LESSON 10

LESSON 10

Discharge from the hospital

A.    READ THE TEXT BELOW

                                      Discharge from the hospital

Discharge from the hospital is the point at which the patient leaves the hospital and either returns home or is transferred to another facility such as one for rehabilitation or to a nursing home. Discharge involves the medical instructions that the patient will need to fully recover. Discharge planning is a service that considers the patient's needs after the hospital stay, and may involve several different services such as visiting nursing care, physical therapy, and home blood drawing.
The procedures in dichraging from the hospital are:
A.    Always check with the nursing supervisor to be sure the patient has officially been discharged by the doctor.
       1.    Sometimes the doctor will discharge the patient on the day the order is written.
        2.    Other times the patient will know several days before.
B.    On the day the patient is to be discharged
       1.    check when the patient will be leaving
       2.    Set up a schedule for the patient's care so that the patient does not become too tired
       3.    Allow for a rest period between the bath and packing
       4.    Make sure the patient is ready when family members arrive
       5.    As you help the patient with her/his care, make sure the instructions are understood about home    care and follow-upvisits.
      6.    Have the nurse answer any questions the patient has
 C.    Ask a family member to check with the business office – this person will be given a release paper stating financial matters for the patient have been taken care of and the patient is ready for discharge.
D.    Help the patient into a wheelchair, and wheel him/her to the entrance of the healthcare facility nearest the car.
      1.    Ask the family to drive up to the entrance.
      2.    To avoid injuries, do not leave the patient unattended until the family members have arrived with their car, and help the patient into the car.
      3.    Make sure all the patient's belongings are put in the car.
      4.    Say goodbye and wish the patient well.
      5.    Return the wheelchair to its proper place.
      6.    Your final responsibility is the terminal cleaning of the patient's unit.

Read more: Discharge from the Hospital - recovery, test, blood, pain, infection, medication, Definition, Description http://www.surgeryencyclopedia.com/Ce-Fi/Discharge-from-the-Hospital.html#ixzz1vwQPBxx5

WORD LIST

•    Discharge        : to allow someone officially to leave somewhere, especially a hospital or a court of law
•    Rehabilitation        : return someone or something to a good or healthy condition
•    Recover        : to get back something lost, especially health, ability, possessions.
•    Therapy        : a treatment which helps someone feel better especially after an illness
•    Supervisor        : a person whose job is to supervise someone or something
•    Release            : to give freedom or free movement to someone or something
•    Wheelchair        : a chair on wheels which people who are unable to walk use for moving around
•    Injuries            : physical harm or damage to someone's body caused by an accident or an attack

Taken from Cambridge Advance Learner’s Dictionary


B.    EXERCISES
     EXERCISE 1

Answer these questions based on the text!

1.    Who discharges a patient?
2.    Who arranges for the patient's transportation home?
3.    Place a check before each sentence that indicates a correct procedure for discharging the patient!
a.    __ Make sure the patient wants to go home before he/she is discharged
b.    __ Tell the patient what you plan to do.
c.    __ Assist the patient to dress if necessary.
d.    __ Accept presents from the patient.
e.    __ Collect the patient's personal belongings from the closet and bedside stand.
f.    __ Get the patient's valuables from the safe.
g.    __ Accept a tip from the patient for providing good nursing care.
h.    __ Get a wheelchair for the patient.
i.    __ Assist the patient into the car.

     EXERCISE 2

Directions: Describe the duties and responsibilities of each of the following individuals when discharging a patient from the healthcare facility.
1.    The physician
2.    The nursing supervisor
3.    The nursing assistant
4.    The patient's family

