护理学专业英语课件：Unit Three Health Assessment

1、Unit ThreeHealth Assessment Unit ThreeText A: Health Assessment I. Warm-up Tasks II. To learn new words and expressions III. Explanation of the textTeaching Aims and Requirements1. Train the ability of listening and speaking 2. Be able to read medical words and expressions correctly and memorize the

2、m.3. Understand, know well and master four primary assessment techniques of health assessment.Language pointsPara.1 Health assessment is an integral component of holistic nursing care and is the basis of the nursing process. Health assessment is a essential part of holistic nursing and is the founda

3、tion of the nursing procedure. holistic nursing care：整体护理nursing process: 护理程序 Para.1 The skills of health assessment enable the nurse to assess patterns reflecting health problems and toevaluate the clients progress following therapy. The skills of health assessment can make the nurse able to asses

4、s the conditions which may show patients health problems and to evaluate the patientsdevelopment after therapy. assess: 评估evaluate 评价 Para. 2 A complete assessment involves a more detailed review of a clients condition. The nurse collects a nursing history and performs a behavioral physical examinat

5、ion. a complete assessment: 完整的评估nursing history: 病史Para. 2 The health history involves a lengthy interview with a client to gather subjective data about the clients level of wellness(present and past), family history, changes in life patterns, socio-cultural history, spiritual health, and mental an

6、d emotional reactions to illness. health history 健康史 family history 家族史 life patterns 生活模式 life styles 生活方式Para. 2 The interview is an opportunity for the nurse to establish a relationship with the client that promotes sharing of information. Finding from the history generally reveal a pattern of re

7、lated signs and symptoms. sharing of information 信息共享 findings from the history 来自病史的调查情况 related signs and symptoms 相关的体征和症状 Para. 3 The physical assessment always supplements information from the history to confirm or refute the data. 4. confirm: (1) to state or show that sth is definitely true or

8、 correct, especially by providing evidence e.g. Rumors of job losses were later confirmed. The experiment confirmed his theory. (2) to make sb feel or believe sth even more strongly e.g. Later events confirmed his previous determination. 5. refute: (1) to provide that sth is wrong. (2) to say that i

9、s not true or fair. e.g. The chairman refuted his argument. I can refuse him easily. Para. 3 It may focus on one specific body system or may be in a systematic manner, which offers objective information about the client and allows the nurse to make clinical judgments. subjective information 主观信息 obj

10、ective information 客观信息 clinical judgments 临床判断 Para. 3 Its procedure always varies according to the age of the individual, the severity of the illness, the preferences of the nurse, the location of the examination, and the agencys priorities. the preference of the nurse 护士的偏爱 agencys priorities 医院的

11、要求（先后顺序） Para. 3 Frequently, nurses assess a specific body area instead of the entire body. These specific assessments are made in relation to the clients complaints, the nurses own observation of problems, the clients presenting problems, nursing interventions provided, and mental therapies. a spec

12、ific body area 特定身体部位 nursing intervention 护理干预 mental therapies 心理治疗Para. 3 The accuracy of a physical assessment influences the choice of therapies a client receives and the determination of the response to those therapies. Continuity in health care improves when the nurse makes ongoing, objective

13、 and comprehensive assessment. determination of the response to those therapies 对治疗反应的判断continuity in health care 健康照顾的连续性Para. 4 Proper preparation ensures a smooth physical examination with few interruptions. Most people need an explanation of the physical health assessment. good preparation can m

14、ake sure that physical examination go on smoothly without interruptions. A lot of people want to know the whole things of the health assessment. Para. 4 So first the nurse should explain when and where it will take place, why it is important and what will happen during the assessment. The clients ph

15、ysical comfort is also vital for a successful examination. Therefore, at first the nurse ought to tell patients when and where the physical examination will be implemented, why it is necessary and what will happen during the assessment. When examining patients comfort is very important for a success

16、ful check-up. Para. 4 Before starting, the nurse asks if the client needs to use the toilet. An empty bladder and bowel facilitates examination of the abdomen, genitalia, and rectum and provides the opportunity to collect urine or fecal specimens. use the toilet 去洗手间empty bladder rectum 排空膀胱和直肠Langu

17、age PointsPara. 5 A physical examination also requires privacy. In hospitals the examination usually occurs in the clients room, where it may be necessary to use room curtains of dividers around the bed. Patients privacy should be protected in a physical examination in hospitals. And check-up often

18、takes place in the sickroom, in which it is very important to use room curtains of dividers around the bed. room curtains of dividers 房间屏风Para. 5 Besides, the nurse should be sure that the client is dressed and draped properly. If the examination is limited to certain body systems, it may be unneces

19、sary for the client to undress completely, after clients have undressed, the nurse should be sure that the client stays warm by controlling room temperature and providing blankets. in addition, the nurse should make sure that the patient is dressed and covered appropriately After the patient took of

20、f his/her clothes, the nurse should make sure that the patient keeps warm by adjusting room temperature and offering blankets. stay warm: keep warm 保暖Para. 6 Sometimes it is difficult to examine clients who are in beds or on stretchers. So the nurse must carefully assist clients to the special exami

21、nation table and prevent them from falling while getting on and off them. the special examination table 特殊检查床Para. 6 A confused, combative or uncooperative client should not be left unsupervised on an examination table. During the examination, the nurse asks clients to assume proper positions so tha

22、t body parts are accessible and clients stay comfortable. It means that a patient with a puzzled, fighting or not cooperative mood should be supervised on anexamination table. assume proper position: lay right physical position Para. 6 Many of the positions, such as lithotomy and knee-chest position

