涉外涉外 护理英语护理英语Unit 2 Taking Medical Specimens对外经济贸易大学出版社对外经济贸易大学出版社TAKING MEDICAL SPECIMENSExplainingtakinganMSUspecimenCheckingunderstandingandsofteningarequestContactingotherstaffExplainingurinarycathetersReadingaPathologyReportGivinganoralreportofthecaseUnit 2 医 学 标 本解释留取中段尿标本确认是否理解并缓和请求联系其他工作人员解释导尿管的使用查看病理报告口头汇报病人病情DESCRIPTIONMedicalspecimensaresamplestakenfromapatient,mostfrequentlytissue,blood,urine,orstool,usedforanalysisanddiagnosis.翻译单元描述医学标本是取自于患者的标本，主要是人体组织、血液、尿液和大便，用于分析与诊断。DescriptionWORK DESCRIPTION Bloodspecimencollectionisperformedprimarilybynursesandphlebotomists.Thephysicianordersthelaboratorytests.Thenurseisresponsibleforinstructingthepatientregardingtheprocedureandassessingthepatientsresponse.Inaddition,thenurseshouldbeknowledgeableabouttheimplicationslaboratoryresultsmayhaveonpatientcare.Priortoobtainingbloodspecimens,thenurseshouldassessthepatient,notingfactorsthatmayaffecttestresults,includingmedications,pregnancy,age,andsex.翻译Blood specimen collectionWORK DESCRIPTIONMakesurethepatienthasfollowedanyspecialinstructions,whichcouldincludefastingforanumberofhoursortakingamedicationatacertaintime.Patientsshouldalsobeassessedfortheirknowledgelevelregardingthetestsordered.Instructthepatientasneededaboutthetestandtheprocedureitself.Althoughmostbloodworkdoesnotrequireanyspecialconsent,sometests,likethoseforHIV,usuallydo.翻译WORK DESCRIPTIONIfneeded,obtainconsentpriortocollectingthespecimen.Therearefourpatient“rights”thenurseshouldconsiderwhencollectingbloodspecimens.These“rights”are:Rightspecimen.Makesurethespecimencollectedisthespecimenordered.Righttime.Certainbloodtestsmustbeobtainedatspecifictimes.Forexample,whendrawingantibioticlevels,troughspecimensshouldbeobtainedimmediatelypriortothenextdose.翻译WORK DESCRIPTIONThetimetodrawpeaklevelsmaybedependentuponwhethertheantibioticisgivenintravenously,orally,orintramuscularly.Rightpatient.Alwaysverifythepatientsidentificationbeforedrawingabloodspecimen.Thepersondrawingthespecimenshouldalsolabelthecontaineritisdrawninto.Rightmethod.Alwaysfollowuniversalprecautionswhenperformingavenipuncture.翻译WORK DESCRIPTION血液标本的采集首先由护士和采血师完成。医生开出实验室检查的医嘱，护士负责指导患者标本的采集以及评估患者的反应。另外，护士还应知道实验室检查结果对患者护理措施产生的影响。血液标本的采集WORK DESCRIPTION在采集血液标本之前，护士必须评估患者，记录可能影响检查结果准确性的因素，如药物、妊娠、年龄和性别，确保患者遵从采血的每一项专门指导，包括空腹禁食若干小时和在规定时间里服药。同时还要评估患者对于所做检查的了解程度，必要时指导患者了解检查项目及其过程。虽然大部分的采血不需要专门同意，有些检验，如检测人类免疫缺陷病毒的，须征求患者同意。如有必要，在采血之前就要征求患者同意。WORK DESCRIPTION护士采血时要考虑到患者的“四对”，它们是：正确的标本。确保采集的血样是医嘱开出的取样标本。正确的时间。某些血液检查必须在特定的时间里采集。比如，检测患者血液中的抗生素水平，标本必须在下一剂用药前采集。采集血液抗生素最高水平的时间取决于抗生素的给药途径：静脉注射、口服和肌肉注射。正确的患者。通常在采血前要核对患者的身份，抽血者要在装血液的容器上贴上标签。正确的方法。做静脉穿刺要时刻全面预防。WORK DESCRIPTIONStoolspecimencollectionisperformedprimarilybynurses.Thephysicianordersthelaboratorytests.Thenurseisresponsibleforinstructingthepatientregardingtheprocedure.Inaddition,thenurseshouldbeknowledgeableabouttheimplicationslaboratoryresultsmayhaveonpatientcare.Togetstarted,collectthefollowingequipment:aspecimencontainerwithlid,gloves,twotongueblades,apapertowelorpaperbag,abedpanorportablecommode,twopatient-carereminders(fortimedspecimens),alabrequestformandalabbiohazardtransportbag.Stool specimen collection翻译WORK DESCRIPTIONAndthen,explaintheproceduretothepatientandhisfamily,ifpossible,toensuretheircooperationandpreventinadvertentdisposaloftimedstoolspecimens.Ifarandomspecimeniscollected,tellthepatienttonotifyyouwhenhehastheurgetodefecate.Havehimdefecateintoaclean,drybedpanorcommode.Instructhimnottocontaminatethespecimenwithurineortoilettissue.Putongloves,usingatongueblade,transferthemostrepresentativestoolspecimenfromthebedpantothecontainer,andcapthecontainer.Ifthepatientpassesblood,mucus,orpuswiththestool,includethiswiththespecimen.Wrapthetonguebladeinapapertowelanddiscardit.Removeanddiscardyourgloves,andwashyourhandsthoroughlytopreventcross-contamination.