LESSON 9

LESSON 9

DISEASE

A.    READ THE TEXT BELOW

                                              ASTHMA

Asthma is a disease of the lungs that is that is characterized by tightening of the air pathways. Common symptoms of asthma are wheezing, shortness of breath, coughing, chest pain, tightness or pressure. Many of these conditions are reversible with medication but not 100% reversible in all patients. Some common features of asthma are inflammation, airway obstruction and airway sensitivity. Some risk factors for asthma are a family history of asthma, regular lung infections, presence of allergies, exposure to tobacco smoke, low birth weight, and being male.
The current rise in asthma cases among children is alarming. Asthma may occur at any age but is very common in children. Approximately 10% of children have asthma and that rate may rise in the future. Experts don't agree why the rate is increasing but here are some ideas:

•      Children are being exposed to more triggers (things that bring on asthma attacks; dust, tobacco smoke,  pollution)

•      Children don't have strong immune systems (they aren't exposed to many childhood diseases.)

•      Decreases in the rates of breast feeding may also play a role.

Asthma is a disease that causes many problems for the patient. However, it can be controlled. With the right information and medical attention medical professionals can prevent many deaths.

Taken from www.hospitalenglish.com



WORD LIST

•    Asthma                : a medical condition which makes breathing difficult by      causing the air passages to become narrow or blocked
•    Disease                : illness of people, animals, plants, etc
•    immune system     : the cells and tissues in the body which make it able to protect itself against infection
•    Breathe                : to move air into and out of the lungs
•    Symptoms            : any feeling of illness or physical or mental change which is caused by a particular disease
•    Tightness              : to be in a difficult situation
•    Wheezing             : to make a high, rough noise while breathing because of some breathing difficulty
•    Pressure               : the force you produce when you press something
•    Infection               : a disease in a part of your body that is caused by bacteria or a virus
•    Treatment             : the use of drugs, exercises, etc. to cure a person of an illness or injury
•    Sensitivity             : having a strong physical reaction to something
•    Inflammation        : a red, painful and often swollen area in or on a part of your body
•    Exposure             : a serious medical condition that is caused by being outside in very cold weather
•    Allergens             : a substance which can cause an allergy

Taken from Cambridge Advance Learner’s Dictionary


B.    EXERCISES

     EXERCISE 1

Choose the right answer for the quetions below!

1.    What are some common symptoms associated with asthma?
        a.    shortness of breath
        b.    coughing
        c.    chest pain
        d.    all of the above
2.    What age does asthma present at?
        a.    any age
        b.    childhood
        c.    30s
        d.    10-12 years
3.    Asthma is ___________ of the lungs.
       a.    a part
       b.    a disease
       c.    a risk factor
       d.    a symptom
4.    Family history of asthma, regular lung infestions, and exposure to tabacco smake are all ___________ of asthma
       a.    risk factors
       b.    triggers
       c.    diseases
       d.    exposures
5.    Recently, there has been an increase in asthma cases among ________.
       a.    young adults
       b.    IV drug users
       c.    the elderly
       d.    children
6.    Many of the symptoms of asthma are 100% ________ with medication in some patients.
       a.    reversible
       b.    stronger
       c.    avoidable
       d.    sensitivity
7.    What percent of children have asthma?
       a.    20%
       b.    1%
       c.    10%
       d.    15%
8.    What is one idea why the asthma rate is increasing in children?
       a.    Children are being exposed to more triggers.
       b.    Children have strong immune systems.
       c.    Breast feeding has increased.
       d.    More children are smoking.
9.    Airway obstruction and airway sensitivity are common ________ of asthma.
       a.    diseases
       b.    triggers
       c.    features
       d.    risk factors
10.    Asthma is a disease that causes _________ .
       a.    severe headaches
       b.    tightening of air pathways
       c.    relaxation of the lungs
       d.    medication

     EXERCISE 2

  Fill in all the gaps with the right word !

