIs'Ldq] розлад
surgery ['sE:Gqri] оперативне втручання
admission [qd'mISn] прийом, поступлення
remote [rI'mqVt] віддалений
acutely ill [q'kjHtli] гостро хворий
alarm [q'lRm] оповіщення
LEAD-IN
 How can monitoring vital signs help doctors treat their patients?
 What can a change in vital signs indicate?
 Can you take all your vitals yourself?
READING
179
 Vital Signs
One of the very first practical skills that students of the medical sciences
learn is how to take vital signs (or vitals). Vital signs include the
measurement of the most basic bodily functions: temperature, respiratory
rate, heart rate (or pulse), blood pressure and, where appropriate, blood
oxygen saturation. These values are dynamic and prove to be important in
assessing one’s general health, indicating disease, and monitoring the
effectiveness of treatment.
Compared to high-tech medical tests, measuring a person’s vital
signs is relatively simple and straightforward, requiring little more than
basic medical equipment – a thermometer, stethoscope, blood pressure
cuff – and a stopwatch or other timing device. The information can, in
some cases, be a matter of life and death, or at least sickness and health.
The sequence for recording vital signs
measurement in the nurses’ notes is T-P-R
and BP. Although factors such as age, sex,
weight, and activity level can influence
vital signs, there is an agreement across the
medical community about what’s normal
for adults in general.
Vital signs should always be monitored and recorded as often as
necessary for the safety of the patient. The frequency of vital signs
measurement depends on the condition of the patient; the nature and
severity of the disorder; and the procedures, surgery, or treatments being
performed. A baseline measurement should be taken on admission and at
least at the beginning of each shift. For acutely ill patients in an intensive
care setting, vitals may be monitored continuously with remote electronic
monitoring and alarm interface.
1. Read the text and answer the following questions.
1. What are vital signs?
2. What equipment is typically used to measure a person’s vital signs?
3. What do T-P-R and BP stand for?
4. What factors can influence patients’ vital signs?
5. What does the frequency of vital signs measurement depend on?

180
2. Label the pictures of medical equipment with the words from the
box. Then, match the vital signs with the correct definitions and
fill in the gaps with the instruments used to measure them.
stethoscope thermometre pulse oximetre sphygmomanometre
digital blood pressure monitor

Equipment Vital Signs Definition

1. blood pressure a) how many times a person
breathes per minute
2. pulse b) how hot the body is

3. respiration rate c) the force with which blood

travels round the body
4. temperature d) how much oxygen is in your
blood
5. oxygen saturation e) how many times the heart
beats per minute

3. Look at the following examples of written and spoken

abbreviations and put the values from the box next to the proper
abbreviations. Then, match (1-5) to (a-e).
18 78 36.8⁰ 97% 125/85
Written Spoken
1. T a) Resps 18
2. P b) Sats ninety-seven percent
3. RR c) Temp thirty-six eight
4. BP d) Pulse seventy-eight
5. O2 e) BP one twenty-five over eighty-five

4. Match (1-5) to (a–e) to make sentences about patients’ vital signs.

. 181
1. Mr Smith’s pulse increased a) it goes up and down.
2. Her temp has been the same
b) between 20 and 25 breaths per
for the last four hours –
minute; his asthma’s still a
3. My child’s temperature was
problem.
36.7, then 38, then 37.2 –
4. The patient’s blood pressure c) from 160/100 to 120/80.
decreased after a few minutes, d) from seventy-five to eighty; she’s
5. Carl’s resps vary very anxious today.
e) it’s stable at 36.7.
5. Complete a nurse’s summary with the words from the box.
1. .We usually ____ the patient’s ____ several times a day. high
2. We ____ the information on the observation ____ and sign low
it. take
3. Medical staff then use this information to ____ the patient. monitor
4. If there are any changes, a ____ temperature (fever), for record
chart
example, or a ____ blood pressure count, we have to
vital signs
inform the Senior Staff Nurse immediately.

Lis
LISTENING
6. Listen to Bessie, the Ward Nurse, taking Samira, a young
. patient’s, Admission Observations and record the information on
the Observation Chart below.
OBSERVATION CHART
Paediatrics
ADMISSION OBSERVATIONS
DATE: 02/10/2009 Full name: Samira
Khadri
T _____ BP _____ Preferred name: Samira
P _____ Wt _____ kg DOB: 05/01/2003
RR _____ O2 SATS _____ % Dr: R Howland
Hosp. No: 87453

Listen again and match the beginnings (1-8) to the endings (a-h) to
complete Bessie’s explanations.
1. I’m going to take a) the information from this machine,
182
2. I’ll just take b) your Obs. now.
3. I’ll get the rest of c) your respirations while you were watching the
4. I’ll wrap machine.
d) the cuff around your arm.
5. ... I’ll just clip
e) your temperature with this special thermometer...
6. I’ll turn on f) weigh you now.
7. I counted g) this lead onto your finger.
8. OK, I’ll h) the machine now.

LANGUAGE PRACTICE
TAG QUESTIONS
Ann, you are worried about the operation, aren’t you?
We often use question tags to Mr. Kent, you don’t like hospitals, do you?
check information, to express I´m late, aren´t I?
surprise, to be friendly, etc. Let’s go, shall we?
Stand up, will you?

7. Find the correct question tags to the sentences on the left.

.
1. This is your first time on this ward, a) aren’t I?
2. The syringe was sterile, b) isn’t it?
3. You haven’t got any privacy in this ward, c) are there?
4. Your wife will be visiting you tonight, d) didn’t he?
5. You have felt her pulse, e) did you?
6. It doesn’t hurt, f) haven’t you?
7. There are no tablets left, g) have you?
8. I’m feverish, h) shall we?
9. Give me your hand, i) won’t she?
10.You didn’t feel that, j) does it?
11.He had a stroke, k) wasn’t it?
12.Let’s do it, l) will you?
8. Complete the replies. Use an adjective from the box and the
. correct verb form to fill in the gaps.
elevated excellent charming helpful soaking terrifying worried
- I think this nurse is a lovely person.
- Yes, she’s very charming, isn’t she?
1. - Her vital signs are good now.
183
 - Yes, they’re ________, _____ they?
2. - His BP was high.
- Yes, it was ________, _____ it?
3. - It’s frightening when it happens, isn’t it?
- Yes, it’s ________, _____ it?
4. - Their instructions weren’t very clear.
- No, they weren’t ________, _____ they?
5. - Your clothes are all wet.
- Yes, they’re ________, _____ they?
6. - Mrs Wilson looks a bit anxious.
- Yes, she does look ________, _____ she?

9. Add a question tag to each of these sentences. Then, match the

. questions with the answers.
1. You don’t eat meat, _____? a) Well, I’m not sure.
2. The doctor won’t be late, _____? b) Yes, a little.
3. You’re tired, _____? c) No, I’m a vegetarian.
4. You don’t like shots, _____? d) No, they hurt a lot.
5. Let’s study English, _____? e) Sure, the test is next week.
6. Alcoholism isn’t a disease, _____? f) In a minute.
7. Mary, start the a.m. care, _____? g) Yes, it’s 36.6.
8. Her temperature’s stable now, _____? h) Yes, it is, and it has no
cure.
WRITING
10. Complete the sentences with the words below, and
. each one to a graph.
match
‘s up went up varies back to
fell stable rising up and down
1. His temperature was ____ all night, but now it’s ____ at 37.5.
2. Her heart rate ____ to 20 bpm, but now it’s ____ again.
3. His blood pressure ____ from 120/80 to 160/100
4. Her pulse rate was extremely low, but now it ____ to 70.
5. His respiratory rate ____ between 10 and 25 bpm.
6. He was running a fever, but his temperature’s ____ normal now.

184
 SPEAKING
11. Complete the following sentences or questions by inserting the
. appropriate words or phrases from the box, so that they have the
same meaning.
trembling perspire feverish orally swings
in the armpit extremely high fever has gone down
1. Do you have a temperature?
Are you
feeling ....................................................................................... ?
2. Does your temperature go up and down suddenly?
Are there any .................................................................. in
temperature?
3. Did you take your temperature under your tongue?
Did you take your
temperature .............................................................. ?
4. Was it an axillary temperature?
Did you take your
temperature .............................................................. ?
5. I’m afraid your son’s temperature is 40⁰ C.
I’m sorry, but your son has
an................................................................. .
6. I’m glad to say that your fever has fallen.
You will be pleased to know that your temperature................................ .
185
 7. My entire body was shaking.
My whole body was................................................................................. .
8. Do you sweat a lot?
Do you ............................................................................................. a
lot?

READING EXTENSION

12. Read the patient leaflet and mark the sentences as true (T) or false
. (F).
Smoking and Cardiovascular Disease
Smoking is a major risk factor for getting cardiovascular (heart and
blood vessel) disease. The more you smoke, the greater your risk. Did you
know that nicotine and carbon monoxide from cigarettes have a significant
effect on your heart and blood vessels? When you smoke, your heart rate
increases and your blood pressure rises. At the same time, your arteries
narrow and blood flow decreases.
Your risk of heart disease begins to decrease almost immediately
after you stop smoking.
 In 20 minutes: your blood pressure and heart rate fall to their normal
level.
 In eight hours: your level of oxygen rises to its normal rate and your
carbon dioxide level drops.
 In 24 hours: your chance of a heart attack starts to go down.
 In 12 months: your risk of a heart attack falls by more than 50%.
 After several years: your risk of heart disease could be similar to that of
someone who has never smoked at all.
Give up smoking – it’s never too late!
1. Your risk of cardiovascular disease is greater if you smoke.
2. Nicotine will increase your blood flow and decrease your blood
pressure.
3. Heart rate returns to normal less than half an hour after stopping
smoking.
4. Even ex-smokers remain high risk for heart disease.

186
5. It is sometimes too late to stop smoking.

187
 Lesson 22
Pain
VOCABULARY

pain [peIn] біль

sensation [sen'seISn] відчуття
body defense [dI'fens] захист організму
nervous system ['nE:vqs sIstqm] нервова система
sharp [SRp] гострий
dull [dAl] тупий
constant ['kPnstqnt] постійний
acute [q'kjHt] гострий
cause [kLz] причина
to cure [kjVq] вилікувати
chronic ['krPnIk] хронічний
to manage ['mxnIG] лікувати
to measure ['meZq] вимірювати
to suffer ['sAfq] страждати
intensity [In'tensqti] інтенсивність
frequency ['frJkwqnsi] частота
unbearable [An'beqrqbl] нестерпний
to relieve [rI'lJv] полегшувати
brain [breIn] мозок
hypnosis [hIp'nqVsIs] гіпноз
acupuncture ['xkjupANkCq] акупунктура
massage ['mxsRZ] масаж
stimulation ["stImju'leISn] стимуляція
injury ['InGqri] травма, пошкодження
wound [wHnd] рана
limb [lIm] кінцівка
neuropathic ["njVqrP'pxTIk] нейропатичний
LEAD-IN
 What would happen if you could feel no pain?
 What are some words to describe pain?
 How do you deal with pain?

188
 READING
Pain
Pain is a general term that describes uncomfortable sensations in the
body and is a vital part of our body’s defences. It is a signal in your
nervous system that something may be wrong. Pain may be sharp or dull.
It may come and go, or it may be constant. There are two types of pain -
acute pain, which lasts a short time and is removed when the cause is
cured, and chronic pain, which can last a lifetime and cannot usually be
treated. Chronic pain must be managed using drugs or other methods.
Pain is also difficult to measure and describe. It is therefore common
practice to give patients lists
of words and ask them to
say which words best
describe three things: the
type of pain they are
suffering, its intensity (how
bad it is) and its frequency (how often they feel it). Some nurses prefer a range
of numbers; 0 is no pain and 10 is unbearable pain. With children words don’t
work very well to describe intensity, so smiley faces or colours may be used.
Drugs relieve pain blocking the nerves’ messages or changing the way
the brain receives the messages, thus reducing their effect. Many methods
of controlling chronic pain without drugs have been developed. These
include hypnosis, acupuncture, massage, and electronic stimulation of
nerves.
Pain sometimes works in strange ways. It is possible, for example, to
suffer a serious injury but not feel any pain - soldiers in battle may not feel
pain from wounds until after the battle. The opposite can happen too -
patients who lose a limb can continue to feel pain in the limb long
afterwards, even though it is missing. This phantom limb pain is an
example of neuropathic pain, caused by damage to the remaining nerves.
1. Read the text and answer the following questions.
1. What is pain?
2. What is the difference between acute and chronic pain?
3. What do nurses use to measure the intensity of patient’s pain?
4. What is used to relieve pain?
189
 5. What is phantom limb pain?
2. Match the words to make word-combinations found in the text. Use
them in the sentences of your own.
1. serious a) defences
2. uncomfortable b) faces
3. body’s c) injury
4. nervous d) limb pain
5. smiley e) messages
6. nerves’ f) sensations
7. electronic g) stimulation
8. phantom h) system

3. In the grid, find key characteristics of pain you can find out
asking the following questions. ( )
1. Where is the pain? /
Where do you feel the pain?
2. What is it like? / Is it sharp or
dull?/
What kind of pain is it?
3. How long does it last? /
How often does it occur?
4. How bad is it? /
How severe is the pain?
5. Do you take painkillers? /
Do analgesics help?
6. Does anything make it better?

4. There are various collocations and expressions patients commonly

. use to describe pain. Match the adjective phrases (1-8) with the
descriptions (a-h).
1. a burning sensation a) It feels like someone is beating a drum.
2. a dull ache b) It feels like someone is hurting me with a
knife or something sharp.
3. a throbbing pain c) It feels very hot.
4. a stabbing pain d) It feels like a bee is stinging me.
5. a tingling feeling e) It’s a mild pain that is continuous.
190
6. a shooting pain f) It feels like someone is pushing lots of small
needles in your skin.
7. a stinging sensation g) It feels like I want to scratch.
8. not a pain, but itchy h) It’s a sudden pain that moves quickly from
one place to another.

5. Complete the sentences the patients or their relatives used to

. describe the pain with the words from the box and put a number
on the pain map for each patient.
hurt sore pain painful headache
stomachache
1
1. I’ve got a terribly ____ throat and I think I’ve got
a temperature.
2. I hurt my ankle this morning, running up the
stairs. It’s still very ____.
3. Have you got a ____? You don’t look very well.
4. Ah, poor thing. Her gums really ____. Her teeth
are coming through.
5. He’s got ____. I don’t think that chicken was
properly cooked.
6. I’ve got a ____ in my lower back and it’s really
aching. It’s from carrying my computer.

Lis
LISTENING
6. Listen to five patients talking about their pain. Write down the
. area where each patient feels the pain.