翻译WORK DESCRIPTIONIfatimedspecimeniscollected,placeapatient-carereminderstatingSAVEALLSTOOLSAMPLESoverthepatientsbedandinhisbathroom.Afterputtingongloves,collectthefirstspecimen,andincludethisinthetotalspecimen.Obtainthetimedspecimenasyouwouldarandomspecimen,butremembertotransferallstooltothespecimencontainer.Asordered,sendeachspecimentothelabimmediatelywithalabrequestformor,ifpermitted,refrigeratethespecimenscollectedduringthetestperiodandsendthemwhencollectioniscomplete.Allspecimensmustbestoredandtransportedinanapprovedlabbiohazardcontainer.Removeanddiscardgloves.Makesurethepatientiscomfortableaftertheprocedureandhehastheopportunitytothoroughlycleanhishandsandperineaarea.翻译WORK DESCRIPTIONItmaybenecessaryforyoutoassistthepatientwithperineacare.Documentthedateandtimeofthespecimencollectioninthepatientsmedicalrecordalongwithinstructionsthatthepatientcanresumehisnormaldietandmedicationregimeunlessotherwisespecified.Ifstoolmustbeobtainedwithanenema,useonlytapwaterornormalsalinesolution.Neverplaceastoolspecimeninarefrigeratorthatcontainsfoodormedicationtopreventcontamination.Notifythehealthcareproviderifthestoolspecimenlooksunusual.翻译WORK DESCRIPTION粪便标本的采集主要由护士完成。医生开出实验室检查的医嘱。护士负责指导患者完成标本采集，除此之外，护士还应知道检验结果可能对患者护理上的影响。首先，准备以下用物：带盖的检便盒、手套、两个检便匙、纸巾或纸袋、便盆或便携式马桶、两张患者护理提醒便条（对于特定时间的标本采集）、检验申请单和实验室生物安全运输袋。粪便标本的采集WORK DESCRIPTION然后，向患者及家属解释采集过程。如果可能，要确保患者合作并避免对定时采集的粪便标本的处理。若收集随机粪便标本，告知患者当有排便冲动时通知你，让他排便于清洁、干燥的便盆或便携式马桶内，指导患者不要将尿液或者卫生纸污染了标本。戴上手套，用检便匙将便盆内具有代表性的粪便取出放于检便盒里，并盖上盖子。如果粪便上带有血液、粘液或者脓水，将它们同标本一起取出，用卫生纸将检便匙包住后丢弃，脱掉并丢掉手套，彻底清洁双手防止交叉污染。WORK DESCRIPTION若收集24小时粪便标本，在患者的床头和洗手间放一张写有“保留所有大便标本”的患者护理提醒便条。戴上手套后，采集第一次粪便标本，将其放入总标本里，就像采集随机粪便标本那样采集24小时粪便标本，但是要记住将所有的粪便放入检便盒内。遵医嘱，立即带上检验申请将标本送去实验室检验。 WORK DESCRIPTION如果条件允许，检验期间要将采集的标本冷藏直至采集完成再送去实验室。所有标本的存放和运输必须在一个被认可的实验室生物安全容器内。脱掉并扔掉手套。采集完后要确保患者舒适，让患者彻底清洁手及肛门周围。必要时要协助患者清洁肛门周围。在患者的医疗记录上记录采集标本的日期、时间并说明。如果没其他规定，患者可以恢复正常饮食和服药。如果粪便标本必须通过灌肠来获得，使用自来水或生理盐水。不要将粪便标本放于装有食品、药物的冰箱里以防交叉污染。如果粪便异常就通知管床医生。WORK DESCRIPTIONWhencollectingaurinespecimen,givethepatientaurinecontainerwithalid.Preparealabelthathasthepatientsinformationonit,includingthemedicalrecordnumber,name,andbirthdate.Avoidincorrectlabelingbylabelingthespecimeninfrontofthepatient.Filloutthelabrequestformandattachittothespecimenaccordingtothefacilityspolicy.Performhandhygieneandweargloveswhenhandlingthespecimen.Explaintothepatientthataurinespecimenisneededforthelab,andprovidehimwiththecontainer.Ifthepatientisachild,instructtheparentandaskhim/hertocollectthespecimen.Ifthepatientisunabletoholdthecontaineroverthetoiletandurinateintoit,givehim/heracleanurinalorbedpantouseonthetoiletorinbed.MSU specimen collection 翻译WORK DESCRIPTIONWhencollectingaclean-catchmidstreamspecimen,properpatientinstructionincleaningtheurinarymeatusandsurroundingtissuebeforecollectionisthesecrettocollectinganuncontaminatedspecimen.Tellyourpatienttostartthestreamandbeginthecollectioninthemiddleofthestream.Instructthemalepatienttocleanthetipofhispeniswithsoapandwater,thenwithdisposablewipesorwithcottonballssoakedinpovidone-iodinesolutionorChloroprep.Tellhimtostarttheurinestreamand,withoutstopping,beginthespecimencollectionbymovingthecontainerintotheurinestream.Foranuncircumcisedmale,remindhimtoretracttheforeskintocleantheurinarymeatusmoreeffectivelyandtokeepitretractedduringvoiding.