  ____is a disease of the ___  that is that is characterized by tightening of the air pathways. Common symptoms of asthma are wheezing, shortness of ___ , coughing, chest pain, tightness or pressure. Many of these conditions are reversible with medication but not 100% reversible in all patients. Some common ____ of asthma are inflammation, airway obstruction and airway sensitivity. Some ___ ___   for asthma are a family history of asthma, regular lung infections, presence of allergies, exposure to tobacco smoke, low birth weight, and being male.
The current rise in asthma cases among ____ is alarming. Asthma may occur at ___ age but is very common in children. Approximately 10% of children have asthma and that rate may rise in the future. Experts don’t agree why the rate is increasing but here are some ideas:
- Children are being exposed to more ___  (things that bring on asthma attacks; dust, tobacco smoke, pollution)
- Children don’t have strong ____ (they aren’t exposed to many childhood diseases.)
- Decreases in the rates of breast feeding may also play a role.
Asthma is a disease that causes many ____  for the patient. However, it can be controlled. With the right information and medical attention, medical professionals can prevent many deaths.

LESSON 8

LESSON 8

MEDICINE 2 (ANTIBIOTICS)

A.    PRE READING

1.    What do the antibiotics do?
2.    What do you know about bacteria?
3.    What should the patient know about antibiotics?


B.    READ THE TEXT BELOW

                                                ANTIBIOTICS

Antibiotics are stong medication that fight infections in body. There are many classes of antibiotics and they have different affects on bacteria. Some antibiotics weaken cell walls. Some antibiotics block protein synthesis or DNA synthesis. Antibiotics can kill bacteria (bactericidal) or they can stop them from replicating or growing (bacteriostatic). Each antibiotic has specific characteristics and they don’t work against all type bacteria.
It is important that patients know several things about antibiotics
     Antibiotics don’t work against viral infection such cold and the flu
     Antibiotics don’t work against sore throats and cough
     It is important to finish all of medication even if you feel better

If a patient doesn’t finish the prescription, it could be dangerous. Patients usually will feel better after 2-3 days. However, the bacteria might not be completely gone. If a patient stops taking their medication, the bacteria may grow, causing the patient to become sick again. Also, the bacteria might become resistant to the antibiotic making fight. Problems can occur with antibiotics. If the patient notice a rash, swelling, or any other allergic reaction, they should stop taking the medication and contact their physician immediately. Also if the patient has problems with nausea or vomitting, they should stop the medication and contact their physician. A more tolerable might be available.

Taken from www.hospitalenglish.com

WORD LIST

•    Antibiotic        : a medicine or chemical that can destroy harmful bacteria in the body or limit their growth
•    Infection          : a disease in a part of your body that is caused by bacteria or a virus
•    Protein            : one of the many substances found in food such as meat, cheese, fish or eggs, that          is necessary for the body to grow and be strong
•    Synthesis        : specialized the production of a substance from simpler materials after a chemical reaction
•    Replicate        : formal      to make or do something again in exactly the same way
•    viral infection   : infection that is caused by a virus
•    prescription     : a piece of paper on which a doctor writes the details of the medicine or drugs that someone needs
•    resistant          : not harmed or affected by something
•    rash                : a lot of small red spots on the skin
•    swelling          : a part of your body which has become bigger because of illness or injury
•    allergic           : having an allergy
•    nausea           : when you feel as if you are going to vomit
•    vomitting        : to empty the contents of the stomach through the mouth
•    physician       : a medical doctor, especially one who has general skill and is not a  surgeon
•    tolerable        : a quality that is acceptable, although certainly not good

Taken from Cambridge Advance Learner’s Dictionary

C.    EXERCISES

     EXERCISE 1
Answer these questions based on the text!

1.    What do the antibiotics do in the body?
2.    What ways do antibiotics do to fight bacteria?
3.    Antibiotics don’t work for common problems. Give some examples!
4.    Why is it important to fininsh the antibiotic prescription?


     EXERCISE 2

Fill the gaps in the sentences using these words from the text!
 
1.    Signs of the illness include fever, ________ and vomiting.
2.    Researchers tried many times to ________the original experiment.
3.    Bandage the wound to reduce the risk of _________.
4.    Put your foot into cold water to help the _________ go down.
5.    He came home drunk and _________ all over the kitchen floor.
6.    I'm taking _________ for a throat infection.
7.    These drugs are only available  on __________.
8.    I've got an  itchy _________ all over my chest.