191
Listen again. Complete the sentences the patient uses to describe the
pain with the words in the box.
burning dull shooting stabbing tingling throbbing
1. I still have a headache. It’s like a drum, a real _____ pain.
2. There’s a _____ ache in my lower back. It’s quite a mild pain, but
sometimes I can feel a _____ pain, like an electric shock.
3. I get this _____ feeling two or three hours after food and sometimes it’s
very sore.
4. It’s a kind of _____ feeling, like pins and needles. I get it in my feet as
well, but it’s better than last week
5. Yes, it’s a _____ pain, like a knife. It’s a severe pain. It really hurts a
lot.
LANGUAGE PRACTICE
ADJECTIVES
-ic historic -ent independent -ed tired
-al cultural -less cloudless -ive active
-able capable -ant brilliant -ish childish
-ible audible -ing interesting -ous famous
-ful wonderful -y rainy -ly friendly
7. Use words on the right to form adjectives for the sentences on the
left.
.
1. Julia is a _____ and responsible nurse. care
2. I also feel _____. nausea
3. I’ve got a _____ sensation. burn
4. What a _____ dress you’re wearing today! love
5. I’d like to apologize for my _____ behaviour. thought
6. The doctor was really _____ at my progress. surprise
7. Brian didn’t expect the ward to be so _____. comfort
8. I hope you understand how _____ for you it is. importance
9. The measures taken by the nurse were _____. effect
10. You’re 18 already, stop being so _____. boy

-ING OR -ED FORMS

192
I am tired. I feel tired.
My job is very tiring. My job makes me tired.
8. Complete these words with -ing or -ed.
. After a long day at work Jake always feels tir___.
1.
2. It’s been a long, tir___ day and now I want to go home and relax.
3. Sarah was shock___ by her friends news.
4. Jackie heard some shock___ news from her friend.
5. We were very disappoint___ with our test results.
6. It was a difficult situation for him. He was embarrass___.
7. I couldn’t carry out simple tasks by myself. It was frustrat___.
8. I hate having to use the urinal bottle. I feel so asham___!
9. I have this very embarrass___ problem. Can I talk to you about it?
10.Joe’s parents are really worr___ about him.
Degrees of Comparison of Adjectives
Comparative Superlative
Adjective
(+than)
 short strong stronger the strongest
adjectives: easy easier the easiest
polite politer the politest
 longer severe more severe the most severe
adjectives: painful more painful the most painful
good better the best
 irregular bad worse the worst
adjectives little less the least
far farther (further) the farthest (furthest)

My leg is as painful as it was yesterday.

I feel much healthier today.
The patient’s condition is less severe than we thought.

9. Look at the information about these three painkillers. Complete

. the sentences, then write three more of your own.
1. Nuradeine is much effective cost side effects
______ (effective) Nuradein  €€ 
e
Ibroxen 193  € 
Solpafen  €€€ 
€
 than Ibroxen.
2. Ibroxen is ______ (cheap) than Nuradeine.
3. Ibroxen has ______ (side effects) than Nuradeine.
4. Nuradeine is ______ ( effective).
5.
6.
7.

WRITING
10. The doctor is describing his patient’s pain. Complete PAIN
. ASSESSMENT FORM with necessary information.
Mr White got a very bad pain in the centre of his chest two weeks
ago. His left arm and lower jaw also ache. The pain is like something
heavy pressing on the chest, and he has to stop doing any activity and sit
down when it comes on. It lasts from 5 to 20 minutes. It usually starts
gradually but increases if he doesn’t stop what he has been doing. He has
noticed that walking long distances brings the pain on; but if the street
goes up a hill, the pain is even more intense and lasts longer. The pain is
always associated with shortness of breath.

PAIN ASSESSMENT FORM

Site:
Character:
Onset:
Severity:
Duration:
Accompanying _________________________________
symptoms:

SPEAKING
11. Match questions (1–6) to answers (a–f). Then, complete 3 short
. dialogues with nurse’s questions about characteristics of
patient’s pain.
1. Where does it hurt exactly? a) It comes and goes.
194
2. How long does the pain last? b) Sometimes it’s quite high,
maybe seven out of ten.
3. When did it start? c) It started three months ago.
4. Where does the pain move to? d) Here, just above my left eye.
5. On the pain scale, how bad is the pain? e) Like someone beating a drum
– a throbbing pain.
6. What does the pain feel like? f) It moves across my head.

1. -
- Here, just under my ribs.
-
- It gets worse and worse. Then it goes away.
-
- Yes. If I eat, it gets better.

2. -
- It started out as intermittent several years ago.
-
- It’s a gnawing kind of pain.
-
- When I cough or take a deep breath, it hurts most.

3. -
- I’d say 10, it’s the worst pain imaginable.
-
- It hurt really badly for about two or three days.
-
- Well, it seemed to get a bit better if I took some
tablets, but it was still pretty bad.

READING EXTENSION

12. Read the article from a health website filling the gaps with the
. words from the box.
195
anti-inflammatory hot-water bottle heat patches pain-killers
comfortable position ice pack muscles pillow shower
swimming
Lower Back Pain
Follow this treatment and most lower back pain will improve:
 Rest in a (1) ____ for the first 1-2 days. You can lie on your side with a
(2) ____ between your knees, or on your back on the floor with it under your
knees. Take a quick (3) ____ (10-20 minutes) every 2-3 hours, then rest in a
comfortable position.
 Take (4) ____ such as paracetamol, or an (5) ____ such as ibuprofen.
These medicines usually work best if you take them regularly and not when
the pain is serious.
 Use a (6) ____ for 15-20 minutes, every 2-3 hours. You could also buy
(7) ____ that last for a maximum of eight hours. Or you could try an (8) ____
for 10-15 minutes every 2- 3 hours.
 Return to normal activities as soon as possible. It is important that you
don’t stay in bed for more than 1-2 days, as your (9) ____ become weak and
this worsens the problem.
 The best exercise for the lower back is walking, beginning with 5-10
minutes a day. Another good form of exercise for lower back pain is (10)
____ in shallow water.

196
 Lesson 23
Laboratory Tests and Diagnostic Procedures
VOCABULARY

laboratory test [lq'bPrqtri test] лабораторний аналіз

urine sample ['jVqrIn sRmpl] зразок сечі
tissue ['tISH] тканина
complete blood count ['blAd kaVnt] загальний аналіз крові
red blood cell ["red 'blAd sel] еритроцит
white blood cell ["waIt 'blAd sel] лейкоцит
platelet ['pleItlqt] тромбоцит
hemoglobin ["hJmq'glqVbIn] гемоглобін
hematocrit [hI'mxtqkrIt] гематокрит
glucose ['glHkqVs] глюкоза
electrolyte balance [I'lektrqlaIt] баланс електролітів
liver ['lIvq] печінка
kidney ['kIdni] нирка
lipid panel ['lIpId pxnl] ліпідограма
cholesterol [kq'lestqrPl] холестерин
urinalysis [jVqrI'nxlqsIs] аналіз сечі
diabetes ["daIq'bJtJz] діабет
stool test [stHl] аналіз стільця
gastrointestinal ["gxstrqVIn'testIn шлунково-кишковий
l]
parasite ['pxrqsaIt] паразит
absorption [qb'zLpSn] поглинання
X-rays ['eks reI] рентгенівські промені
ultrasound ['AltrqsaVnd] ультразвукове
дослідження
computerized [tq'mPgrqfi] комп’ютерна
tomography томографія
magnetic resonance ["rezqnqns 'ImIGI магнітно-резонансна
imaging N] томографія
LEAD-IN
 Why do doctors order laboratory tests?
 What tests and procedures have you had?
 What are traditional ways of testing the sex of an unborn baby?
197
 READING
Laboratory Tests and Diagnostic Procedures
Medical tests can help determine a diagnosis, plan
treatment, see if treatment is working, or monitor the
patient’s condition over time. A laboratory test is a
procedure in which a sample of blood, urine, other bodily
fluid, or tissue is examined to get information about a
person’s health.
The complete blood count (CBC) gives an overview of a patient’s
general health status by providing information about the cells in a patient’s
blood. It includes red blood cells, white blood cells, platelets, hemoglobin,
and hematocrit. The comprehensive metabolic panel test, or chemistry
panel, measures the body glucose levels, fluid and electrolyte balance, as
well as liver and kidney function. The lipid panel measures the different
types of fats and cholesterol in the blood and is used to help predict a
patient’s risk of developing heart disease.
Urinalysis is used to check for early signs of disease. Special strips
react by turning colours when dipped into a urine sample testing for blood,
glucose (sugar), and other substances that may indicate urine infection as
well as other diseases such as diabetes and problems with the kidneys.
A stool test helps to diagnose certain conditions affecting the
gastrointestinal (GI) tract. These conditions can include infection (such as
from parasites, viruses, or bacteria), poor nutrient absorption, or cancer.
Factors that can cause person-to-person variation in laboratory test
results include a person’s age, sex, race, medical history, and general
health. The results are considered normal if they fall between certain lower
and upper limits or values known as the “reference range”.
Other diagnostic tests, such as imaging tests, are often used in
addition to laboratory tests to learn more about a person’s health. Imaging
tests include X-rays, ultrasound, echocardiogram, computerized
tomography and magnetic resonance imaging.
1. Read the text and answer the following questions.
1. What is a laboratory test?
2. What three main tests is a blood test typically composed of?
3. What test is usually used to check for early signs of disease?
4. What conditions does a stool test help to diagnose?
198
 5. What are the most common imaging tests?
2. Find in the text the terms for the following definitions of lab tests.
1. A diagnostic test that determines the exact numbers of
each type of blood cell in a fixed quantity of blood
2. This test involves checking the appearance, concentration
and content of urine for the presence of disease, drugs, etc.
3. This type of test looks at fecal matter for evidence of
infection, allergy, blood or digestive problems
4. A common blood test that measures the amount of
cholesterol and triglycerides in your blood
5. A group of blood tests that provide an overall picture of
your body’s chemical balance and metabolism

3. Look at these photos of medical equipment and complete the

labels with the medical imaging tests given in the table below.
Then, match these tests (1-6) to the uses (a-f).

1. angiogram a) takes a picture of the breast

2. CT scan b) gives a 3-D image of the body
3. mammogram c) takes a picture of the bones
4. MRI d) uses a magnetic field to take pictures of the body
5. ultrasound e) takes an image of the blood vessels
6. X-ray f) uses high-frequency waves to take a picture of the body
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 4. Put the radiographer’s instructions in the correct order.
. Breathe in, hold it.
In a moment I’ll ask you to take a deep breath in and hold it.
Keep still.
1 Please, stand facing this hoard.
Push your elbows out.
Put your hands on the back of your hips and your elbows forward.
Thank you. I’ll need to check the film.
That’s it. Fine. You can breathe out now.

5. Complete the following explanations using the words in the box.

.
Bacteria microbes microbiology microscopy antimicrobial
culture pathology erythrocytes sensitive leucocytes
1. Elevated ____, or white blood cells, can indicate infection.
2. The bacteria in Mrs Grey’s urine is ____ to ampicillin, so she started
treatment with the antibiotic this morning.
3. The presence of ____ in the urine strongly suggests that she has a UTI.
4. ____ which include viruses and bacteria, are infective agents.
5. Medications which attack microbes in the body are called ____ drugs.
6. The study of micro-organisms – that is. organisms which cannot be
seen by the naked eye – is called ____.
7. Red blood cells, also called ____ transport oxygen in the blood.
8. The study of diseases is called ____.
9. ___is the use of a microscope to visualize the presence of microbes in
specimens.
10. The population of microbes which is grown in a laboratory and
analyzed by a pathologist is called a ____.
Lis
LISTENING
6. Listen to the dialogue between Mrs Murphy and the nurse and
. decide if these sentences are true (T) or false (F).
1. Mrs Murphy drank nothing before the scan.
2. Before the scan, Mrs Murphy was worried about the baby.
3. Mrs Murphy’s pregnancy has just started.
200
 4. She doesn’t want to know the sex of the baby.
5. The heartbeat is very weak.
6. The nurses also suggested reducing part-time positions.

Complete the sentences with the verbs below. Then listen again and
check.
looks shows up passing work
makes lie back putting stopped
1. ...just_____ on this examination table.
2. I’m _____ some gel onto your abdomen.
3. That helps the ultrasound____ well.
4. Your notes say the baby has ____ moving.
5. ... and it ____ a picture here on the monitor.
6. It ____ any abnormalities.
7. I’m ____ the transducer over your abdomen now.
8. So, the baby’s alive and ____ good.

LANGUAGE PRACTICE
THE PASSIVE

be+V3e
d
 We use Passive verbs to say what is
done to people and things.
every day now up to now

X-ray is taken X-ray is being X-ray has been

taken taken
yesterday at that time by that time

X-ray was X-ray was being X-ray had been

taken taken taken
tomorrow by this time tomorrow
201
 X-ray will be X-ray will have been
taken taken
The nurse always checks the patient’s vitals before this procedure.
The patient’s vitals are always checked before this procedure (by the nurse).
7. Read the following information about Mr Mark Collins and fill in
. the gaps with the past participle of the verbs from the box.
Mr Collins complained of lack of energy and decrease administer
in appetite. A family history of kidney problems was 1_____.
conduct
Standard tests for renal function were 2_____. Lab tests suggest
that the patient’s blood pressure is at the high end of the normal develop
range. Results show a reading of 130/90. A high level of elevate
albumin present was 3_____ in the patient’s urine. A blood test
showed that creatinine levels are slightly 4_____. These results establish
suggest that kidney disease is being 5_____. order
6
As the next step a GFR test and a BUN test will be _____.
A biopsy may also be 7_____ to determine the cause of the reveal
kidney disease. The pathology report should be 8_____ sent
immediately to Suite 203 on the second floor.

8. Read the sentences and make a passive sentence from the words in
. brackets.
1. The polyclinic looks very old. (when / it / build?)
2. Dr Smith is an experienced doctor. (he / like and respect / by
everybody).
3. Have you seen the accident? — Yes. (a lot of people / to hospitalize).
4. Has Jane been examined? — I don’t know. (When I came / she / examine /
still).
5. This is a strong effective drug. (it / prescribe / by the doctor).
6. Is the mixture ready? — No. (it / prepare / still).
7. Have you seen Pete lately? — Don’t you know? (he / admit to hospital /
last week).
8. At last Nick has fallen asleep. — (he / give / a sedative?)
9. Is Jack feeling better? — Much better, I think. (he / discharge / in some
days).
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10. Did anybody call an ambulance to the place of the accident? — Yes.
(but nobody / injure / so it / not need).

9. Passive verb forms are very common when we describe medical

. and other procedures. Change the sentences describing
procedures into the Passive.
1. The nurse explains the procedure to the patient.
2. The nurse cleans the skin.
3. Doctors without training don’t perform this emergency procedure.
4. The doctor inserts the needle.
5. The doctor then applies gentle pressure to the puncture site.
6. The doctor taps the vein.
7. Nurses often assist doctors in this procedure.
8. Generally, nurses don’t perform this procedure.