翻译WORK DESCRIPTIONInstructthefemalepatienttocleanhergenitalareawithsoapandwaterandthentositfarbackonthetoiletortositbackwardonthetoilet.Itmaybeeasierforhertostripfromthewaistdowninordertospreadherlegsfarenoughapart.Withdisposablewipesorcottonballssoakedinpovidone-iodinesolutionorChloroprep,instructhertowipefirstdownoneside,andthendowntheotherside,andfinallydownthemiddleofthelabialfolds,vulva,andurinarymeatus.Stresstheimportanceofwipingfromfronttobacktoavoidfecalcontamination.Instructthepatienttobeginvoidingintothetoiletandtokeepthelabialfoldsseparatedduringthespecimencollection.Tellhertostartthestreamand,withoutstopping,begincollectingthespecimeninthemiddleofthestreambymovingthespecimencontainerintothestream.翻译WORK DESCRIPTIONWearglovestocollectthecontainerandputonthelidwithouttouchingtheinsideofthelid.Iftheoutsideofthecontainerissoiled,cleanitandwipeitdry.Washyourhandsandinstructthepatienttodothesame.Whencollectingaspecimenfromanin-dwellingcatheter,clampthecatheteratleast30minutesbeforecollectingthespecimentoallowurinetocollectinthebladder.Nevertakeaspecimenfromthecollectionbagbecauseitsconsideredcontaminated.Clampthetubejustbelowthepointwherethespecimenwillbecollected.Ifthedrainagetubehasabuilt-insamplingport,putonglovesandwipethesamplingportwithalcohol.翻译WORK DESCRIPTIONAta90-degreeangle,insertaneedlewithalargesyringe,dependingonhowmuchurineisrequiredforthespecifictest.Collectthespecimenandunclampthetubing.Placethespecimenintheappropriatecontainer,labelit,andsendittothelabimmediately.Regardlessofthetypeofurinespecimen,recordthetimeofcollection,whenitissenttothelab,themethodofcollection,andthetestordered.Theodor,color,andanyunusualcharacteristicsarealsodocumented.翻译WORK DESCRIPTION当采集尿标本时，给患者一个带盖的标本容器，准备一张写有患者信息的标签，包括医疗记录号、姓名和出生日期。为避免贴错，当着患者的面贴。根据医院规定填写检验申请单，将其贴于标本盒上。处理标本时要清洁双手并戴上手套。向患者解释需要尿标本检验，并给患者提供容器。如果患者是小孩，指导家长采集尿标本。如果患者不能在马桶上拿住容器将尿排于容器中，给他提供清洁尿壶或便盆放于马桶或是床上使用。中段尿标本的采集WORK DESCRIPTION当采集清洁中段尿标本时，正确指导患者在采集前清洁尿道外口和周围组织，这是采集无污染标本的秘诀。告诉患者开始排尿，然后采集尿的中段部分。指导男性患者先用肥皂和水，再用蘸有碘伏或消毒剂的一次性湿巾或棉球清洁阴茎头。告诉他开始排尿，持续排尿，然后指导患者将尿排于容器中。对于未割包皮的男性，提醒他缩回包皮以有效清洁尿道外口，并且排尿时要一直保持缩回。WORK DESCRIPTION指导女性患者用肥皂和水清洁生殖器区，蹲于远离马桶的上方，患者最好把衣物从腰部尽量往下脱以便双腿能够足够分开，指导患者用浸有碘伏或消毒剂的一次性湿巾或棉球，首先从上至下擦外阴和尿道外口的一边，接着另一边，最后中间。强调必须由前往后擦拭的重要性以避免粪便污染。指导患者到马桶排尿，保持阴唇分开。告诉患者开始排尿，直至采集中段尿于容器中。WORK DESCRIPTION收集容器时要戴手套，盖上盖子时不要碰到盖子的内面。如果容器的外面被污染，洗后擦干净。护士洗手，也指导患者洗手。从留置导尿管中采集标本时，采集标本前必须夹闭导尿管至少30分钟使尿液保留在膀胱内。不要从尿袋内采集标本，因为其中的尿液被认定为污染了。如果尿管有内置采样端口，戴上手套并用酒精消毒端口处。 WORK DESCRIPTION在90度角的地方，插入针头。注射器的大小取决于用于检验的量。收集标本，开放导尿管，将标本置于适当的容器内，做好标记，然后立即送实验室检验。不管采集何种尿标本，要记录采集的时间、送检的时间、采集的方法及检验医嘱。气味、颜色，以及任何异常的特征也得记录下来。TASK 1 EXPLAINING TAKING AN MSU SPECIMENTakinganMSUspecimenistogetaspecimen(sample)ofurinefromthemiddleofonesbladder.Urineisnormallysterile(nobacteriapresent).Ifbacteriaarefoundinthesample,itmeansthattheurineisinfected.Description 翻译任务一 解释留取中段尿标本采集中段尿标本指采集从膀胱排出的中段尿标本。