LESSON 7

LESSON 7

MEDICINE 1

A.    READ THE TEXT BELOW

                    WHAT SHOULD YOU KNOW ABOUT DRUGS

   A medicine is a substance which can cure or prevent disease, replace vital substance that the body lacks and suppress or relieve symptoms.
    All drugs possess a potential benefit and a potential risk. Drugs for minor complaints generally have obvious benefit and negligible risk; otherwise, most of us would prefer to put up with the complaint. For more serious diseases more powerful drugs are required and the risk of adverse reaction is usually higher, but well worth taking. With dangerous diseases like cancer, the benefit x risk ratio becomes a major consideration. Often unwanted side effects, such as loss of hair, have to be accepted to gain benefits.
    Adverse reaction to drugs takes many forms. Some happen to every one; some affect only certain people, such as those with liver disease. Xerostomia (dryness of the mouth), drowsiness, skin rash, ithchiness are minor reaction. Anaphatic shock is a major reaction that may occasionally be fatal.

Taken from:English For Nurse, By:  Abu Nawas,dkk (2009,14)




WORD LIST

Substance            : type of solid liquid
To extract            : remove or obtain a substance
Plant                : living things in the ground to grow
To use            : take a particular amount of a liquid
Heart failure            : not operating heart
Drug                : medicine
To inject            : put something into somebody
Nurse                : a person whose job is to take care ill
To cause            : person/thing that makes something happens
Intense            : very strong
Language            : system of communication
To master            : learn or understand something completely
Well                : in a good
To heal            : making something health again
To depend            : rely on somebody/something
To increase            : making something greater in amount

B.    EXERCISES

     EXERCISE 1
Answer these questions below based on the text!

1.    What is medicine?
2.    Mention some minor reaction that may be produced by drugs!
3.    Which of the two names do you know better
4.    Does a nurse have the right to prescribe drugs? Why?


     EXERCISE 2

Comprehension check
Read the text below and write T (true) or F (false) next to each of the statements.

1.    A medicine is a substance which can reduce vital substance that the body lack.
2.    All drugs only possess a potential benefit.
3.    For more serious diseases the risk of adverse reaction is usually higher.
4.    Adverse reaction to drugs that just happen to ceratin people is called major reaction.

LESSON 6

LESSON 6

OFFERING SOMETHING

  READ THE TEXT BELOW

                                        OFFERING SOMETHING

In hospital every patient need a different and various meals. It depends on her/his disease. Hospital patients are served breakfast ( buffet), morning snack, lunch, afternoon snack and dinner. Breakfast is served at 7 o’clock am. The morning snack is served at 9 am or harder out together with breakfast.

    Lunch is usually served for starters and gruel type soup contains flour is usually served to patient on     diet.
    Dinner consist of meat dish with garnishing and salad or sweet dish with stewed fruit.
    Dinner is usually served at 9 o’clock pm. There are some useful expression can be used at her/his work.

Taken from:English For Nurse, By:  Abu Nawas,dkk (2009,31 )

WORD LIST
Food and Drink in Hospital


     Breakfast
-    Coffee, cocoa, milk
-    White bread
-    Porridge
-    Butter
-    Jam
-    Cheese
-    Honey
-    Fried Rice


     Morning Snack
-    Coffee or Milk
-    Sour milk and yogurt
-    Sweet white bread
-    Croissant
-    Fruit


     Lunch
-    Soup
-    Meat dish and rice
-    Vegetables
-    Potatoes
-    Fish
-    Chicken



     Dinner
-    Meat dish with garnishing
-    Salad
-    Sweet dish with stewed dish
-    Slice sausage
-    Salad and bread
 

EXERCISE 1

Answer thsese questions below based on the text !

1.    How to choose the right meals for the patient?
2.    When the breakfast is served?
3.    For whom is the gruel type soup contain flour served?
4.    When the dinner is served?