WRITING
10. Read the paragraph from a textbook about venipuncture and
. complete your notes below with appropriate words.
During venipuncture, the phlebotomist, a technician who takes blood,
inserts a needle into a vein and withdraws blood into a specimen tube,
which is sent to the hematology laboratory for analysis. Usually, the
phlebotomist can find a vein in the inner pan of the elbow, the antecubital
fossa, that is easily accessible. She may apply a tourniquet - a tight band -
above the site, or the patient may be asked to clench their hand to make a
fist, in order to make the vein more prominent. Afterwards, the patient
may be asked to press lightly on a dressing, usually a piece of gauze, to
help the blood to clot and to prevent swelling and a hematoma (a black and
blue mark, or a bruise) where the vein was punctured.
(1) ________ are specially trained in taking blood. They are
skilled at (2) ________ — puncturing the vein to take a blood
sample. The wrist, hand and foot can be used but more often
a vein in the inner part of the elbow is used. If it is difficult to
locate a suitable vein, the patient may be asked to make a
(3) ________, or a (4) ________ may be applied on the upper
arm to make the vein more apparent. Afterwards, a
(5) ________ is applied and the patient is asked to press

203
 gently. This helps to stop the bleeding and prevent
(6) ________ at the site. It is important that (7) ________ are
labelled correctly before they are sent to the hematology
(8) ________ where a full blood count or other investigations
will be carried out.

SPEAKING
11. Look at the Biochemistry and Hematology lab report and
. complete the sentences below describing its results.

Value Range Unit

Full blood count (FBC)
Hemoglobin (Hb) 143 115 - 165 g/L
Hematocrit (HCT) 22 37 - 47 %
White cell count (WCC) 7.4 4.0 - 11.0 109/L
Urea and electrolytes (U&E)
Urea 4.5 2.5 - 6.6 mmol/L
Creatinine 125 60 - 120 µmol/L
Sodium (Na) 138 135 - 145 mmol/L
Potassium (K) 4.5 3.6 - 5 mmol/L
Liver function test (LFT)
Bilirubin 7 3 - 16 µmol/L
Alkaline Phosphatase (Alk.Phos) 131 40 - 125 U/L

Terms used to describe lab results: o - normal

o - within normal
limits
up high low
+ down -
elevated raised reduced

1. Hemoglobin is _______ ________ _______, one hundred and forty-

three grams per litre.
2. Hematocrit is slightly ________, twenty-two per cent.
3. Potassium is ________, four point five millimols per litre.
204
4. Creatinine is somewhat _______, fifty-eight micromols per litre.
5. Alkaline Phosphatase is ______, one hundred and thirty-one units per litre.
6. Bilirubin is _______, seven ________ per _________.

READING EXTENSION

12. Read the clinic’s website about medical imaging. Use the word
. given in capitals at the end of some of the lines to form a word that
fits in the gap in the same line.
g/L
At the Community Health Clinic, we have a wide range
of medical (1) ____ techniques available. Radiography is the IMAGE
use of X-rays to take pictures of the internal body. It is a
common imaging technique used in many (2) ____ situations. DIFFER
A CT scan is an advanced form of radiography. It uses many
different two-dimensional X-rays to create a three-dimensional
image. REFLECT
An ultrasound uses the (3) ____ of sound waves to
create images. A special gel placed on the skin aids this BEAR
process. (4) ____ children are often examined through EXAMINE
ultrasounds. Recently the use of endoscopes during (5) ____
and surgery has become quite common. A doctor feeds a tube DIRECT
with a tiny camera on its end (6) ____ into the organ or cavity
to be examined.
Advanced imaging techniques include MRIs and ECGs. DETAIL
An MRI utilizes the magnetic properties of atoms to create
very (7) ____ pictures. An ECG measures the electrical
activity of the heart.

205
 Lesson 24
Surgical Nursing
VOCABULARY

surgical ['sE:GIkl] хірургічний

perioperative ["peri'PpqrqtIv] періопераційний
operating room ['PpqreItIN] операційна кімната
procedure [prq'sJGq] процедура
staff [stRf] персонал
to recover [rI'kAvq] одужувати
observation ["Pbzq'veISn] спостереження
preoperative [pri'PpqrqtIv] доопераційний
postoperative ["pqVst'PpqrqtIv післяопераційний
]
intensive care unit [In"tensIv 'keq] відділення інтенсивної
терапії
surgery ['sE:Gqri] оперативне втручання
scrub nurse ['skrAb nE:s] операційна медсестра
circulating nurse ['sE:kjqleItIN] палатна медсестра
surgical scrub ['sE:GIkl skrAb] дезінфекція рук і шкіри
equipment [I'kwIpmqnt] устаткування, обладнання
surgeon ['sE:Gqn] хірург
sterile ['steraIl] стерильний
vitals ['vaitls] життєво важливі ознаки
anesthesia ["xnqs'TJziq] анестезія
assessment [q'sesmqnt] оцінка
consent form [kqn'sent] форма згоди
to sign [saIn] підписувати
bleeding ['blJdIN] кровотеча
to suture ['sHCq] накладати шви
complication ["kPmplI'keISn] ускладнення
dressing ['dresIN] перев’язка
bandage ['bxndIG] бандаж
LEAD-IN
 What personnel are involved in surgical operations?
 What equipment can you find in an operating room?

206
 What risks should patients be warned about before surgery?
READING
Surgical Nursing
Surgical nurses are often referred to as perioperative nurses or operating
room (OR) nurses. They are responsible for caring
for patients before, during, and after surgical
procedures. Their primary responsibilities are to
assist the OR staff, provide care to patients
recovering from a procedure and document their
observations. On a day-to-day basis, a surgical
nurse may be assigned to patients who are in
preoperative, postoperative, and intensive care
units.
During the surgery itself, there are two main roles for nurses: scrub
nurse and circulating nurse. A scrub nurse does a surgical scrub and goes
into the surgery with the surgical patient and doctors. Essentially, she is the
right hand of the surgeon. A scrub nurse ensures all the surgical equipment is
sterile and ready to go, knows the specific function and names of the surgical
instruments and hands them to the doctor during the surgery. They also
ensure that patient needs are met, such as taking vitals and monitoring
anesthesia levels. Circulating nurses work outside the sterile field and
manage activities in the operating room. They do preoperative assessments,
make sure that consent forms are signed and may update family members on
the surgery status during the operation.
Post-anesthesia care units (PACU) are where patients are taken after
their surgery is complete. The nurses work with the surgeon to help with
controlling bleeding, suturing, watching for signs of complications, applying
dressings and bandages, and carrying out many other functions They ensure
the patient is comfortable, take vital signs and work with family members.
They also help patients understand their pain medications and how to care for
themselves.

1. Read the text and answer the following questions.

1. What are surgical nurses responsible for?
2. What does a scrub nurse do?
207
 3. What are the main tasks of a circulating nurse?
4. Where are patients taken after their surgery is complete?
5. What do PACU nurses help the surgeon with?
2. Read the sentence pairs. Choose where the words best fit the gaps.
1. general anesthesia / operating theatre
A. Surgeries are performed in the ____.
B. Anesthesia is provided locally or as ____.
2. anesthesiologist / surgeon
A. The ____ will make sure you are unconscious during the operation.
B. This ____ has performed hundreds of resections.
3. pre-op / post-op
A. An important ____ guideline is not to eat for 12 hours before
surgery.
B. In the recovery room a nurse will give you medications to take ____.
4. operating room / recovery room
A. Visitors can see patients in the ____ after surgery.
B. Please, prepare the ____ for the next procedure.
5. operation / resection
A. The ____ of this tumour should save the rest of the patient’s lung.
B. Please be here at 6:30 in the morning for the ____.
___

6. circulating nurse’s / scrub nurse’s

A. Part of the ____ role is to document patient consent forms.
B. One of the ____ primary duties is selecting and passing instruments
to the surgeon.
3. Nurses must be able to identify thousands of surgical instruments.
Label the pictures (a-h) with the words in bold from the text.

208
 Cutting or dissecting instruments can also be called “sharps,”
because, well, they’re sharp! We’re talking about scalpels, blades and
surgical scissors that come in a huge range of sizes. Grasping tools include
forceps and clamps which are used to hold things that may be too difficult
for the fingers to grasp. Retractors basically hold things open, like organs,
ribs or tissue, in order to provide access to the operative site. Surgeons use
stapling devices and needle holders to close a wound or rejoin tissue after
an operation. Probes can be used to enter a natural opening, like a bile
duct. Or they might dilate, or expand an opening, to provide access to a
narrow passage.

4. Match all the combining forms with their meaning. Then, complete
. the sentences by combining some of these prefixes and suffixes.
1. laparo- a) nose
2. nephro- b) breast
3. cysto- c) large bowel
4. chole- d) chest
5. col(on)- e) bile
6. hystero- f) kidney
7. thoraco- g) abdomen
8. rhino- h) bladder
9. masto- i) uterus
10. -tomy j) fixation
11. -stomy k) incision
12. -ectomy l) opening
13. -pexy m)removal
14. -plasty n) repair
15. -rrhaphy o) suture

209
 1. We’re going to do something called a ____ to have a look inside your
tummy.
2. So, how do you feel about having your womb removed by laparoscopic
____?
3. What we’re going to do is to fix the large part of your gut in a procedure
called ____.
4. You’ll have ____, also referred to as a “nose job”, which will enhance
facial harmony.
5. You’ll need the standard ____ for safe removal of the gallbladder.
6. This procedure will involve a ____, where we remove several ribs.
7. After this surgery you’ll get a temporal ____, an opening of the colon
through the skin.
8. I’m afraid we’re going to have to do a ____ to remove your right kidney.
9. We can do a ____, where we stitch the urinary bladder.
10. We can do bilateral ____, where we lift both breasts.

5. Complete the following sentences about Recovery using the words

. and phrases in the box.
alert and oriented oxygen mask Intensive Care Unit (ICU)
Coronary Care Unit (CCU) Post Anesthesia Care Unit (PACU)
1. Recovery, or ____, is where patients go to wake up after an operation.
2. In Recovery, nurses check that the patient is ____ that they are awake
and know where they are.
3. Patients often need to breathe using an ____ until they recover from
the anesthetic.
4. If patients are too ill to go to the ward, they go to the ____ .
5. If a patient has heart problems, they go to the ____.

Lis
LISTENING
6. Listen to a conversation between a nurse and a patient. Choose
. the correct answers.
1. What can you infer about the patient?
a) He is hungry.
b) He is nervous about the surgery.
c) He has had other surgical procedures.

210
 d) He met with the surgeon the day before.
2. According to the dialogue, what does the patient still have to
sign?
a) the anesthesia permit
b) the operative permit
c) the NPO order
d) the chlorhexidine form
Listen again and complete the conversation.
Nurse: Hello. Mr. Willis How are you feeling?
Patient: Okay. I’m ready to get (1) ____ ____ over with.
Nurse: We’re almost ready. I just need to finish reviewing this
(2) ____ ____ with you.
Patient: Sure.
Nurse: I have your signed anesthesia permit here. But I still need
you to sign the (3) ____ ____.
Patient: Alright. Where (4) ____ ____ ____?
Nurse: Right here. Thanks. Now, did Dr. Martinez give you an
NPO order?
Patient: Yeah. I haven’t had anything to (5) ____ ____ ____ since
about 11 pm yesterday. I can’t wait to eat again.
Nurse: I can imagine. Now. do you have (6) ___ ___ to latex or
dyes?
Patient: No, not that I’m aware of. …
LANGUAGE PRACTICE
ZERO AND FIRST CONDITIONALS
If you press that button,
a bell rings.
Type 0

If  Present Simple,
If you have any questions,
 Present Simple.
call the helpline.

If my pain gets worse,

Type 1

I will go to the doctor. If  Present Simple,

If we don’t act quickly, he will die.  will V1.

7. Choose the correct option to complete the sentences.

. 211
1. If you (will give / to give / give) blood, you’ll help a lot of people.
2. If blood stops moving, it (will be / is /be) a bad sign.
3. If your infection is treated, it (‘ll heal / heals / ‘ll heals) quickly.
4. (If /If not / Unless) she takes her medication, she’ll never get better.
5. If you (don’t know /won’t know /will know) what to do, ask the nurse.
6. Blood (will clots / clots / clot) when it is exposed to air.
7. (You will work / Work you / Will you work) here when you have
finished training?
8. If you don’t eat less sugar, you (get / ‘ll get / getting) diabetes when
you are older.

8. Complete these sentences using the Zero or the First Conditional.

.1. If you explain the problem to the nurse, she _____ (tell) you what to
do.
2. When you get an anesthetic, it _____ (stop) you feeling pain.
3. If you _____ (want) more information about how to avoid constipation,
I can give you a leaflet.
4. Let me explain our surgery plan. If you _____ (have) any questions,
please just ask.
5. If your aunt _____ (want) to get around by herself, she needs to use an
electric wheelchair.
6. You _____ (have) a fever if your temperature _____ (be) over
37.5°C.
7. A person _____ (die) if their brain _____ (not get) oxygen.
8. If you ____ (take) a sleeping pill before you go to bed, you ____
(sleep) well tonight.
9. If the doctor _____ (prescribe) a laxative syrup, your constipation
_____ (improve) in a couple of days.
10. If your father _____ (need) assistance with his ADLs, _____ (call)
the nurse.

9. Correct the mistakes in five of these sentences with zero or first

. conditionals.
1. Call the practice nurse if you will want more information about mobility
aids.
2. If your father is still in pain, his GP prescribe stronger pain relief.
212
3. My wife won’t be able to attend the appointment if it will be at ten
o’clock.
4. If your mother is not able to stand for long periods, she can use the
shower chair.
5. I’m worried that Mr Parker will slip if we won’t help him.
6. What will happen if I will can’t attend the appointment at the clinic?
WRITING
10. Match the beginnings and endings of the sentences to get the
.
instructions for nurses on operating room preparation and surgical
procedures.
1. With the assistance of a) bactericidal soap, gowns, gloves,
cleaning staff, ensure that masks, and shoe covers.
2. Gather and sterilize all b) including scissors, forceps,
surgical tools, retractors, and scalpels.
3. Set up sterile table with c) scrubbing and gowning.
4. Stock the scrub room with d) the room is sterile.
5. Assist the surgeons in e) the surgeons during operations.
6. Pass tools to f) to the post-operative unit.
7. After each procedure, g) to clean and sanitize the operating
transport the patient room and all equipment.
8. Then work with the h) tools, sponges, towels, and
cleaning staff medications.

SPEAKING
11. When patients wake up in the recovery room, a nurse usually asks
. some questions. Choose the correct sentence (a or b) from the
them
following pairs. Then, in pairs practise checking a patient in Recovery.
a) Can you open your eyes, please?
1.
b) Can you opening your eyes, please?
a) I’ll just take out your oxygen mask.
2.
b) I’ll just take off your oxygen mask.
3. a) Can you breath well?
b) Can you breathe well?
4. a) Do you know where are you?
b) Do you know where you are?
213
 a) How do you feel?
5.
b) How do you feeling?
a) Can you hear me?
6.
b) Can you to hear me?
a) Do you feel nauseous?
7.
b) Can you feel nauseous?
a) Are you in any pain?
8.
b) Have you pain?
9. a) You are warmer now?
b) Are you warmer now?
10. a) Does it still hurts?