尿液通常是无菌的（无微生物寄存）。如果标本中有细菌，表明尿被感染。任务描述RELATED INFORMATION Themid-streamurinespecimen(MSU)istakenforanalysisatthepathologylabwhenurinarytractinfection(UTI)issuspected.TheresultoftestingthemicrobiologyofMSUisawaitedbeforeantibiotictherapyisstartedsoastotargettheinfectionwiththecorrectantibiotic.TestresultsarereceivedinthewardviathehospitalintranetandlaterasapapercopywhichisfiledinthePatientRecord.Nursesmayhavetocontactthepatientsdoctortopassonthetestresultssothatantibiotictherapycanbestartedassoonaspossible.The reasons for taking an MSU specimen翻译相关信息当怀疑有尿道感染时，采集中段尿标本作病理学实验室分析。在进行抗生素治疗前须等待中段尿标本的微生物学检测结果，以便使用正确的抗生素来治疗感染。病房里查看医院内部联网可收到化验结果，打印出后可贴在患者的记录单上。护士需联系医生告诉他检测结果以便医生能够尽可能快地进行抗生素治疗。采集中段尿标本的原因UTIAurinarytractinfection(UTI)isabacterialinfectionthataffectsanypartoftheurinarytract.Symptomsincludefrequentfeelingand/orneedtourinate,painduringurination,andcloudyurine.ThemaincausalagentisEscherichiacoli.Althoughurinecontainsavarietyoffluids,salts,andwasteproducts,itdoesnotusuallyhavebacteriainit,butwhenbacteriagetintothebladderorkidneyandmultiplyintheurine,theymaycauseaUTI.翻译ThemostcommontypeofUTIisacutecystitisoftenreferredtoasabladderinfection.Aninfectionoftheupperurinarytractorkidneyisknownaspyelonephritis.Althoughtheycausediscomfort,urinarytractinfectionscanusuallybeeasilytreatedwithashortcourseofantibioticswithnosignificantdifferencebetweentheclassesofantibioticscommonlyused.翻译泌尿道感染泌尿道感染是细菌感染，可以发生在泌尿道的任何部位。症状包括尿频感、尿痛和尿浑浊。主要病原菌是大肠杆菌。虽然尿液含有水分、无机盐和代谢废物，但通常是无菌的，但当细菌侵入膀胱或肾脏，在尿道繁殖，就会导致泌尿道感染。最常见的泌尿道感染类型是急性膀胱炎，常称为膀胱炎。上泌尿道或肾脏的感染称作肾盂肾炎。泌尿道感染引起的不适，通常用短程抗生素易于治疗，疗效和其他等级的常用抗生素没有显著区别。ASKING FOR CLARIFICATION Askingforclarificationwhenunsurethataninstructionhasbeenreceivedcorrectlyisanimportantfeatureofactivelisteningskillstoavoidmisunderstandings,whichisvitalinthehealthcaresetting.Thereareseveralclarificationstrategiesasfollows:1.Askthespeakertoclarifywhathe/shehassaid.翻译Medical specimens are samples taken from a patient, most frequently tissue, blood, urine, or stool, used for analysis and diagnosis. 2.Paraphrasewhathasbeensaid.3.Useaquestioningintonationpattern.4.Repeattheinformationbacktothespeaker.MSU is short for the mid-stream urine, which is taken for analysis at the pathology lab when urinary tract infection (UTI) is suspected.Privacy must be respected especially when patients are in a multi-bed room; cultural sensitivities can also be an issue. To monitor the progress of their patients, to check for toxicity of a drug before administration, to monitor infection and decide on changing patient precaution code (standard precaution to special precaution). DISCUSSION OF THE NURSING TOPIC 1.Whatkindsofspecimenaretakenandwhy?2.WhatisanMSUanditspurposes?Medical specimens are samples taken from a patient, most frequently tissue, blood, urine, or stool, used for analysis and diagnosis. MSU is short for the mid-stream urine, which is taken for analysis at the pathology lab when urinary tract infection (UTI) is suspected. 