Useful expressions of offering something

     Would you like to eat ... Mr.Jhon?
     What would you like to drink?
     I have coffee tea and milk
     I’d like to have plain rice
     Please don’t drink, eat or smoke after midnight
     You must have an empty stomach tomorrow morning
     Can I help you?
     Let me shave your moustache
     Let me cut your nails
     Do you want me to comb your hair?
     This position is not comfort for me
     Do you want anything else
     Why don’t you eat Madame?
     I have no appetite today
     I don’t eat fork
     I am vegetarian, please don’t give me meat
     Please, chew it well




Example

Nurse         : did you sleep well last night ?
Patient     : yes, I did, but now I’m hungry, nurse.
Nurse:        : what do you want to eat, Mrs.Robert?
Patient    : I’d like to have a hot soup with meat in it.
Nurse        : oh I’m sorry; you are not allowed to consume meat.
Patient    : oh that’s ok, just soup with carrot and potatoes. I
Nurse        : And what would you like to drink?
Patient    : I think it would be nice to drink a glass of avocado juice.
Nurse        : Ok! Please wait a minute. I’ll take it.
Patient    : You are very kind, nurse.
Nurse        : Thank you.     

EXERCISE 2

1.    Make conversation about offering something!
2.    Arrange the menu for your patient, which food are good for him/her abd give your suggestion/recommendation!

Disease                      Food                       Drink                                Recommendation

Typhoid               -    Porridge         -    mineral water             -    don’t eat hot and spicy food
                           -    Soup                                                     -    total bed rest
                           -    cereal   

               
Hypertension            ...                              ...                                         ....

 
Diabetes Mellitus      ...                              ...                                         ...


Obesity                    ...                              ...                                          ...

DHF                       ...                               ...                                         ...


       
STRUCTURE: POLITE REQUEST

Polite request is a format sentence which is used for asking someone to do something politely.


    Polite request

       - Will you + V 1 ...?
       -  Would you like to + V 1 ... ?
       - Would you mind + V ing ...?

Ex: would you like to eat, Mrs. Robert?


    Negative request

     - Would you mind + not + V ing ... ?
     - Would you like + not to + V 1 ... ?

Ex:  would you mind opening the window?

EXERCISE 3

Make polite request by using these sentences!

1.    The doctor asks the nurse to inject the patient.
2.    The nurse asked the patient to sit down.
3.    A patient asks the nurse to take her medicine.
4.    Fiya has apothecary give her antibiotic.
5.    Her doctor had her come to the hospital.

LESSON 5

LESSON 5

NURSING INSTRUCTION

A.    READ THE TEXT BELOW

                                           NURSING INSTRUCTION

A nurse must be able to identify the health condition of a patient. Before a thorough treatment is carried out, a nurse must make a record of signs and symptoms of disease. Accordingly, the recording skill demands a fully knowledge of identifying in which part of the body the illness is. In this unit you will study some useful expressions how to ask your patient to do something.
     I’d like to check your body
     Sit down please!
     Raise your arm, please!
     We would to make the beds please get up!
     Would you mind opening your tongue, please!
     Lie down, please!
     Can you get up alone?
      Would you bend your back. Please!
     Lower your foot, please!
     All right, put out your tongue, please!
     Now, say ah!
     Could you touch your toes?
     Last but not least, would you mind wriggling your finger?
     Roll your sleeve up, please!
     Take your dress off, please!
     Keep your eyes shut, please!

Taken from:English For Nurse, By:  Abu Nawas,dkk (2009,7 )


Example:

Nurse         : I’d like to check your body.
Patient    : Thank you

     EXERCISE 1

1.    Write down a conversaton about nursing instruction!
2.    Practice the conversation above!
3.    Write down another nursing instruction that you have found!
4.    Share with your friends

B.    STRUCTURE

     Imperative Sentence
Imperative sentence is a type of sentence that gives advice or instructions or that expresses a request or command.

    Positive Imperative Sentence

           V I + Object, please !

          Example:
                    Lie down, please !