READING EXTENSION

12. Read the text below. Use the word given in capitals at the end of
. some of the lines to form a word that fits in the gap in the same
line.
Surgical nurse shifts begin (1) ____ one hour before APPROXIMATE
the first scheduled surgical procedure. Please see that the
operating room is fully prepared fifteen minutes prior to
use. When it is ready, notify Dr. Jenkins, Operating Room
Coordinator. Always follow these steps to (2) ____ the SURE
health and (3) ____ of both patients and staff. SAFE
 With the (4) ____ of cleaning staff, ensure that the ASSIST
room is sterile.
 Gather and (5) ____ all surgical tools, including STERILE
scissors, forceps, (6) ____, and scalpels. RETRACT
 Set up sterile table with tools, sponges, towels, and
(7) ____. MEDICATE
 Stock the scrub room with bactericidal soap, gowns,
gloves, hairnets, masks, and shoe covers.
 Assist the surgeons in scrubbing and gowning.
 Pass tools to the surgeons during (8) ____. OPERATE
After each procedure, transport the patient to the
post-operative unit. Then work with the cleaning staff to
214
clean and sanitize the operating room and all (9) ____.
EQUIP

215
 Lesson 25
Wound Care
VOCABULARY

wound [wHnd] рана

pain [peIn] біль
healing ['hJlIN] загоєння
acute [q'kjHt] гострий
surgical ['sE:GIkl] хірургічний
trauma ['trLmq] травма
clean-cut wound ["klJn 'kAt] чиста рана
suture ['sHCq] шов
clips [klIp] скоби
chronic ['krPnIk] хронічний
venous ulcer ["vJnqs 'Alsq] венозна виразка
arterial ulcer [R'tIqriql] артеріальна виразка
pressure sore ['preSq sL] пролежень
dermis ['dE:mIs] дерма
technique [tek'nJk] техніка, метод
debridement [deI'brJdmqnt] обробка рани
bandaging ['bxndIGIN] перев’язування рани
surgery ['sE:Gqri] оперативне втручання
antibiotic ["xntibaI'PtIk] антибіотик
exudate ['FksjudeIt] випіт, ескудат
periwound condition [kqn'dISn] стан навколо рани
immunosuppression ["ImjunqVqsq'pre ослаблення імунітету
Sn]
obesity [qV'bJsqti] ожиріння
mobility [mqV'bIlqti] рухливість, мобільність
nutrition [nju'trISn] харчування
moist [mOIst] вологий
gaseous exchange ['geIsIqs IksCeInG газовий обмін
]
impermeable [Im'pE:miqbl] непроникний
LEAD-IN
 What types of wounds do you know?
 How can people get burns?
216
  Have you ever had a surgical wound?
READING
Wound Care
The importance of wound care in nursing relates to the ability to
reduce a patient’s pain and promote healing
as quickly and completely as possible.
Wounds are initially classified as:
1) acute (surgical and trauma wounds) – a
clean-cut wounds usually closed by
sutures or clips; generally heal in a couple
weeks;
2) chronic (venous and arterial ulcers,
pressure sores, diabetic ulcers) – open
wounds usually expanding into the second layer of the skin called the
dermis; healing occurs over weeks to years.
Nurses use several techniques to assess, treat, and care for patients
with wounds. This usually includes wound debridement, cleaning,
bandaging, and working with the doctor to determine if other treatments
are necessary (surgery, antibiotics, etc.) The five parameters to consider in
wound assessment include size, tissue type, wound exudate, periwound
condition, pain level.
Most wounds heal without becoming infected or chronic; however,
there are many risk factors for infection and prolonged healing, including
immunosuppression, chronic diseases (e.g., diabetes), obesity, smoking,
older age, stress, impaired mobility, and inadequate nutrition.
Nurses also educate patients on caring for their wounds at home,
preventing infections, and avoiding further injury. An ideal dressing for a
wound should maintain a moist environment, promote wound dressing,
provide mechanical protection, and allow for removal without pain or
trauma. It should also allow gaseous exchange, be impermeable to
microorganisms, acceptable to the patient, easy to use and cost-effective.

1. Read the text and answer the following questions.

1. What are acute wounds?
2. What are examples of chronic wounds?
3. What techniques do nurses use to care for patients with wounds?
217
 4. What are risk factors for infection and prolonged healing of
wounds?
5. What is an ideal dressing for a wound?
2. Match the medical terms (1-10) with their meanings (a-j).
1. bandage a) smell
2. discharge b) liquid which comes out of a wound
3. dressing c) a long piece of soft cloth that you tie around an injury
d) red, painful and swollen
4. inflamed
e) an injury to the skin
5. odor f) a covering that protects an injury
6. pus g) the skin around a wound
7. surrounding skin h) cells which make up the skin
8. sutures i) stitches used to sew up a cut
9. tissue j) a yellow substance that comes from an infected part
of your body
10.wound

3. Choose the correct answer, A, B or C.

1. First, I prepare my equipment: I wash my hands and then I put on ____.
A antibiotics B dressing C disposable gloves
2. Next, I remove the old ____ from the wound and dispose of it
immediately in the bin.
A tape B dressing C sutures
3. After that, I check the wound carefully for any ____ or a bad odour,
changes in colour, redness or swelling.
A pus B wound C dressing
4. If the wound looks clean and healthy and the ____ are beginning to join
up, I know that it is healing.
A wounds B sutures C edges
5. I can then clean it with ____ and use a piece of cotton wool to dry the
wound.
A saline solution B antibiotics C dressing
6. Finally, I put a new dressing on the wound and secure it with ____.
A sutures B tape C cotton wool

218
 4. Read this conversation between a nurse and a patient and match
. the words in bold (1-8) to words with a similar meaning (a-h).
N: Mr Liber, it’s time to (1) remove your (2) stitches.
P: Will this hurt?
N: You may just feel a (3) tug. Are you sitting comfortably?
P: Yes.
N: First, I’m just going to clean your wound. It looks good. The cut
(4) healed nicely - no signs of infection.
P: That’s good news.
N: Now I’ll just (5) snip the suture near the knot, like this. With these
(6) scissors I’ll just pull out the stitch. How was that?
P: Fine - no problem.
N: Great. Now I’ll just clean the wound again ... and put some tape on
your skin. Be sure not to (7) take off the tape.
P: OK. Can I take a bath?
N: It’s better to shower for the first week to let it (8) heal.
P: OK, thanks.
a) stich cutter e) take out
b) get better f) cut
c) joined up g) sutures
d) pull off h) pull

5. Complete the following sentences using the words from the box.
.
slough eschar swab necrosis cellulitis
inflammation debridement desiccation
1. Mrs Ximenes has an area of ____, or dead tissue, on her left lower leg.
There are blackened areas, or ____, on the upper wound which will be
surgically debrided tomorrow.
2. Mr Edwards has ____ in the lower leg. The wound is showing signs of
drying out, or ____, - there is quite a lot of skin flaking off his leg.
3. The skin surrounding Mrs Warren’s leg wound is red and warm to the
touch. The ____ is a sign of infection and was confirmed by a wound ____
sent to the Pathology lab three days ago.

219
4. The yellowish ____, or dead fibrous tissue, on the inner part of Derek’s
wound will have to be softened before ____, or removal of the tissue, is
possible.
Lis
LISTENING
6. Listen and complete the nurse’s sentences of the dialogue with the
. words from the box.
wound assessment absorbent dressing antibiotics dressing edges bin
disposable gloves saline solution sutures wound tape pus
1. … it means the ____ is healing, so there’s no infection and you don’t
need any ____.
2. Sorry, just give me a minute to put on my ____ ____.
3. Let me see, you’ve got ____ and we need to change your ____ every
day.
4. I’ll just pop that in the ____.
5. There’s no ____ or bad odour and the ____ are joining up nicely.
6. I’m going to use some ____ ____ just to clean the wound.
7. OK, Ms Hagans, I’m just going to clean that up and put the ____
____ on.
8. I just need to secure the dressing with some ____. There we go.
9. Let me just fill in your ____ ____ chart and we’re done.
Listen again to complete the chart.

Wound Assessment & Treatment Chart 23.07.2022

Name Ms Una Hagans DOB: 25.09.1983
Type of wound traumati surgical burn diabetic pressure other
c ulcer ulcer
Wound Location: abdomen
Infection yes no
Dressing frequency twice a day 3 times a day daily every 3rd day
Antibiotics no yes oral IV
Odour yes slight no
Pain assessment 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 1 0
Wound closure sutures clips open wound

220
Wound dressing NAD antimicrobial hydrating absorbent

Comments feels nauseous – painkillers

LANGUAGE PRACTICE
SECOND AND THIRD CONDITIONALS
Type 2

If I were you, If  Past Simple,

I would consult the doctor.  would V1.
If  had V3,
Type 3

If you had asked me,

I would have helped you.
 would have
V3.

7. Work in pairs and see how quickly you can match the parts of the
. sentences.
1. If you are feeling tired, a) her health will improve.
2. If she sleeps longer, b) I will bring them to you.
3. If Dr Brown spoke slowly, c) I would speak to him myself.
4. If you took my advice, d) I would understand him.
5. If you rub this ointment, e) it heals more quickly.
6. If you used anesthesia, f) it can become a chronic wound.
7. If you expose a wound to air, g) it wouldn’t be so painful.
8. If I knew Dr Trent better, h) take a rest.
9. If I find your glasses, i) you will feel much better.
10. If an acute wound fails to heal j) you would recover sooner.
within six weeks,

8. Make contrary to fact conditional sentences with the help of the

. following clues.
1. call the nurse / solve this 1. If you had called the nurse, she
problem would have solved this problem.
2. put sun cream on / not burn yourself
3. not eat all that food / not be sick
4. follow the doctor’s instructions / recover sooner
5. have an anesthetic / stop feeling pain
6. explain the problem to your doctor / tell you what to
221
 do
7. take a sleeping pill / sleep well last night
8. know the patient’s diagnosis / save his life
9. Complete these sentences with the first, second or third conditional
. form.
1. If I were you, I ________ (not/worry) about it.
2. If I ________ (know) you were in hospital, I would have visited you.
3. If you ________ (exercise) regularly you will be strong and healthy.
4. If he had been more clear, I ________ (understand).
5. He would have passed the exam if he ________ (study) enough.
6. You will lower your cholesterol if you ________ (go) for a walk
every day.
7. If I ________ (be) you, I would sit and study for the tomorrow’s
exam!
8. If she ________ (not/be) in a hurry, she wouldn’t have lost those
documents.
WRITING
10. Complete these instructions for removing sutures with the words
. in the box. Then, put the instructions in the correct order.
Apply a sterile dressing and remove gloves. Secure the dressing with tape.
Dispose gloves, wash your hands, and put on sterile gloves.
Dry wound edges and surrounding skin.
Explain the procedure to the patient.
Gently flush all areas of the wound.
Inspect the incision for bleeding, inflammation, drainage and healing.
Position the patient comfortably. Expose only wound area.
Remove the dressing from the wound and discard it into a plastic bag.
Wash your hands again and document procedure and observations.
Wash your hands and put on disposable gloves.
SPEAKING
11. Look at the chart and get ready to present Mia Fox’s case history.
. Wound Assessment & Treatment Chart 20.04.2023
Name Mia Fox DOB:
18.02.2005
Type of wound traumatic surgical burn diabetic ulcer pressure ulcer other
222
Wound left arm
Location:
Infection yes no
Dressing twice a day 3 times a day daily every 3rd day
frequency
Antibiotics no yes oral IV
Odour yes slight no
Pain assessment 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 1 0
Wound closure sutures clips open wound
Wound dressing NAD antimicrobial hydrating absorbent
Mia _________, ______, student
______ to the left _____. following an accident in the kitchen. The
wound has become ________ and inflamed, but there is no _____. The
patient feels _____ pain - __/10 on the pain scale.
Apply ________ dressing - change in ____ days’ time - ____ antibiotics.

READING EXTENSION

12. Read the text about removing sutures choosing from (A-G) the one
. which fits each gap (1-7).
A. that removing sutures doesn’t hurt
B. use the word stitches
C. dry your hands
D. like a glove
E. removing sutures
F. check for inflammation around them
G. on a sterile tray
H. it is tied back securely
Before removing sutures, it is important to follow these directions.
When (1) ____, put on an apron. If you have long hair, be sure
(2) ____. First, explain to the patient that you are going to remove their
sutures (the patient will probably (3) ____). Second, ask the patient if he or
she is comfortable. The patient may ask if it will hurt. Reassure the patient
(4) ____. Third, wash and (5) ____. Then prepare some gauze, cleansing
solution and a stitch cutter (6) ____. After that, put your hand inside a
sterile waste bag and use it (7) ____ to remove the bandage from the

223
sutures. Turn the sterile bag inside out so that the bandage is now inside
the bag. Put on sterile gloves. Finally, look at each suture and (8) ____.

Lesson 26
Essential Medical Procedures
VOCABULARY

224
skill [skIl] вміння, навик
injection [In'GekSn] ін’єкція
to administer [qd'mInIstq] призначати
liquid ['lIkwId] рідина
syringe [sI'rInG] шприц
muscle ['mAsl] м’яз
intramuscular ["Intrq'mAskjqlq внутрішньом'язовий
]
intradermal ["Intrq'dE:mql] внутрішньошкірний
subcutaneous ["sAbkju'teIniqs] підшкірний
vein [veIn] вена
intravenous ['Intrq'vJnqs] внутрішньовенний
infusion therapy [In'fjHZn Terqpi] інфузійна терапія
catheter ['kxTqtq] катетер
to drip [drIp] вводити по краплях
chronic illness ['krPnIk] хронічне захворювання
antibiotic ["xntibaI'PtIk] антибіотик
hydration [haI'dreISn] гідратація
bloodstream ['blAdstrJm] кровотік
absorption rate [qb'zLpSn] швидкість поглинанння
intubation ["Intju'beISn] інтубація
to breathe [brJD] дихати
endotracheal ["endqVtrq'kJql] ендотрахеальний
airways ['eqweI] повітряні шляхи
anesthesia ["xnqs'TJziq] анестезія
sedation [sI'deISn] седація
emergency medicine [I'mE:Gqnsi] невідкладна медицина
blood transfusion ['blAd trxnsfjHZ переливання крові
n]
routine procedure [rH"tJn prq'sJGq] рутинна процедура
LEAD-IN
 What medical procedures can be dangerous?
 What do you need to make an injection?
 Have you performed any of medical procedures?
READING
Essential Medical Procedures
225
 As highly trained members of the medical team, nurses need a broad
skill set to perform essential medical procedures.

An injection (also called a ‘shot’ or ‘jab’) is a way of administering a

liquid to a person using a needle
and syringe. Injections are among
the most common health care
procedures used to give a wide
variety of different medications.
They can be administered within
muscles (intramuscular), in
between the layers of the skin
(intradermal), within the fat layer of the skin (subcutaneous) or directly into a
vein (intravenous).
Infusion (IV) therapy involves administering medications using an
infusion pump and IV catheter to drip fluids directly into the veins. It
allows for much more efficient treatment of chronic illnesses since it
delivers medicine, antibiotics, and/or hydration directly into the
bloodstream. As a result, there’s a higher absorption rate and relief can be
obtained faster.
Intubation is used to aid patients when they can’t breathe on their
own. Endotracheal intubation is the process of inserting a tube through the
patient’s mouth and into their airway. This is done for patients who need to
be placed on a ventilator during anesthesia, sedation, or severe illness.
Although intubation is not typically performed by nurses, those who work
in emergency medicine may be allowed to intubate patients.
Blood transfusion (BT) therapy is a potentially life-saving procedure
that replaces blood lost during surgery or injury. It is a routine medical
procedure that delivers blood into a patient’s body through a narrow tube
that’s connected to a vein in their arm or hand.
1. Read the text and answer the following questions.
1. What are common medical procedures?
2. What methods of injections are frequently used?
3. What does infusion (IV) therapy involve?
4. What is endotracheal intubation?