3.Whatspecialconsiderationsareneededwhentakingurinespecimens?4.Whyisitimportantfornursestounderstandtheresultsofthepathologytests?Privacy must be respected especially when patients are in a multi-bed room; cultural sensitivities can also be an issue.To monitor the progress of their patients, to check for toxicity of a drug before administration, to monitor infection and decide on changing patient precaution code (standard precaution to special precaution). COMMON PATTERNS AND QUESTIONS FOUND IN A DIALOGUE WHEN TAKING AN MSU1.Doyoumean?2.Tellmewhathappenswhen3.Sowhatyouresayingisthat4.Itsoundsasifyoumighthave5.Weusuallycallitforshort.6.Thepurposeofthetestistoseeif7.IneedtogetanMSU,ormidstreamurinespecimen.openPRACTICE OF THE TASK (Eileen, the ward nurse, is talking with Mrs. Brown, a patient who has got some problems when she goes to the toilet.) Eileen:Illpullthecurtainsaroundsowecanhaveaprivatechatnow.Well,howareyoutoday,Mrs.Brown?Mrs.Brown:Nottoobad,butIvegotsomeproblemswhilegoingtothetoilet.Eileen:Mm.Doyoumeanithurtswhenpassingurine?Mrs.Brown:Yes.Thatsright翻译Eileen:Yes,themorningnursementioneditduringhandover.Tellmewhathappenswhenyoupassurine.Mrs.Brown:It,um,burnswhenIgotothetoilet,andIhavetogoallthetime.Eileen:Right.Sowhatyouresayingisthatithurtswhenyoureactuallypassingtheurine,andyoufeellikeyouhavetopassurinefrequently?Isthatright?Mrs.Brown:Yes.Ithurtswhentheurinecomesout,anditsworsebecauseIfeelIhavetogotothetoiletsooften.Eileen:Iknowwhatyoumean.Itsoundsasifyoumighthaveaurinarytractinfection.Mrs.Brown:Oh.Whatdidyoucallit?Aurinarywhatwasit?Eileen:Itsfullnameisurinarytractinfection.WeusuallycallitUTIforshort.HaveyoueverheardofaUTIbefore?Mrs.Brown:Yes,Iveheardofit,Ithink.Eileen:Illphoneyourdoctoraboutitinaminute.HellaskyoutodoaurinespecimentosendtothePathologyLaboratoryforaCultureandSensitivityTest.Thepurposeofthetestistoseewhetherthereisanyinfectioninyoururinarytract.Dr.Blairwillprobablystartyouonsomeantibioticsiftheresultscomeouttobeaninfection.Mrs.Brown:OK.Soyouwantmetodoaurinespecimen,doyou?Eileen:Yes,thatsright.IneedtogetanMSU,ormidstreamurinespecimen.Somepeoplecallitaclean-catchspecimen,becauseyouhavetocollectaurinesamplefromthemiddlepartofyoururinestream.Itsbettercollectingasamplefromthemiddlethanfromthebeginningoftheurinestream,becauseitislesscontaminated.Mrs.Brown:Lesscontaminated?Eileen:Yes,thesampleislesslikelytohavebacteriafromtheoutsideofyoururethra.IllgoandgeteverythingyouneedtodotheMSU,andIllbebackinaminutetoexplainhowtodoit.Mrs.Brown:OK,thanks.任务案例（艾琳，一位病房护士，正在和患者布朗太太谈话。布朗太太上厕所有些问题。）艾琳： 我会把床帘拉上，这样我们现在就可以进行私密对话了。好的，布朗太太，您今天感觉怎么样？布朗女士：不是太坏，但是我今天去上厕所时出现了些问题。艾琳： 您是不是指在排尿时疼痛？布朗女士：是的，很对。艾琳： 是的，今天早上交接班时护士提到了这一点。告诉我您排尿时出现了什么症状？布朗女士：嗯，上厕所时有灼烧感，而且总往厕所跑。艾琳： 对的，您说的是您每次排尿时都有疼痛感，而且您感觉您尿频，对吗？布朗女士：是的，尿液出来时会很疼，更糟糕的是我总是如此频繁地感觉想上厕所。艾琳： 我懂您的意思。听上去您可能患有泌尿道感染。布朗女士：噢，你称它为什么？泌尿道那是什么？艾琳：它的全名是泌尿道感染，我们通常简称它为“UTI”，您以前听说过“UTI”吗？布朗女士：是的，我想我以前听过。艾琳：我马上打电话告诉您的医生这件事，他会让你留取尿标本，标本将会送到病理实验室做培养和抗生素敏感性实验。实验的目的是看您的泌尿道是否有感染。如果实验结果是感染，那么布莱尔医生可能将开始对您使用抗生素。布朗女士：好的，那么你想让我留取尿标本，对吗？艾琳：是的，对的，我需要中段尿标本或者是尿的中段部分。有些人称它为清洁的标本，因为您必须从尿的中段部分来采集尿标本。采集中段尿比采集前段尿更好，前者污染更少。布朗女士：污染更少？艾琳：是的，中段尿标本不容易从尿道外感染细菌。我要离开一会儿，将您留取中段尿标本的物品准备好。我会马上回来告诉您怎么做。布朗女士：好的，谢谢！A. READ THE CONVERSATION ABOVE AND ANSWER THE FOLLOWING QUESTIONS.1.WhatsymptomsdoesMrs.Brownhave?2.Whatconditionmightshehave?3.WhatisthenameofthetestwhichwillbedoneatPathologyLab?4.WhatdoesEileenhavetocollectfromthepatient?It hurts when she passes urine and she needs to pass urine frequently. She might have UTI. Culture and Sensitivity Test (C&S). A midstream urine specimen (MSU).B. FILL IN THE BLANKS WITH AN APPROPRIATE WORD ACCORDING TO THE CONVERSATION.1.Sowhatyouresayingisthatit_whenyoureactually_.2.Itsoundslikeyoumighthavea_infection.3.Weusuallycallit_forshort.4.Hellaskyoutodoa_tosendtothePathologyLaboratoryforaCultureandSensitivityTest.5.Dr.Blairwillprobablystartyouonsome_iftheresultscomeouttobeaninfection.hurts passing the urine urinary tract UTI urine specimen antibiotics C. USING THE CLARIFICATION STRATEGIES IN BRACKETS TO RESPOND TO THE FOLLOWING SENTENCES. 