    Negative Imperative Sentence

        Don’t + V1 + O, Please !

        Example :
                       Don’t drink or smoke after midnight, please !

     EXERCISE 2

Make imperative sentences by using thi sentences !

1.    Nurse ask the patient to open his mouth.
2.    Nurse ask patient to move his head.
3.    Nurse ask patient to hold her breath in.
4.    Nurse ask patient to chew her food well.

LESSON 4

LESSON 4

Pain Assessment

A.    PRE READING

Think about how you describe pain in your own language. What sort of words and expressions do you use?

B.    READ THE TEXT BELOW

                                                 Pain Assesment

                                                   By Marie McCullagh & Ros Wrigth

Pain assessment

Assessing pain can be complicated as the physical and physiological aspects of the patient all need to be considered. Because the experience of pain is very subjective, the nurse needs to be able to use some objective criteria to evaluate the location, nature and intensity of the pain so a diagnosis can be made. One of the most widely accepted definitions of pain was put forward by McCaffery (1979, p.18), who suggests that pain is ‘whatever the experiencing person says it is and exists whenever he says it does’.

Assessments of the patient’s pain experience

When identifying the characteristics of the patient’s pain it is essential the nurse considers the following:
•    The type of pain: is it crampy, stabbing, sharp? The patient’s description of the pain may help in diagnosing its cause. Myocardial (heart) pain is often described as stabbing, but liver pain as cramping or aching.
•    Its intensity: is it mild, severe or excruciating? This can be described by using a pain assessment scale. The nurse asks the patients to rate the pain on a scale of 0 to 10; zero being no pain and 10 being excruciating pain. With children, a range of pictures showing a child changing from happy to sad can be used. Colour charts with a series of colours from black through grey to yellow and orange can be used, especially with patients who have difficulty grasping numbers or articulating exactly what their pain is like.
•    The onset: was it sudden or gradual? Find out when it started and in what circumstances. What makes it worse? What makes it better? What was the patient doing immediately before it happened?
•    Its duration: is it persistent, constant or intermittent?
•    Its location: ask the patient to be as specific as possible, for example, indicating the site by pointing.
•    Changes in the site: there may be tenderness, swelling, discolouration, firmness or rigidity. With appendicitis, a classic sign is the movement of pain to the right and downwards. In a myocardial infarction (a heart attack), pain classically radiates down the arm, and with liver pain it can radiate to the shoulder.
•    Any associated symptoms: Some of the common symptoms of disease that can influence the response to pain are anorexia, constipation, cough, inflammation, anxiety and fear, dryness of the mouth.
•    Signs such as redness, swelling or heat.


Adapted from Foundations of Nursing Practice (3rd Edition), edited by Richard Hogston and Barbara A. Marjoram: Palgrave Macmillan (2008). Reproduced with permission from Palgrave Macmillan. 


C.    EXERCISES

     EXERCISE 1

Fill the gaps in the sentences using these words from the text.


1.    _____________________ is the amount of time something lasts.
2.    A pain is ______________________ when you cannot bear it.
3.    A description is ______________________ when it is based on the individual’s experience or perceptions.
4.    A patient who is ______________________ is able to explain things very well.
5.    The ______________________ of a pain is when it begins.
6.    A pain ______________________ when it spreads out from a central point.
7.    The ______________________ of a pain describes the degree to which the patient feels it.
8.    In order to ______________________ a patient’s pain, a nurse needs to know its characteristics.
9.    Being ______________________ means relying on facts, rather than personal beliefs or feelings.
10.    ______________________ on part of the body is when it is sore or uncomfortable to touch.


     EXERCISE 2

Comprehension check

Read the text below and write T (true) or F (false) next to each of the statements.

1.    Assessing pain is a straightforward process.
2.    Pain is an objective experience.
3.    It is important for a nurse to use objective criteria to measure the level of pain.
4.    Colour ‘mood’ charts are only useful for children.
5.    The first step for a nurse is to identify characteristics of the patient’s pain.