226
 5. What procedure is used to deliver blood into a patient’s body?
2. Match the opposites.
1. essential a) detrimental
2. liquid b) extubate
3. common c) ineffective
4. different d) lower
5. efficient e) rare
6. faster f) similar
7. higher g) slight
8. severe h) slower
9. intubate i) solid
10.life-saving j) unnecessary

3. Complete the gaps with commonly used methods of injection.

1. The upper outer quadrant of the buttock is the ideal place for IM ____
injections.
2. Like insulin, it is administered by SC ____ injection.
3. IO ____ injections for knee osteoarthritis are safe and effective.
4. ID ____ injections are used when a localized reaction is required, for
example with some vaccinations or allergy testing.
5. For IV ____ injections healthcare professionals choose a site by
identifying a good vein to place a cannula, often on the inside of the
elbow, forearm or hand.

4. Put the steps of giving an intramuscular injection in the correct

.
order.
 Inject medication slowly (around 10 seconds per
ml), remove the needle quickly, and gently apply
pressure to site for 10 seconds.
 Discard the syringe. Never recap the needle.
 Spread the tissue taut with your non-dominant hand.
Have the patient relax and take a deep breath. As he
inhales, insert the needle at a 90-degree angle in a
quick dart-like motion.
 Apply Band-Aid if needed.
 Explain the procedure to the patient and choose an appropriate site.
1 Confirm the medication order, wash your hands and prepare the syringe.
227
 Put off gloves and wash your hands.
 Assess patient for response to the injection.
 Put on gloves. Swab the injection site with an alcohol pad. Allow the
alcohol to dry.
5. Solve the crossword puzzle.
. 1
2 3 4
5 6
7 8 9 10
11
12
13
14
15

15. A hollow elongated cylinder especially one that conveys a fluid or

functions as a passage.
DOWN:
1. Blood vessel that carries blood to the heart.
2. A drug or other form of medicine that is used to treat or prevent disease.
3. A small flexible plastic tube inserted into a vein.
4. A machine that helps people breathe when they cannot breathe
naturally.
5. The act of putting a liquid, especially a drug, into a person’s body using
a needle and a syringe.
7. The speed with which something moves or happens.
8. The insertion of a tube into a patient’s body, especially that of an
artificial ventilation tube into the trachea.
9. A piece of equipment that is used to cause liquid, air, or gas to move
from one place to another.

Lis
LISTENING
6. Dina, the ward nurse, is talking to Mrs Noonan, a patient. Listen
. and circle the words that Dina uses in the following extracts from
228
 the conversation.
1. I’m (sorry but/afraid) I need to put a tube through your nose into your
stomach now.
2. I know it’s not very pleasant but I’ll (try/help) to make you as
comfortable as possible.
3. I’ll (show/tell) you everything I’m going to (do/use) so you’ll
understand what’s happening.
4. (I must/I’ll just) turn off the TV so we’re not distracted.
5. Here’s the tube which goes (into/through) your stomach.
6. I’ll (get you to/make) you swallow as I feed the tube through your nose.
7. I’ll stop if you need a (drink/break).
8. Just hold (out/up) your hand and I’ll stop.

Listen again and answer the following questions.

1. What is Dina going to do?
2. What does Dina do first?
3. What does Mrs Noonan have to do?
4. What will Dina do if Mrs Noonan wants a break?

LANGUAGE PRACTICE
WISH-SENTENCES
 I wish I were at home. Past Simple
Present
I wish /  He wishes he had a bigger salary. V2
If only  I wish I had come to the hospital sooner. Past Perfect Past
 I wish I had studied English at school. (had+V3)
7. Read these notes. Write seven sentences about the patient’s wishes
. from l-7 below.
1. I feel homesick. I wish I ______ (be) at home with my children now.
2. If only I ______ (can) see my family.
3. I wish you ______ (not stop) me going home now.
4. I wish the doctor ______ (see) I am OK.
5. If only I ______ (be) at work at the moment.
6. I wish you ______ (bring) me a glass of water. I am very thirsty.
7. I wish I ______ (know) more about this procedure. I could have done it
earlier.

8. Complete the sentences making them true about yourself.

. 229
1. I wish I were ______ right now.
2. I wish I had more ______.
3. I wish I didn’t have to ______.
4. I wish my parents had ______.
5. I wish I knew ______.
6. I wish I could speak ______.
7. If only I could ______ this evening.
8. If only I had ______ when I was younger.
9. I wish I had ______ last year.
10. I wish I could meet ______.

9. Circle the correct form of the patients’ wishes and regrets.

1.. I wish I (contacted / had contacted) the hospital sooner.
2. If only we (had brought / brought) him here yesterday.
3. I wish I (didn’t have / hadn’t had) to repeat the examination tomorrow.
4. I wish he (were /had been) less anxious at the moment.
5. I wish my son were OK and (didn’t need /hadn’t needed) to take
antidepressant drugs.
6. If only I (didn’t go / hadn’t gone) home when I wasn’t fully recovered.
7. I wish I (had done/ could do) things all over again now.
8. If only I (followed / had followed) the advice the doctor gave me.

WRITING
10. Read Lisa’s email to her friend Karen and write Karen’ response
. about her day at work. Karen works as a practice nurse in a big
doctor’s surgery. Practice nurses carry out a lot of routine
procedures: they check patients’ vital signs, administer necessary
drugs, change dressings and treat wounds, etc.
Hi Karen,
How’s life? I’ve got my first job since graduation. I like the fact that
every day is different.
I’m just sooo busy! I have a 12-hour day today. I’m meeting with
the geriatric consultant at 9 a.m. to discuss treatment for one of my
patients. After that I’m feeding patients in rooms 10 to 30. I only
have 15 minutes for my lunch, so I’m meeting Stefan for a quick

230
 sandwich. I am also responsible for giving health checks and
advising patient on health conditions such as asthma or diabetes.
In the afternoon I’m checking medical records with the receptionist
and then I’m phoning an insurance company about a patient in
room 15. That always takes a long time. After that I’m checking IV
fluids in all the rooms. It’s nonstop!
Anyway, that’s all for now! Off to work!
Lisa

SPEAKING
11. Match the pictures with the stages involved in changing an IV bag
. given below Then, in pairs practicse explaining how to perform
the procedure.

 a) After that, connect the IV to the patient’s cannula.

 b) Before you start, wash your hands.
 c) Don’t forget to sign the IV Prescription.
 d) Finally, write up the IV infusion on the Fluid Balance Chart.
 e) First, check the IV bag against the IV prescription.
231
  f) Next, prime the line of the giving set.
 g) Now you can start the infusion.
 h) Then, set the rate on the infusion pump.
READING EXTENSION

12. Read the text filling the gaps with the words given below. Can you
. give any advice for Anna?
"I want to be a nurse, but I’m terrified of giving injections.
How can I overcome my fear?"
“I’m about halfway through my first nursing (1) ___ and absolutely
loving it. The only (2) ____ is I’m terrified of (3) ____ injections. I’ve
wanted to be a nurse all my life and I am passionate about (4) ____
people but I’m embarrassed to say, I don’t think I’ve got it in me to give
injections. “So far, I’ve managed (5) ____ giving them but I know at
some point I’m going to have to and just thinking about this makes me
(6) ____ . “I know it sounds (7) ____, but I really don’t think I can do it.
Is it (8) ____ to be a nurse and not give injections? I’m (9) ____ to think
that if I can’t do something with this then maybe nursing isn’t the
(10) ____ for me after all.”
(Career, problem, feel sick, possible, caring for, course, starting, silly,
to avoid, giving).

232
 Lesson 27
The Nature of Food
VOCABULARY
nutrient ['njHtriqnt] поживна речовина
carbohydrate ["kRbqV'haIdreIt] вуглевод
protein ['prqVtJn] білок
calorie ['kxlqri] калорія
vitamin ['vItqmIn] вітамін
starch [stRC] крохмаль
fiber ['faIbq] волокно
to break down ['breIk daVn] розщеплювати
glucose ['glHkqVs] глюкоза
muscle ['mAsl] м’яз
brain [breIn] мозок
growth [grqVT] ріст
enzyme ['enzaIm] фермент
tissue repair ['tISH rIpeq] відновлення тканини
lipid ['lIpId] ліпід
cell membrane ['membreIn] клітинна мембрана
to yield [jJld] надавати
soluble ['sPljqbl] розчинний
red blood cell ["red 'blAd sel] еритроцит
to synthesize ['sInTqsaIz] синтезувати
vision ['vIZn] зір
iron ['aIqn] залізо
iodine ['aIqdJn] йод
fluorine ['flVqrJn] фтор
phosphorus ['fPsfqrqs] фосфор
potassium [pq'txsiqm] калій
zinc [zINk] цинк
sodium ['sqVdiqm] натрій
LEAD-IN
 How do your eating habits affect your life?
 Which foods do you think are highest in calories?
 What do you have for breakfast?
READING
233
 The Nature of Food
Based on the amount of the nutrients each person needs to consume on a
daily basis, all the nutrients can be divided into two groups: macronutrients
and micronutrients. Macronutrients are the nutrients your body needs in larger
amounts, namely carbohydrates, protein, fat and water. These provide your
body with energy, or calories. Micronutrients are the nutrients your body
needs in smaller amounts, which are commonly referred to as vitamins and
minerals.
Carbohydrates are the sugars, starches and fibers found in fruits, grains,
and vegetables. They’re the most important source of quick energy in your
diet because they’re easily broken down into glucose, which the muscles and
brain use to function. Proteins are needed in our diets for growth (especially
important for children, teens and pregnant women) and to improve immune
functions. They also play an important role in making essential hormones and
enzymes, in tissue repair, and supplying energy. Fats and oils are important
nutrients for young children who need a lot of energy-rich food. Lipids also
serve as major components of cell membranes, surround and protect organs,
aid in temperature regulation, and regulate many other functions in the body.
Water is essential for life but unlike the other macronutrients, it does not yield
energy. An adult needs about 2–3 litres of water each day. That is why giving
drinks is so important when people lose a lot of water.
As their name implies, vitamins are a vital factor in the diet. They are
classified into two groups: fat-soluble (A, D, E and K) and water-soluble (C
and all of the B vitamins). Vitamins play a role in making red blood cells,
synthesizing bone tissue, normal vision, and immune function. Minerals are
the substances that people need to ensure the health and correct working of
their soft tissues, fluids and their skeleton. Examples of minerals include
calcium, iron, iodine, fluorine, phosphorus, potassium, zinc, selenium, and
sodium. The best sources of micronutrients in our diets are fruits and
vegetables.
1. Read the text and answer the following questions.
1. What two groups can all the nutrients be divided into?
2. What are carbohydrates?
3. Why do we need proteins in our diets?
4. What two groups of vitamins are there?
234
 5. What are examples of minerals?
2. Match the words to make word-combinations. Use them in the
sentences of your own.
1. daily a) components
2. immune b) functions
3. tissue c) membranes
4. major d) regulation
5. cell e) basis
6. temperature f) repair
7. fat-soluble g) tissues
8. soft h) vitamins

3. Match each nutrient with the food that contains it.

1. Proteins a)

2. Carbs b)

3. Vitamins c)

4. Minerals d)

5. Fats e)

235
 4. Find words in the grid which have the same meaning as the
. dictionary definitions (1-12).
W E C R T Y U H F V F H E N

M C A R B O H Y D R A T E S

Y S L C E A C Z Q W T E R T

U I O H E R V Z X C V B N M

A P R O T E I N A D F G H S

K L Y L N U T R I T I O N U

C V E E B N A Z X C V B N G

L K S S J H M I N E R A L A

M N B T V C I L K J H G F R

U Y T E W E N R T Y U I O P

F I B R E A E Q W E D G T X

H E D O V E R W E I G H T B

C M A L N O U R I S H E D Y

Q W E G S T C V T W R D W T

1. A substance found in certain kinds of food, that provide you with

energy.
2. A substance found in meat, eggs, and milk that people need to grow.
3. The process of taking food into the body and absorbing the nutrients.
4. A natural substance in some foods that you need for good health, for
example iron and calcium.
5. The part of fruit, vegetables, and grains that cannot be digested and
helps food to pass through your body.
6. Too heavy, often as a result of eating too much.
7. Physically weak because of not eating enough food or not eating the
right kind of food.
8. A unit of measurement of energy in food.

236
 9. A fatty substance found in fats and oils, also produced by the liver and
forming an essential part of all cells.
10. Essential substance which is not synthesized by the body but is found
in food and is needed for health and growth.
11. A substance contained in foods such as meat, cheese, and butter which
forms an energy store in your body.
12. A sweet substance usually in the form of crystals that is used to make
food and drinks sweet.

5. Complete the sentences with the words from Ex. 4.

.
1. She’s counting ____ as she tries to lose weight.
2. If you want to grow up more and get taller you need to eat more ____.
3. She has to eat more ____ as she needs more energy.
4. If you want to avoid cholesterol, eat lean meat with no ____.
5. Calcium is a ____ most often associated with healthy bones and teeth
6. The doctor says I’m ____ and must go on a diet.
7. Many of the children in the refugee camp were ____.
8. A balanced diet provides proper ____ for your body.
9. Eating large amounts of saturated fat and sugars can raise ____ levels.
10.You need to watch the ____ and mineral levels in your diet.
11.A diet that doesn’t contain enough ____ can cause constipation and
other intestinal problems.
12.We are working with manufacturers and suppliers to lower ____, salt
and fat in ingredients.
Lis
LISTENING
6. Max is explaining safe swallowing to Mrs Hudson. Listen and
. complete the following extracts from the conversation using the
words and phrases from the box.
It’s also important it’s a good idea you should Don’t
it’s really important Take your time Try not to It’s better

1. First of all, ________ not to rush meals. ________ eating your food.
2. ________ to eat smaller meals than larger meals. Why’s that?
3. That’s why ________ eat the amount of food which fits on a teaspoon.
4. ________ to keep food and liquids separate.
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 5. ________ drink and eat at the same time.
6. ________ talk while you eat. Relax and enjoy your meal.
7. After your meal, ________ to sit up for around thirty minutes to let
your food settle.
Listen again and answer the following questions.
1. What kind of diet is Mrs Hudson starting?
2. Why is it better for people who’ve had a stroke to eat smaller meals?

LANGUAGE PRACTICE
THE ARTICLE
"A" ("an") is used with countable nouns to I saw a doctor going down the
talk about things which are not specific. hall.
"The" is used to talk about specific or The doctor was going to the
known things. operating room.