1.Ivegotsomeproblemswhilegoingtothetoilet.(Askthespeakertoclarifywhathe/shehassaid.)_2.ItburnswhenIgotothetoilet.(Paraphrasewhathasbeensaid.)_3.Ihavetogotothetoiletsooften.(Useaquestioningintonationpattern.)_Mm. Do you mean it hurts when passing urine? Right. So what youre saying is that it hurts when youre actually passing the urine. And you feel like you have to pass urine frequently? 4.Youmighthaveaurinarytractinfection.(Askthespeakertoclarifywhathe/shehassaid.)_5.Thedoctorwillaskyoutodoaurinespecimen.(Repeattheinformationbacktothespeaker.)_6.Thereslesscontaminationwithamidstreamspecimen.(Useaquestioningintonationpattern.)_Oh. What did you call it? A urinary what was it? Ok. So you want me to do a urine specimen, do you? Less contaminated? D.USE THE FOLLOWING INFORMATION TO CREATE A CONVERSATION ABOUT COLLECTING A BLOOD SPECIMEN, USING THE STRATEGIES OF ASKING FOR CLARIFICATION. Thepatientshouldbeinstructedaboutwhatbloodtestshavebeenorderedandwhy.Furthermore,explaintheprocedureandwhatthepatientcanexpect.Askthepatientifanyonehashadtroubledrawingbloodfromhim/herinthepast.Thismaybeanalerttopotentialproblemsinfindinganappropriatevein.Alsoaskthepatientwhatpositionwouldbemostcomfortableforhim/herwhendrawingthespecimen.Venipuncturemakesmanypatientsnervous,andhavingthemliedownmayhelpthemtorelaxandbettertoleratetheprocedure.Afterobtainingtheorderedspecimens,removetheneedlefromtheveinanddiscarditintoapuncture-proofcontainer.Pressureshouldbeappliedtothesiteforaboutaminute(longerifthepatientisonanyanticoagulants).Afterapplyingpressure,inspectthesiteforanysignsofbleedingorhematomas.Applyabandagetothesite.Thespecimencontainersshouldthenbelabeledandsenttothelaboratory.Makesurethepatientiscomfortableandnotexperiencinganyadverseaffectsbeforebeingallowedtogetup.TASK 2 CHECKING UNDERSTANDING AND SOFTENING A REQUESTNursesareoftencalledontogivepatientsinstructionsinmanyareasofhealth-care,forexample,collectingspecimens,usingmedicalequipmentandkeepingpersonalcarerecords.Patientcomplianceisonlypossiblewhenpatientshaveaclearunderstandingofwhatisexpectedofthem.Therefore,nursesareencouragedtouseseveralstrategiestocheckunderstandingwhendealingwithpatients.Description 翻译Inordertoestablisharapportwithapatient,nursesoftenuseasofteningormitigatinglanguagesuchas“just”and“only”.Usedwithafriendlytoneofvoice,softenedrequestsaremorelikelytobesuccessful.Theeffectofusingsuchsoftenersistoremovebarrierstocommunication,suchastheperceptionthatthenurseisinapositionofpower.翻译任务二 确认是否理解并缓和请求在很多保健领域，护士都要给患者进行健康指导，比如，采集标本、使用医疗器械和保管个人护理记录。当患者清楚地理解自己要做的事情，他们才可能会遵从指导。所以，在与患者沟通时，鼓励护士使用各种技巧来确认患者是否理解。为了与患者建立融洽的关系，护士多使用轻柔或和缓的语言，如“只是”和“仅仅”。用友好的口吻、委婉的请求会更有可能成功。使用这些柔和语言就是要消除沟通障碍，如打消护士处于权威位置的看法。