23、s, are embarrassing and uncomfortable. Therefore, the clients should be kept in these positions no longer than necessary. no longer than necessary 不必过长Para. 7 The four primary assessment techniques are inspection, palpation, percussion, and auscultation. Inspection is the process of deliberate, purp

24、oseful observations performed in a systematic way. Observations are made by using visual, auditory, and olfactory sense to gather data throughout the entire assessment. Adequate lighting, either natural or artificial, is essential for distinguishing color, texture, and moisture of body surfaces. Ins

25、pection 视诊 palpation触诊 percussion叩诊 auscultation 听诊7. the four primary assessment techniques:They are inspection, palpation, percussion, auscultation. Inspection is the process of deliberate, purposeful observations performed in a systematic way. Palpation is a technique that uses the sense of touch

26、. Percussion is the act of striking one object against another for the purpose of producing sound.Auscultation is the act of listening to sound produced within the body using a stethoscope. Para. 8 Palpation is a technique that uses the sense of touch. The hands and fingers are sensitive tools and a

27、re used to assess temperature, turgor, texture, moisture, vibrations, and shape. The dorsum, or back, of the hand and fingers is used for gross measure of temperature. turger: 弹性gross measure of temperature 粗略估测温度Para. 8 When a discriminatory sense is needed for differentiating between texture, shap

28、e, fluid, size, consistency, and pulsation, the palmar surface of the fingers and finger pads are used. Vibration is palpated best with the palm of the hand. 当需要辨别纹理、形状、流动度、大小、硬度、颤动时，就需要使用手指和指垫的掌面。用手掌对震颤进行触诊是最好的。 Para. 8 Light or deep palpation may be used and is controlled by the amount of pressure

29、 by placing the fingers together and depressing the skin and underlying structures about 1 cm. For deep palpation, press inward about 2 cm. Applying intermittent pressure to a specific area allow assessment of surface characteristics and underlying structures. 进行浅表或深部触诊时，可以通过手指并拢按压皮肤及其下面约1cm的组织的压力大小

30、来实施和控制。深部触诊按压深度可达2cm 。在某特定区域，间歇运用这种压力，可以对体表特征和其深部结构进行评估。 Para. 9 Percussion is the act of striking one object against another for purpose of producing sound. The sound waves produced by the striking action are known as percussion tones and are generated by body tissue. Percussion is used to assess t

31、he location, shape, and density of tissues. percussion tones 叩诊音 body tissue 身体组织 the location, shape, density of tissues 组织的位置、形状、密度Para. 9 The nurse uses both hands to produce sound waves. The nondominant hand is placed directly on the area to be percussed, with the fingers slightly separated and

32、middle finger placed firmly on the body surface. The opposite hand is the striking force, which is initiated by sharp downward wrist movement with the forearm stationary and the wrist relaxed. body surface 体表sharp downward wrist movement 腕部用力，迅速向下叩击Para. 9 The tip of the middle finger of the dominan

33、t strikes the joint of the middle finger of the nondominant hand. This action produces a vibration that allows the nurse to discriminate among five different tones: tympany, resonance, hyper-resonance, dullness, and flatness. tympany 鼓音 resonance 清音 hyperresonance 过清音 dullness 浊音 flatness 实音 Para. 1

34、0 Auscultation is the act of listening to sound produced within the body by using a stethoscope. It is performed by firmly placing the stethoscope diaphragm or bell against the body part being assessed. The diaphragm of the stethoscope is used to detect high-pitched sounds, such as normal lung and b

35、owel wounds. the diaphragm of the stethoscope 膜形听诊器 the bell of the stethoscope 钟形听诊器 high-pitched sounds 高调声音 bowel wounds 肠鸣音Para. 10 The bell of the stethoscope is used to detect low-pitched sounds, such as those produced by the heart and vascular system. Four characteristics of sound should be a

36、ssessed by auscultation. They are pitch, loudness, quality, and duration. low-pitched sounds 低调声音 pitch 音调 loudness 响度 quality 音质 duration 持续时间 Study & Practice : I. Reading Comprehension Choose the best answer for each of the following questions. 1. If the client complains of severe headache, the n

37、urse should first carefully examine _ function. A. musculoskeletal B. neurological C. cognitive D. spiritual Answer : B 2. The purposes of draping during the physical examination doesnt include _. A. providing privacy B. providing warmth C. preventing unnecessary exposure D. making the body parts ac

38、cessible Answer : B 3. The “dominant hand ” in the 11th paragraph refers to _? A. right hand B. left hand C. stronger D. striking hand Answer: D 4. The character of the sound produced by percussion depends on the _. A. moisture of the surface B. turgor of the skin C. temperature of the organs D. the

39、 density of the underlying tissues Answer: D 5. Which of the following is not mentioned in this article? A. The health assessment is a major component of nursing care. B. The auscultation should be carried out last in the four processes of physical assessment C. The procedure of the health assessmen

40、t can vary according to different conditions D. It is important to prepare the environment before starting the assessment Answer: B II. Word to Practice Fill in the blanks with the words or expressions given below. Change the form where necessary. component inspection texture stretcher unsupervised

41、privacy olfactory dorsum palpation stethoscope _1. _ is the visual examination, that is, assessing by using the sense of sight. Answer: Inspection 2. The effectiveness of _ depends largely on the clients relaxation.Answer: palpation 3. In some instances, the nurse may also need to use the _ sense to detect unusual skin odors(气味). Answer: olfactory 4. Implementation is a continuous process and interacts with the other _ of the nursing process. Answer: components 5. When body parts are exposed, the clients need _ surroundings to make