7. Look at the food and beverage(s) in a hospital menu and write a,

an or some.
cheese apple juice
omelette cranberry juice
mashed potatoes coffee
. turkey sandwich cola
apple tea
banana water
orange
fruit salad
yoghurt

8. Look at these sentences that a nurse or patient might say. Circle

. word which best completes each sentence.
the
1. Please have a / some / any cheese – it’s come all the way from
France.
2. Do they have a / some / any butter? We need some to make the
cookies.
3. There isn’t some / much / many salt in this dish, is there?
238
4. You seem to eat a little / a lot / some of tropical fruit.
5. That’s too sweet for me – there’s too lot / much / many honey.
6. I try not to eat a little / much / any dairy products – I’m allergic to
them.
7. Sometimes I have a / an / some bar of chocolate as a special treat.
8. Last week was my birthday and my grandchildren bought me a / an /
some Belgian chocolates, which were delicious.
9. I’m a / an / the Muslim so I don’t eat some / any / no pork dishes,
but I do eat a lot of / lots of / lots /chicken.
10. As a / an / the diabetic I don’t eat much / many / lots meat and 1 also
don’t eat too many / much / some dairy products.

9. Read some interesting facts about food and complete the

. sentences with articles a/the where necessary.
1. ____ fresh egg sinks.
2. Eating ___ large number of beetroots can affect ___ colour of your
urine.
3. You can cure your hiccups with ____ spoonful of ____ sugar.
4. Brussels sprouts may be ____ most hated vegetable, but it’s among
____ most nutritious veggies out there.
5. ____ nectarines are ____ high source of ____ Vitamin C and A
6. If you’re ever ____ little low on energy during ____ afternoon, then
consider eating ____ apple instead of buying ____ cup of coffee.
7. Studies have shown that eating ____ peanut butter can help lower
cholesterol, aid in weight loss, add protein to your diet and prevent
____ type 2 diabetes.
8. Ketchup was once thought to be ____ great cure.
9. Breast milk is ____ only single food that provides all ____ nutrients
that our bodies need.
10. Next time you’re feeling dehydrated and don’t feel like drinking ____
water, try snacking on ____ cucumber; it’s 96 percent water.
11. ____ expiration date on ____ bottle of water is actually not for ____
water but instead it’s for ____ bottle.
12. Cheese is ____ most stolen food in ____ world.

239
13. ____ cluster of bananas are called ____ ‘hand’ and ____ single
banana is known as ____ ‘finger’.
14. When it comes to eating ____ orange, there are usually 10 segments in
one fruit!

WRITING
10. Read this food journal and complete the sentences with the words
in the box.
Food Journal: Kevin Baker
Tuesday Time Typical food intake
Breakfast 7:30 nothing
Mid morning 11:00 large milky coffee, 2 chocolate muffins, banana
Lunch 13:30 steak, chips, cake, large coke, 2 cups of strong
coffee
Mid afternoon 15:00 a cups of coffee, chocolate bar
Dinner 21:00 pasta and meat sauce, white bread roll and butter,
ice cream, fizzy drink
Evening 23:30 a cup of coffee, ½ packet of biscuits

The patient’s diet is not very ______. His ______ intake balanced
is very high and most of the calories come from fat and calorie
sugar sources. He only eats one ______ of fruit a day and no
vegetables (except potatoes). The patient often ______ on fibre
foods that are high in fat. He ______ the most important portion
meal of the day – breakfast. The patient should eat more skips
______ and include five portions of fruit and vegetables in
snacks
his diet. He should also reduce the amount of coffee he
drinks.

SPEAKING
11. Write your own food journal. Get ready to present an assessment
. of your food intake to the class.
Food Journal:
Tuesday Time Typical food intake
Breakfast 7:30
Mid morning 11:00
240
Lunch 13:30
Mid afternoon 15:00
Dinner 21:00
Evening 23:30

READING EXTENSION

12. Taste is one of our basic senses. It helps you evaluate food and
. drinks so you can determine what’s safe to eat. It also prepares
your body to digest food. Read the text about tastes and match
choices (A-F) to the paragraphs (1-6).
A. Bitter food
B. Salty food
C. Savory food
D. Sour food
E. Sweet flavoured foods
1. These foods act on the spleen and stomach helping digestion and
neutralizing the toxic effects of other foods (potato, lotus root, wheat,
polished rice, pea, milk, pork, chestnut, honey).
2. Scientists think tasting this food sometimes described as umami or
meaty helps increase our appetite and control protein digestion (meat
broth, aged cheese, ripe tomatoes, asparagus)
3. It acts on the liver and gallbladder and controls diarrhea and excessive
perspiration (tomato, tangerine, plum, lemon, grape, papaya, cherry
apple, pomegranate, vinegar).
4. This food acts on the heart and small intestine and reduces body heat
and excessive fluids and induces diarrhea (bitter melon, almond,
orange peel, tea, coffee, bitter green).
5. This food acts on the kidneys and bladder and softens hardness of
muscles or glands (barley, millet, sea weed, kelp, pork, beef, crab, table
salt)

241
 Lesson 28
Nutrition and Diet-Related Problems
VOCABULARY
nutrition [nju'trISn] харчування
habit ['hxbIt] звичка
deficiency [dI'fISnsi] дефіцит
obesity [qV'bJsqti] ожиріння
blood pressure ['blAd preSq] артеріальний тиск
cancer ['kxnsq] онкозахворювання
inherited [In'herItId] спадковий
behavior [bI'heIvjq] поведінка
weight loss [weIt] втрата ваги
eating disorder ['JtIN dIs'Ldq] харчовий розлад
anorexia nervosa ["xnq"reksIq анорексія

nE:'vqVsq]
bulimia [bu'lJmiq] булімія
to starve [stRv] голодувати
binge-eating ['bInG JtIN] компульсивне переїдання
to vomit ['vPmIt] блювати
psychiatric ["saIki'xtrIk] психіатричний
food allergy ['xlqGi] харчова алергія
immune system [I'mjHn sIstqm] імунна система
tingling ['tINglIn] поколювання
rash [rxS] висип
swelling ['swelIN] набряк
eczema ['eksmq] екзема
abdominal cramp [xb'dPmInl krxmp спазми черевної
] порожнини
diarrhea ["daIq'rIq] діарея
wheezing ['wJzIN] задишка
intolerance [In'tPlqrqns] непереносимість
LEAD-IN
 Do you think fast foods should be limited like cigarettes?
 Is obesity a choice or an illness?
 How can diabetes be prevented?
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 READING
Nutrition and Diet-Related Problems
The secret of good heath is to eat a balanced diet, with the right amount
of food, and to take plenty of physical exercise. Poor eating habits can cause
vitamin deficiency, illness, and even death.
Obesity is defined as excessive amount of body fat. It’s a medical
problem that increases the risk of heart disease, diabetes, high blood pressure
and certain cancers. Usually, obesity results from inherited, physiological and
environmental factors, combined with diet and physical activity. A healthier
diet, increased physical activity and behavior changes can help a person lose
weight.
In the case of eating disorders such as anorexia nervosa and bulimia,
the imbalance leads to weight loss, when a person eats less than they need.
Sufferers are mostly teenage girls – they either starve themselves in order to
lose weight or eat a lot of food at once (binge-eating) and vomit up all the
food later. They often end up in hospital, and after emergency life-saving
treatment they receive psychiatric help and counselling.
Food allergies are extremely common and occur when the body’s
immune system reacts to certain proteins in food. Any food can cause an
allergic reaction. However, 90% of all reactions are caused by the following
eight foods: fish and shellfish, peanuts, milk, eggs, wheat, nuts and soy. Food
allergy symptoms generally appear within a few minutes or up to two hours
after eating one of these foods. Minor reactions include a tingling sensation
in the mouth, a rash and swelling, or eczema, abdominal cramps, diarrhea, or
vomiting. More serious reactions could be swelling of the tongue and throat,
wheezing, breathing difficulties, or a decrease in blood pressure.
With food intolerance, the immune system isn’t responsible. Most of
the time it’s a problem with digesting the food. For example, being allergic to
milk is different from not being able to digest it properly because of lactose
intolerance.
1. Read the text and answer the following questions.
1. What is essential for good heath?
2. What is obesity and how can it influence our health?
3. Who most frequently suffers from anorexia nervosa and bulimia?
4. What kinds of food cause 90 % of all allergic reactions?
243
 5. Is food intolerance a synonym to food allergy?
2. Find in the text the terms for the following definitions. The first
letter is provided.
1. a special course of food to which a person restricts
themselves, either to lose weight or for medical reasons d_______
2. a lack of something that your body needs d_______
3. a condition of being too fat in a way that is dangerous for
health o_______
4. a disease in which the body cannot control blood sugar d_______
level
5. a measurement of how heavy a person or thing is w______
6. a serious mental illness in which a person does not eat, or
eats too little, often resulting in dangerous weight loss a_______
7. an illness in which a person vomits intentionally after
eating to control body weight b_______
8. a medical condition in which you become sick as a
reaction to something you eat, breathe, or touch a_______
9. a medical condition that makes your skin dry, sore, and
itchy e_______
10.an illness in which the body’s solid waste is more liquid
than usual and comes out of the body more often d_______

3. Read about how to calculate BMI or body mass index. Complete

the gaps with the words in the box. Then, calculate your BMI.

obese weight overweight underweight

BMI Readings
Body mass index, or BMI, is used to BMI of less than 18.5 is (2) ___.
decide if a person’s (1) ____ is BMI from 18.5 to 24.9 is the
healthy or not. right weight for women.
To calculate a person’s BMI, we use BMI from 20.5 to 25.0 is the
the formula: right weight for men
Weight in kilograms BMI of 25 to 29.9 is (3) ____.
Height in metres2 BMI of 30 is (4) ____.

244
 4. Put the vitamins in alphabetical order. Complete the table with
. the given information. Use the Internet if you need help.

VITAMIN SOURCES BENEFITS DEFICIENCY DISEASE

1.
2.
3.
4.
5.
6.

5. Match each sentence (1-10) with a second sentence (a-j). Use the
. key words in bold to help you.
1. A lot of people are allergic to nuts.
2. Many people do not trust genetically modified foods.
3. Organic vegetables are more expensive, but they are better for you.
4. There has been an outbreak of salmonella, listeria and other food
poisoning in Perth.
5. Too many people don’t eat a balanced diet.
6. Other studies have shown that eating in front of a mirror makes fast
food taste less appealing.
a) This is because they are cultivated naturally, without using any
chemical fertilizers and pesticides.
245
 b) They are not sure that altering the composition of cells to change
certain characteristics is safe.
c) A lot of people are in hospital as a result.
d) They say, a diet of burgers, pizzas and fried chicken is detrimental to
our health.
e) They physically react very badly.
f) They don’t consume sufficient quantities of the different food groups.

Lis
LISTENING
6. Listen to a conversation between a nurse and a patient and
. choose the correct answers.
1. What is the conversation mostly about?
a) a patient’s recent weight loss
b) the impacts of a poor diet
c) how to improve a patient’s nutrition
d) the benefits of B vitamins and omega 3
2. What will the patient likely do?
a) purchase fish
b) eat healthier fats

246
 c) stop drinking soda
d) schedule a second check up
Listen again and complete the conversation.
Nurse: John, before we finish your (1) ____, there’s something we
should discuss.
Patient: What’s that?
Nurse: Your weight gain. You understand the risks of (2) ____,
don’t you?
Patient: I do, yeah. I know my weight is getting (3) ____ ____ ____.
Nurse: You need to change your diet drastically and exercise more.
Patient: I know. But I get tired so easily.
Nurse: Changing your diet will help. Add (4) ____ ____ and B-
vitamins. Your muscles will recover faster.
Patient: Oh. thanks. Are there certain foods I should look for?
Nurse: Well, poultry has both. But you’ll also need to (5) ____
____ the bad stuff. Fewer fats, and no high fructose corn
syrup. So, soda is out.
Patient: I do drink it often, probably one or two cans a day.
Nurse: You can’t do that if you want to (6) ____ ____ ____.
Patient: Okay. Starting today, no more.

LANGUAGE PRACTICE
REPORTED SPEECH
am/is/ are was/ were this/ these that/ those
was/were had been here there
have/has had now then / at that
moment
will / can / would / could / today/ tonight that day /that
may might night
must had to tomorrow/ the following
next… (day)
V1 (s) V2 yesterday the day before
do/does not did not last… the previous …
V2ed had V3ed … ago … before
did not V1 had not V3ed in (a week) (a week) later

247
.
 7. A Senior Staff Nurse is explaining the layout of the hospital.
Choose the correct prepositions in italics to complete the
explanations 1-6.
Alice: I must drink lots of water and eat little but often.
Mrs. Taylor: I had a pain in my abdomen after eating this fruit.
Nurse Dora: We are having a wonderful dessert tonight.
Tina: I will start eating healthy food and exercising tomorrow.
Robert: Lora had a severe allergic reaction to nuts a week ago.
Mr. Clark: I had fish for lunch today which was really tasty.
Nurse Oscar: I will check your blood sugar in a minute.
Sindy: There’s too much honey in these cakes and they’re really
sweet, but I can’t eat a lot of them.
Mrs. Bennett: A friend of mine cooked traditional Indian food last night,
but I don’t like spicy food.
Dr. Anderson: I’m sorry, but potato and other starchy vegetables cannot
be included in your diet.
Doctor: “Do you have any
Sam: “Where is the nurse?”
allergies?”
Sam asked me where the nurse Doctor asked me if I had any
was. allergies.

8. Match (1-6) to (a-f) to make patient questions. Then, report them.

1.
.What’s the a) to eat the cherry cheesecake?
2. What does b) lasagne made of?
3. Am I allowed c) the glucometer measure?
4. I’m a vegetarian. What can d) are there in a black coffee?
5. I have problems swallowing. What e) I have today?
6. How many calories f) do you suggest?
REPORTED ORDERS
Patient: “Say something,
Ann: “Don’t say a word!”
please”
The patient asked me to say
Ann told me not to say a word.
something.

9. Match the Dos (1-6) and Don’ts (a-f) of safe swallowing which Dr.
. Martin said to his patient. Then, report them.
248
1. Eat small amounts of food a) Don’t mix food and drink in the
several times a day. same mouthful.
2. Eat and drink separately. b) Don’t rush meals.
3. Finish eating before talking.
c) Don’t lie down after eating.
4. Take time eating your food.d) Don’t try to talk when you are
eating.
5. Sit upright for 30 minutes e) Don’t try to eat a lot of food in one
after you finish eating. meal.
WRITING
10. Complete the article with the words given in the box.
. Diabetes occurs when your body does not produce balance
enough insulin, a hormone that controls the level of _____ childhood
in the blood. One type of diabetes appears in _____, and diet
the other type appears after the age of eighteen. It is very
glucose
common for very _____ people to get diabetes, so the
illness is linked to _____. For this reason, it is important to active
get the right _____ between food and exercise. It is obesity
important to be _____, and to eat a healthy _____, overweight
containing plenty of fruit and vegetables. Nutritionists say snacks
_____ are better than big meals.