任务描述RELATED INFORMATION Whennurseswanttoaskthepatienttorepeattheinformationbacktothem,theymaysay,“CouldyourepeatbackthestepsformesoIcanbesureyoufollowedmyexplanation?”Whennurseswanttoaskthepatienttodemonstratetheuseoftheequipment,theymaysay,“Canyoushowmehowyoullholdthespecimenjar?”Some useful strategies to check understanding which nurses can use 翻译Whennurseswanttoaskforclarificationtoensurethepatientunderstandswhathasbeensaid,theymaysay,“Doyouunderstand/seewhatImean?”Whennurseswanttoaskthepatienttolistthestepsofaprocedureorprocess,theymaysay,“Right,soStepOneis?”翻译相关信息当护士要求患者复述所说的信息时，会说：“您能将流程复述一遍吗？这样我才能确定您理解了我的意思。” 当护士要患者演示使用医疗器械时：“您能拿住标本瓶给我看看吗？” 当护士要求澄清以确保患者理解，会说：“您能理解/明白我所说的吗？” 当护士要求患者说出流程或过程时，会说：“那么第一步是做什么？”检查理解程度的策略SOME OTHER USEFUL EXPRESSIONS WHICH NURSES CAN USE Whennurseswanttomakesurepatientsunderstandthem(Doyou)understandwhatImsaying?(Doyou)knowwhatImean?(Doyou)knowwhatImtalkingabout?Doesthatmakeanysense?Doyoufollowme?翻译Are you with me?Are you with me so far?You know?You see?Right? 翻译相关表达方式当护士想要确定患者理解他们的话您能理解我所说的吗？您知道我的意思吗？您知道我在说什么吗？您明白了吗？您听懂了吗？您明白我的话吗？目前听明白了吗？您知道了吗？您懂吗？对吗？WHEN NURSES UNDERSTAND WHAT PATIENTS ARE SAYINGIseewhatyouresaying.Iseewhatyoumean.Iknowwhatyoumean.Iknow.Iunderstandwhatyouresaying.Imwithyou.Ihearyou.Ihearwhatyouresaying.翻译当护士理解患者所说的话我明白您所说的。我明白您的意思。我知道您的意思。我知道。我理解您所说的。我明白您的意思。我听明白了。我听见您所说的了。WHEN NURSES DONT UNDERSTAND WHAT THE PATIENT IS SAYINGIdontgetit.Idontfollowyou.ImnotsureIgetyourpoint.ImnotsureIknowwhatyoumean.翻译当护士不理解患者所说的话我不理解。我不明白您的意思。我不确定明白您讲的要点。我不确定明白您的意思。THE REASONS FOR SOFTENING A REQUESTMakingrequests,involvesanunderstandingofetiquetteorpoliteness.InmakingrequestsinEnglish,itisnecessarytolearnnotonlycertainwordsandexpressions,butalsohowtousethemappropriately.Firstofall,thewayapersonaskswilldependonthesocialdistancebetweenthepersonhimselfandtheotherperson.翻译Forinstance,ifapersonisaskingateacherforhelp,thepersonwillprobablyusemoreindirectandmoreformalwordsthanifthepersonisaskingaclosefriendorrelative.Second,thelanguageoneuseswilldependontheweightofthefavor.Ifapersonismakingaspecialrequestfromevenaclosefriend,saytoborrowseveralthousanddollars,thepersonwillprobablyuseamorepolitelanguagethanifthepersonismerelyaskingtoborrowapen.翻译Evenwiththeseguidelines,itcansometimesbehardtoknowhowtomakearequest,especiallyin“sticky”situations.Forinstance,ifapersonwantsastrangertokeepquietinamovietheater,thepersonmightwanttogivehimadirectcommandratherthanmakearequestinordertoshowhowannoyedthepersonis.However,eveninthiscase,thepersonwillprobablygetbetterresultsifthepersonaskshim/hertoquietdowninapoliteandconsiderateway.翻译Themostpoliterequestsgenerallyusetheexpression:“Wouldyoumind?”or“Doyoumind?”Forexample:1.WouldyoumindifIborrow(ed)yourelectronicdictionary?DoyoumindifIturntheradiooff?DoyoumindturningtheTVdown?翻译Requeststhatareslightlylessformal,butstillindirectandpolite,beginwith“Wouldyou”,“Couldyou”or“Canyou”.“Please”canbeaddedforadditionalpoliteness.Noticethattheserequestsarestillintheformofaquestion.2.Wouldyou(please)speakmorequietly?Couldyouspeakmoreloudly,(please)?Canyou(please)speakmoreslowly?翻译anyou(please)speakmoreslowly?Ifapersonwantstobemoredirect,thepersoncanmakearequestintheformofanimperativesentenceratherthanaquestion.Inthiscase,youcanretainasenseofpolitenessbyaddingtheword“please”.Forexample,pleaseputthebooksonthetableoverthere.翻译Ifapersonwantstogiveanorder,oradirectcommand,thenthepersoncandeletetheword“please”.Thefollowingsaremostoftenusedwhensomeoneisimpatientorirritated:Sitsown,wouldyou?Icantseethetelevision.Sitdown!Icantsee!翻译委婉请求的原因提出请求，涉及对礼仪或礼貌的理解。