SPEAKING
11. Look at the food pyramid for a healthy diet. Label sections (1-4)
. with the appropriate foods and get ready to talk about food
groups people should combine to make a balanced diet.

249
 The food pyramid was designed to offer an easy-to-understand look
at healthy eating. The food groups at the top of the pyramid should be
eaten in moderation (small amount) but food groups at the bottom of the
pyramid should be eaten in larger amounts.
The bottom of the pyramid is the carbohydrate group, recommending
6-11 servings per day (bread, rice, potatoes, pasta and cereals).
On the next level up, we have …

READING EXTENSION

12. It is important to give patients help at mealtimes as good nutrition

. helps patients recover more quickly. Read the text and match
choices (A-D) to (1-3). There is one choice you don’t need to use.
7. F. Eating with the patient
8. G. Helping the patient to eat
9. H. Preparing the patient to eat
10. I. Encouraging the patient
1.
A patient is more likely to want to eat if he or she is clean,
comfortable and relaxed.
Help patients to:

250
 • go to the toilet, wash their hands and brush their teeth.
• sit upright in bed or a chair.
You should also:
• put the tray table at the right height for the patient.
• cut up food into small pieces.
• give non-slip mats and two-handled cups, etc. (if necessary).

2.
• Sit in front of the patient and make eye contact.
• Give small portions and stop for a minute after each mouthful.
• Give a drink after each mouthful (if necessary).

3.
It is important that patients try and eat something – even if it’s just a
little.
You could:
• smile and be friendly.
• say positive things about the food.

251
 Lesson 29
Diet in Disease
VOCABULARY
diet ['daIqt] харчування
nutrition [nju'trISn] харчування
vital ['vaitl] життєво важливо
medication ["medI'keISn] лікарський засіб
treatment ['trJtmqnt] лікування
surgical ['sE:GIkl] хірургічний
restriction [rI'strIkSn] заборона, обмеження
dysphagia [dIs'feIGiq] дисфагія
to swallow ['swPlqV] ковтати
protein ['prqVtJn] білок
fever ['fJvq] гарячка
to dilute [daI'lHt] розводити, розбавляти
beverage ['bevqrIG] напій
headache ['hedeIk] головний біль
raw [rL] сирий
nausea ['nLziq] нудота
liquid ['lIkwId] рідина
stomach ['stAmqk] шлунок
to relieve [rI'lJv] полегшувати
disease [dI'zJz] захворювання
diabetes ["daIq'bJtJz] діабет
kidney failure ['kIdni feIljq] ниркова недостатність
to prescribe [prI'skraIb] призначати, приписувати
appetite ['xpItaIt] апетит
supplement ['sAplImqnt] добавка
assistance [q'sIstqns] допомога
to ensure [In'SVq] забезпечити
cutlery ['kAtlqri] столові прибори
LEAD-IN
 What patients might be required to follow a strict diet?
 Which foods contain high levels of vitamin C?
 Have you ever been on a diet?
READING
252
 Diet in Disease
Nutrition is an essential aspect of nursing care. It is as vital as
medication and other types of treatment. Before
offering patients a meal, it is important to
establish whether they are allowed to eat.
Depending on their medical or surgical status
patients may have diet and/or fluid restrictions.
For example, patients with dysphagia are
among those at risk because of their inability to
swallow.
If the patient is able to eat, choosing
food that is high in energy and protein, for example milky puddings, will
help patients to meet their daily nutritional needs. When fever is present,
grapefruit juice diluted with cold water is the best beverage. The only
food that a sick person is fit to take, when he has a headache, is fresh
raw fruit or fruit juices, and water. In case of nausea cold liquid, such as
freshly made lemon juice, is the best way to stimulate the stomach and
relieve the feeling of nausea.
Such diseases as diabetes and kidney failure require special diets
that are a major part of the medical treatment. The doctor will prescribe
such diets in detail, and other foods should not be given to the patient.
When a patient has a poor appetite, supplements may be necessary.
The timing of meals is very important for providing effective
nutrition to patients. The nurse must make sure that patients receive the
right food and drink at the right time. Food should be served as quickly
as possible after preparation, ensuring that it is still hot. During
mealtimes nurses should focus on patients who need assistance. This
may involve ensuring that appropriate aids are used, such as adapted
plates and cutlery or that the meal is placed within easy reach of the
patient.
1. Read the text and answer the following questions.
1. What is important to establish before offering patients a meal?
2. What food will help patients to meet their daily nutritional needs?
3. What is the best way to relieve the feeling of nausea?
4. What diseases require special diets?
253
 5. What can nurses help patients with during mealtimes?
2. Look at the pictures. Can you name all these foods? Read the
descriptions and label the pictures.

1. You need me to make a sandwich or toast.

2. We are a small round red fruit. We grow on trees.
3. Eat us fried, boiled or scrambled.
4. I’m white and I make your coffee sweet.
5. I’m a popular fast food with a sausage in the middle.
6. I’m a delicious fried, grilled or roasted meat.
7. I’m a long yellow fruit.
8. I’m yellow and sweet. People sometimes put me in their tea.
9. I am a round fruit. I am usually green or red.
10.I’m yellow and people like me on their pizza.
11.We are made from potatoes and taste great with ketchup.
12.We are a very small round green vegetable.
13.Children like me with their cereals. Cats just love me.
14.I’m a black hot drink.
15.Rabbits just love this vegetable.
16.We are a small fruit and can be used to mane wine.
17.I’m cold and sweet. I am especially eaten in summer.
18.I’m a juicy tropical fruit. I have sweet yellow flesh.

3. Label the pictures with the words from the box. Then complete
the sentences with some of them.

bottle can carton glass packet

piece slice segment stick tablespoon

254
 1. One portion of fresh fruit can be one apple, fourteen cherries or two
____ of mango.
2. If you eat canned fruit at home, then eight ____ of grapefruit is
considered a portion, for example.
3. And for dried fruit - try one ____ of raisins or two figs.
4. A medium ____ of fruit juice or a small ____ - that’s 150 ml - counts
as one portion.
5. If you like salads - then three ____ of celery counts as one portion.
6. Three tablespoons of cooked, canned or frozen vegetables is also one
portion.
4. Complete the descriptions of vitamins and minerals needed for a
. healthy diet with the words from the box.
immune system bones blood skin thyroid
nervous system heart teeth eyes oxygen
1. Vitamin A keeps the ____ healthy and is important for good vision. It is
found in fatty foods like butter, cheese, whole milk, and yoghurt.
2. The B-vitamins keep the ____ healthy and help reduce stress. They are
found in foods like wholegrain bread and cereals.
3. Vitamin C is needed to help the ____ repair itself when it is cut or
damaged. It is found in fruit, especially citrus fruit like oranges and
grapefruit.
4. Vitamin D is needed for healthy bones and ____ because it helps the
body absorb calcium. Our body makes Vitamin D when our skin is
exposed to sunlight.
255
5. Vitamin E makes our ____ healthy and arteries clean.Nuts, avocados,
pumpkins are the best source of this vitamin.

256
6. Vitamin K keeps our ____ healthy and helps it to clot properly. You can
get this vitamin eating broccoli, cabbage, and eggs.
7. Calcium is needed for children’s ____ and teeth to grow. It is found in
foods like milk, cheese, and yoghurt.
8. Iodine plays an important role in the production of ____ hormone. Foods
high in iodine include fish and seafood, as well as iodized salt.
9. Iron helps your blood carry ___. It is found in red meats, especially liver.
10. Zinc makes your ____ stronger so that you can fight colds and
infections. It is found in shellfish, nuts, and seeds.
5. Fill in the gaps using vitamins and minerals from Ex. 4.
. She has osteoporosis because she did not eat enough ____.
1.
2. He has goiter because the food he ate did not contain enough ____.
3. She has anemia. She needs to eat more food that contains ____.
4. His cut hardly stops bleeding. He did not eat enough ____.
5. He always has constipation. He should drink more ____.
6. He has scurvy because he did not eat enough ____.
7. She has beriberi because she did not eat enough ____.

Lis
LISTENING
6. You’re going to hear practice nurse Brad giving advice to three of
. his patients. Listen and complete the statement for each patient.
1 Lena is recovering from glandular fever and wants to ______.
2 Frank has just had a heart attack and wants to ______.
3 Edith is on a weight loss programme, but she wants to ______.

Listen again and complete the nurse’s suggestions. Then match each
one to the correct patient L (Lena), F (Frank) or E (Edith).
1. How about ___ the ____?
2. Can I suggest you ____ little and ___ at first?
3. Why don’t you try ____ ____ instead of meat?
4. It is important to ____ if you want to ____ ____.
5. And it’s important to ____ lots of ____.
LANGUAGE PRACTICE

.
257
 7. A student nurse (SN) is asking a nurse (N) about the clear liquid
diet. Complete the conversation with much and many and report
it.
SN I don’t know (1) _____ about the clear liquid diet. Can you explain it
: to me?
N: Yeah, of course. It’s a diet of clear liquids. Patients can digest these
easily, so we give it to them after an operation, for example.
SN I see. For how (2) _____ days do they have to follow it?
:
N: Not more than three days, and then we put them on a full liquid diet.
For the clear liquid diet, patients can drink (3) _____ different kinds
of liquid.
SN So how (4) _____ do patients drink in one day on this diet?
:
N: For some patients, not more than 600 ml. We encourage others to
drink as much as possible.
SN How (5) _____ calories can they have in total?
:
N: Well, it depends. But remember, water, black coffee and tea have
zero calories but there are 255 calories in a glass of cranberry juice.
8. Read the text about following a healthy diet below and choose the
. option (a, b, or c) which best fits each space (1–10).
(1) _______ a healthy diet is not about strict limitations, staying
unrealistically thin, or depriving yourself (2) _______ the foods you love.
Rather, (3) _______ about feeling great, having more energy, improving
your health, and boosting your mood.
Healthy eating doesn’t have to be overly complicated. If you feel
(4) _______ by all the conflicting nutrition and diet advice out there,
you’re not alone. It seems that for every expert who tells you a certain
food is good for you, you’ll find another saying exactly the opposite.
(5) _______ truth is that while some (6) _______ foods or nutrients have
been shown to have a beneficial effect (7) _______ mood, it’s your overall
dietary pattern (8) _______ is most important. The cornerstone of a
healthy diet should be to replace processed food with real food whenever

258
possible. Eating food that is (9) _______ close as possible to the way
nature made it can (10) _______ a huge difference to the way you think,
look, and feel.
1. a) Eat b) Ate c) Eating
2. a) of b) at c) from
3. a) it b) its c) it’s
4. a) overwhelm b) overwhelmed c) overwhelming
5. a) - b) A c) The
6. a) specify b) specific c) specifically
7. a) in b) on c) at
8. a) this b) that c) who
9. a) as b) so c) such
10. a) make b) to make c) making

9. Fill the gaps with the correct tense form.

. I ____ (learn) nursing for two years now. But last term I
____ (not work) hard enough for my study, that’s why my marks ____ (not
be) really good then. As I ____ (want) to pass all my exams successfully
next year, I ____ (study) harder this term.
During my last two weeks’ holiday, my parents ____ (send) me on a
nursing course to London. It ____ (be) great and I ____ (think) I
____ (learn) a lot. Before I ____ (go) to London, I ____ (not enjoy)
learning nursing. But while I ____ (do) the course, I ____ (meet) lots of
young people from all over the world. There I ____ (notice) how important
it ____ (be) to help people.
Now I ____ (have) much more fun learning Anatomy than I
____ (have) before the course. And I ____ (begin / already) to read my
textbooks again. My exams ____ (be) on 15 July and 3 August, so there
____ (not be) any time to be lost. If I ____ (pass) my exams successfully,
maybe I ____ (go) back to London to work there for a while.
WRITING
10. Write a post addressing schoolchildren about the benefits of
. eating breakfast. The first sentence is written for you.

259
 Breakfast is often called ‘the most important meal of the
day’, and for good reason. …

SPEAKING
11. Put the words in 1-4 in the correct order to make the patients’
. questions. Then, work in pairs and make a short dialogue
ordering lunch from the menu in hospital.
I have problems swallowing. / you / do / what / suggest / ?
vegetable lasagne / made / what’s / the / of / ?
have / can / today / I’m / what /I / so / a vegetarian, / ?
I / the cherry tart / am / to eat / allowed / ?

Menu Tuesday 19th October

To order your meal, choose one item from each section.
Starters Side dishes
 Chicken soup (D)  Mashed potatoes (V)
 Orange juice (D/V)  Rice (D/V)
 Bread roll & butter (D/V)
Main courses Desserts
 Grilled chicken and vegetables (D)  Fresh fruit salad (D/V)
 Beef salad (D)  Ice cream (D/V)
 Cheese omelette (V)  Cherry tart (V)
 Mediterranean vegetable lasagne (D/V)  Yoghurt and honey (D)
 Tomato & mozzarella salad (V)
Codes: V = vegetarian; D = diabetic;

READING EXTENSION

12. Read the text below. Match choices (A-H) to (1-5). There are three
.
choices you do not need to use.
HOW TO STAY HEALTHY AND HAPPY
1. Stay away from junk foods.
2. Look forward to the day with a smile.
3. Get enough sleeping.
4. Do drills every day.
5. Think positively.
260
 6. Eat five times a day in moderation.
7. Eat any kind of fruits every day.
8. Try joining a club
1. Apple is rich in fibre which is very good for digestion. Crapes and
berries have high antioxidants. Orange is rich in vitamin C which is
believed to be very effective especially if you have a cold or flu.
2. Don’t eat foods that contain trans fatty acids, which could cause
clogged arteries. Such foods include spreads, margarine, packaged
foods and fries and chicken from fast foods that are deep fried.
3. Learn to control your appetite, like for instance a cereal and a juice for
breakfast, a chicken pasta for lunch and a salad for dinner. In between
have some fruits for snacks.
4. Always make it a point to include exercise on your daily regime like for
instance walking every morning. Walking is a good aerobic exercise.
Aside from that you can also do stretching exercises for your neck and
low back.
5. Sleeping for 7-8 hours a day is considered to be the best relaxation after
all day’s work, especially if you had a good sleep.

261
262
1. Greeting someone
 Morning!
 Good afternoon!
 Hello, there!
 Hello, everybody!
 You are just the person I want to see!
 Good to see you!

2. Introducing yourself
 Hello! ... I’m...
 Hello? My name’s...
 Hello? ... speaking.
 May I introduce myself?
 How do you do? My name’s...
 First let me introduce myself.
 Excuse me, my name’s...

3. Introducing someone
 Oh, Paul, I’d like someone to meet.
 Oh look, here’s Mary. Mary meet...
 I’d like to introduce...
 Paul, may I introduce Mary?
 This is...
 Let me introduce...
 Have you met...?
 Do you know...?

4. Answering an introduction
 Yes, we’ve already met.
 Pleased to meet you.

263
  I’ve been wanting to meet you.
 Good to meet you.
 How do you do?

5. Attracting someone’s attention

 Look...
 Listen...
 Sorry, but...
 Sorry to trouble/bother you, but...
 May I have your attention, please?
 I wonder if we could begin.
 Excuse me!
6. Asking how someone is
 How are you?
 How are you keeping?
 How are things with you?
 What’s new?
 How is it going?
 Are you better?
 How’s life?
 Are you well?
7. Thanking
 Thanks a million for ...
 Great!
 That is really nice of you to....
 Thanks very much for....
 Thanks a lot.
 Thank you.
 Many thanks.
 I really can’t thank you enough.
 Much appreciated.
 I’m very grateful to you.
8. Responding to thanks
 That’s all right.
264
  That’s 0K.
 Thank you.
 Any time.
 You’re welcome.
 My pleasure.
 It’s a pleasure.
 Don’t mention it.
 No trouble at all.
9. Saying sorry
 Sorry for...
 I feel bad about...
 My fault.
 I’m very sorry.
 I’m really awfully sorry for...
 I am terribly sorry...
 Please, forgive me.
 Please, accept my apologies.
 I must apologize.
 I can’t tell you how sorry I am for...

10. Accepting an apology

 That’s 0. K.
 Please, don’t feel bad about it.
 Forget it.
 There’s no reason to apologize.
 That’s quite all right.
 Please, don’t worry.
 It really doesn’t matter at all.
 All right.

11. Summing up
 To summarize// To sum up, …
 So, what I’m saying is …
 In other words, …
 In a word …
265
  To put it simply, ...
 All things considered, ...
 Taking everything into account, ...

12. Ending a conversation

 Well, better to going, I suppose.
 Sorry, I’ve got to rush.
 I’ve got to make a phone call, sorry.
 I’m (awfully) sorry, but I’m meeting someone....
 It’s been very nice/interesting talking to you,but....
 I hope you’ll excuse me, but....
 I’m afraid I must go now.

13. Giving an example

 Like ... for example.
 … for instance.
 …for example.
 Look at ...
 Such as ...
 An example of this would be ...
 Let me take an example: ...

14. Checking if you are understood

 Got it?
 Are you with me?
 Do you understand...?
 Do you see?
 That’s clear, isn’t it?
 Is that reasonably clear?
 Have I made myself clear?
 Does that seem to make sense?
 I hope that’s clear.

15. Checking that you understand

 If I’ve got the picture, then ...
 Can I get this clear?
266
  That means .... Right?
 So, am I right in saying ...?
 In other words, .... Right?
 I’m sorry, I’m not sure I understand.
 If I’ve got it right, then ...
 Do you mean...?

16. Showing you are listening

 Well, well!
 Well! Indeed?
 Tell me more.
 Really! Really?
 I see.
 I know what you mean.
 How interesting!

17. Reminding
 You haven’t forgotten about ... have you?
 What about ...?
 You won’t forget about ... will you?
 You will remember to ... won’t you?
 Won’t you forget it again?
 Should I phone you to remind ...?
 Will you, please, remember ...?
 Please, don’t forget about/to ...

18. Comparing
 There’s no way ... is better than ...
 You just can’t compare ... and ...
 There’s absolutely no comparison between... and ...
 On the whole, ...
 If you compare ... and ...
 I don’t see how you can talk about ... and... in the same way.
 All in all, ...
 ... better than ...
267
  ... is less valuable than ...

19. Asking for information

 Have you got any idea ...?
 I’d like to know ...
 Can you tell me ... (please)?
 Can you help me?
 Do you happen to know ...?
 Have you heard about ...?
 Have you got any idea about ...?

20. Asking someone to say something again

 Sorry, I didn’t get any of that.
 Pardon?
 I’m sorry.
 I’m sorry, what did you say?
 I’m sorry, I couldn’t hear what you said.
 I’m sorry, I didn’t hear ...
 I didn’t catch ...
 Would you repeat what you said?
21. Expressing your opinion
 Well, I must say ...
 I’d say ...
 I’d like to say ...
 The way I see it, ...
 It seems to me ...
 I’m convinced that ...
 If you ask me, ...
 I think ...
 I believe...
 In my opinion ...
 As I see it, ...
 To my mind, ...

22. Listing points

268
  Firstly, ...
 First of all, ...
 In the first place, ...
 First and foremost, ...
 To begin with, ...
 Secondly, ...
 Thirdly, ...
 Finally, ...
 Lastly, ...
 Last but not least, ...

23. Buying time: fillers

 Well …
 Actually …
 You know/ see …
 As a matter of fact, …
 Let’s see.
 In fact, …
 I wonder …
 The thing is …
 It’s like this, you see …
 What I’m trying to say is …
 What I would say is …
 Let’s put it this way …
24. Giving Reasons
 This is why we have decided . . .
 The main reason is . . .
 Another important reason …
 Our decision is …
 Therefore, we believe …

25. Asking for someone’s opinion

 I don’t think much of ..., do you?
 What would you say to ...?
 What do you think of/about ...?
269
  What are your feelings about ...?
 What/How about …?
 How would you react to ...?
 How do you see...?
 How do you feel about ...?

26. Agreeing
 Well, that’s the thing.
 I’m with you there.
 Yes, I agree ...
 That’s what I was thinking.
 That’s true.
 That’s quite right.
 I agree absolutely with ...

27. Disagreeing
 You must be joking!
 You can’t mean that!
 You can’t be serious!
 No way!
 I disagree, I’m afraid.
 That’s wrong...
 That’s not the way I see ...
 Surely not! ...
 Not really.
 No, I don’t think ...
 I’m not sure, in fact.
 I can’t agree ...
28. Saying the information is not correct
 Nothing of the kind!
 I’ve never heard anything like that.
 I don’t think you are right.
 You are wrong.
 You are not telling us the truth.

270
  It’s not correct.
 Your information is not correct.
 I’m sorry, but you must be mistaken.

29. Expressing doubt

 I take/see your point but …

 I see what you mean but …
 I agree with you on the whole but …
 But don’t you think/see that …?
 That’s true I suppose but …
 Well, you have a point there but …

30. Expressing excitement

 What a great idea!
 Terrific!
 Super!
 Fantastic!
 It’s very exciting.
 How wonderful!
 How marvelous!
 How exciting!

31. Saying you do not know

 I wish I knew ...

 I haven’t got a clue ...
 I’m sorry, I really don’t know ...
 I’m afraid, I’ve no idea ...
 I’m afraid, I don’t know much about...
 I’m afraid, I don’t know anything about ...
 I’m afraid, I haven’t got that information.
32. Saying something is important
 Sure, it’s most important.

271
  You shouldn’t ignore it.
 That’s of great concern.
 It’s less important than ..., I think.
 It’s absolutely important, believe me.
 It matters a lot.
 It’s something you should pay more attention to...
 ... is of vital importance in this case.

33. Suggesting
 What about ..., then?
 Let’s ...
 How about ..., then?
 Why don’t we ..., then?
 We could always ..., then.
 Shall we ...?
 We might as well ...
 You may like to ...

34. Telling someone to do something

 I’d like you to .... (please).
 Would you mind ... (please)?
 Would you ..., please?
 Will you ..., please?
 I have to ask you to..., (I’m afraid).
 Come and see ...
 Would you be so kind as to ...?
 I must ask you to ..., please.
35. Telling someone how to do something
 You do it like this: you ...
 Watch. First you ...
 Look, all you do is ...
 Let me show you. First you ...
 It’s like this: …
 First you have to ...
 First you ..., then you ...
272
  This is how you do it: you ...
 You should follow this procedure: ...
36. Saying someone should not do something
 You needn’t ...
 You don’t need to ...
 There’s really no need to ...
 I can’t see why you should ...
 Don’t do it, please.
 You’re not to ...
 You’re not meant to ...

37. Giving permission

 Why not?
 Sure.
 No reason why you shouldn’t ...
 No reason why not.
 It’s 0K.
 Go ahead.
 Feel free ...
 You’re welcome to ...
 Yes, certainly you can.

38. Offering to do something for someone

 Want a hand ...?
 Need some help, ...?
 Can I help out?
 What can I do to help ...?
 Shall I ...?
 Let me ...
 I’ll do it for you.
 I’ll ....
 Can I help?
 Would you like any help ...?
 Is there anything I can do ...?

273
39. Showing relief
 Thank heavens!
 Oh, what a relief!
 Oh, thank goodness for that.
 That’s a great relief.
 I’m extremely glad to hear ...
40. Showing sympathy
 That is a shame.
 Oh, ... that’s awful.
 I know how it feels.
 You must be very upset.
 That is a pity.
 I’m very sorry to hear ...
 How terrible!
 What a terrible situation for you!

41. Calming or reassuring someone

 Try and look on the bright side.
 The best thing is to keep cool.
 Relax.
 Now take it easy.
 Now, don’t get upset.
 It’s all right.
 It is not as bad as all that.
 Don’t worry!
 Come on! It’s 0K!
 There’s nothing to worry about.

42. Defining
 People
 It’s a person who works in …
 someone you can find in …
 somebody who is known for …
 Things
274
  It’s something like …
 made of …
 It’s a kind/ type of …
 It’s a thing that is used to …
 People use it to …
 Places
 It’s a place where …
 Time
 It’s the time when …

43. Calling
 Hello/Good morning/afternoon. this is .... (name) from....
(company)
 Hello, my name’s ... (name) I’m calling from.... (company)
 I’d like to speak to.... please?
 Could I have the...department, please?
 Is....there, please?
 I’m ringing to....
 I’d like to....
 I need some information regarding...
 Can I leave him/her a message?
 Please tell him/her that...
 Please ask her/him to ring me on.(number)

44. Answering the phone

 Hello....Department, ... speaking, how can I help?
 Who’s calling, please?
 Rease hold on a moment.
 Just a second
 I’ll see if he/she is in
 I’m sorry / I’m afraid he’she is not available.
 Would you like to leave a message?
 Can I take a message?
 Shall l ask him/her to call you back?
 Can l take your number please?
 OK. I’ll make sure he/she gets the message
275
  Can anyone else help you?
 Can I help you at all?

45. Reporting severe adverse events

 The patient has a history of ...
 A report was received from the physician indicating that ...
 Before the event, the patient was on the following
medication: ...
 After examining the patient, the physician …
 After taking (drug), the patient experienced...
 At the time of the report, the patient’s condition was
unchanged.
 At the time of the report, the patient had completely
recovered.

276
become became become ставати
begin began begun починати
bite bit bitten кусати
bleed bled bled кровоточити
break broke broken ламати
bring brought brought принести
build built built будувати
burn burnt burnt горіти; обпекти
buy bought bought купити
catch caught caught ловити
choose chose chosen вибирати
come came come приходити
cost cost cost коштувати
cut cut cut різати
do did done робити
draw drew drawn малювати, тягти
dream dreamt dreamt марити; мріяти
drink drank drunk пити;
drive drove driven водити; їхати
eat ate eaten їсти
fall fell fallen падати
feed fed fed годувати
feel felt felt відчувати
fight fought fought битися
find found found знаходити
fly flew flown літати
forget forgot forgotten забувати
forgive forgave forgiven пробачати
get got got отримувати
give gave given давати
go went gone йти
grow grew grown рости
have had had мати
hear heard heard чути
hit hit hit вдаряти;
hold held held тримати
hurt hurt hurt ранити, боліти
keep kept kept зберігати
know knew known знати
277
lay laid laid класти; покласти
leave left left залишати
let let let дозволяти
lie lay lain лежати
lose lost lost втрачати
make made made робити
mean meant meant означати
meet met met зустрічати
pay paid paid платити
put put put класти
read read read читати
ride rode ridden їздити верхи
ring rang rung дзвонити
run ran run бігти
say said said казати
see saw seen бачити
sell sold sold продавати
send sent sent відправляти
set set set встановлювати
shake shook shaken трясти
shoot shot shot стріляти
show showed shown показувати
shut shut shut закривати
sing sang sung співати
sink sank sunk занурювати; тонути
sit sat sat сидіти
sleep slept slept спати
smell smelt smelt пахнути
speak spoke spoken говорити
spend spent spent витрачати, проводити
spill spilt spilt проливати
spoil spoilt spoilt псувати
stand stood stood стояти
steal stole stolen вкрасти
strike struck struck вдаряти; бити
swim swam swum плисти
take took taken брати
teach taught taught навчати
tear tore torn рвати
tell told told розповідати
think thought thought думати
throw threw thrown кидати
understand understood understood розуміти
278
wake woke woken прокидатися
wear wore worn носити (одяг)
win won won вигравати
write wrote written писати

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Логос", 2005. – 384 с.
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мови (з вправами): Навч. посібник. – 5-те вид., доопрац. – К.:
Освіта, 2001. – 414 с.
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Ніжин, 2002. – 211 c.
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посібник. – Тернопіль: Астон, 2002. – 162 с.
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UNIT 1
PUBLIC HEALTH CARE
Lesson 1 I’m a Medical Student ..………………………………………….. 9
Lesson 2 Healthcare Facilities ………………………………..……………. 21
Lesson 3 Emergency Medical Care...……………………………………… 27
Lesson 4 Types of Medications ……………………………..……… 34
Lesson 5 Communication Skills in Nursing………………………… 43
UNIT 2
STRUCTURE AND FUNCTIONS OF THE HUMAN BODY
Lesson 1 Structure of the Human Body ………………………………….. 52
Lesson 2 Infrastructure Body Systems …………………………………… 59
Lesson 3 Regulation Systems of the Body ……………………………… 64
Lesson 4 Human Body Energy Systems ………………………………… 70
UNIT 3
NURSING FOUNDATION
Lesson 1 Nurses’ Specialties ……………………………… 126
Lesson 2 Qualities of a Professional Nurse ………………………...……… 133
Lesson 3 A Working Day of a Nurse ………………………………… 139
Lesson 4 Infection Prevention ……………….…………………………….. 145
UNIT 4
CARE OF THE PATIENT
Lesson 1 Patient Admission …………………………..……………… 182
Lesson 2 Daily Care of the Patient …….………...……………………… 187
Lesson 3 Nursing Care Records ……………………………..….……… 192
Lesson 4 Administering Medication ……………….……………………… 197
Lesson 5 Hospital Discharge ………………………………… 203

UNIT 5
PATIENT’S STATE EVALUATION
Lesson 1 Nursing Assessment …………………………………………… 213
Lesson 2 Signs and Symptoms ……………………………. 219
282
Lesson 3 Vital Signs ………………………………………………… 225
Lesson 4 Pain ………………….…………………… 231
Lesson 5 Laboratory Tests and Diagnostic Procedures ………………… 236
203
UNIT 6
DIFFERENT TYPES OF NURSING
Lesson 1 Surgical Nursing …………………………………………… 241
Lesson 2 Wound Care ………………………………………….. 248
Lesson 3 Essential Medical Procedures …………………………………… 254
UNIT 7
FOOD AND NUTRITION
Lesson 1 The Nature of Food ……………………………………………… 327
Lesson 2 Nutrition and Diet-Related Problems ……………………………. 333
Lesson 3 Diet in Disease …………………………………………………... 339
344
356
Functional Language……………………………………………………… 358
Irregular Verbs…………………………………………………………….
Bibliography……………………………………………………………......

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