用英语提出请求，要学习一定的单词和表达方式，而且要学习如何正确地使用。首先，两人间的社会距离决定询问的方式。比如，向一位老师寻求帮助，较之密友或亲戚，更可能使用间接和正式用语。第二，请求帮助的程度决定了语言的使用。如果一个人提出借几千美元的请求，即使是向密友提出，相比借一支钢笔，会更多地使用礼貌性语言。了解了这些指导方针，有时候还是不知道如何提出请求，特别是在“棘手”的处境中。比如，让一位陌生人在电影院保持安静，直接用命令句比提出请求更能表达出他有多吵。然而，即使在这种场合，如果以一种礼貌、体贴的方式让别人安静，也许会得到更好的结果。最礼貌的请求通常表达为“你介意？”或者是“你介意吗？”比如：1.你介意我将收音机关掉吗？请将电视音量调小点，好不好？有些请求虽不那么正式，但还是间接、礼貌的，并以“你能”开头。额外礼貌的话可以加上“请”。注意这些请求仍然是疑问句的形式。2.你能说话再轻点吗？你能说话再大点声吗？请你说话再慢点，好吗？如果一个人想说话更直接，就可以使用祈使句而不是疑问句。这种情况，你可以添加“请”来保持礼貌。如：“请将书放在那边那张桌子上。”如果一个人想下命令，或者直接提出要求，就可以去掉“请”。当一个人没礼貌或是生气时，最常使用：坐下，可以？我看不到电视。坐下！我看不见！DISCUSSION OF THE NURSING TOPIC1.Whyisitnecessaryfornursestocheckunderstandingofthepatients?2.Howdonursessoftenarequest?When having a conversation with a patient, nurses always want to make sure that they understand what each other is saying. As for nurses, it is a good conversational strategy to check, from time to time, if the patient they are talking to understands what they are saying. Nurses should do it in a polite and considerate way. For example, they can use the expression: “Would you mind ?” 3.WhatequipmentisneededwhentakinganMSUspecimen?4.HowmanystepsarethereintakinganMSUspecimen?Whatarethey?A sterile specimen container for the urine specimen and some disposable wipes. Five steps. First of all, wash your hands thoroughly. Then, you need to clean the area around the urethra from front to back with these disposable wipes. After that, dont touch the inside of the container when you take the lid off. Next, try to catch the middle part of the urine stream. Last, tighten the lid before you give me the specimen container, please.COMMON PATTERNS AND QUESTIONS WHEN CHECKING UNDERSTANDING AND SOFTENING A REQUEST1.Right,soStepOneis.?2.Doyouunderstand/seewhatImean?3.Canyoushowmehow?4.Isthatexplanationclearorwouldyouliketoaskanyquestions?5.CouldyourepeatbackthestepsformesoIcanbesureyoufollowedmyexplanation?6.Idjustlikeyouto7.Youjustneedtomakesurethat8.Justdoitlikethissothat9.Itsonlyto10.WejustwanttoPRACTICE OF THE TASK(Eileen, the ward nurse, is talking with Mrs. Brown, a patient, about how to do the MSU.)Eileen:Allright,hereweare.IvebroughteverythingyouneedtodotheMSU.Ivegotasterilespecimencontainerfortheurinespecimenandsomedisposablewipes.Mrs.Brown:OK.SowhatshouldIdo?翻译Eileen:First,Idjustlikeyoutowashyourhandsthoroughly.Thenyouneedtocleantheareaaroundtheurethrafromfronttobackwiththesedisposablewipes.Right,soStepOneis?Mrs.Brown:Ah,thefirstthingistowashmyhandsandthencleantheareaaroundmyurethrawiththesedisposablewipes.Eileen:Mm,thatsit.Youjustneedtomakesuretheareaiscleansotheurinespecimendoesntgetcontaminatedwithanybacteriafromtheoutside.翻译Mrs.Brown:Right.ThenwhatdoIhavetodo?Eileen:Then,takethelidoffthespecimencontainerlikethis.Donttouchtheinsideofthecontainerwhenyoutakethelidoff,otherwisetheurinespecimenwillbecontaminatedbyanybacteriaonyourhands.Justdoitlikethissothatyoukeepyourfingersawayfromtheedge.Donttouchanypartinhere.Imean,insidethespecimencontainer.DoyouseewhatImean?翻译Mrs.Brown:Yes,Isee.Thatsquiteimportant,isntit?Eileen:Yes,itis.Itsonlytoavoidbeingcontaminatedbyanybacteriaonyourhands.Canyoushowmehowyoullholdthespecimenjar?Mrs.Brown:Sure.Illtakeitlikethis,andtakethelidoffwithouttouchingtheinside.翻译Eileen:Thatsgreat.Itssoimportantthatyoudothetestcorrectly,orwellgetafalsereading.Now,passsomeurineintothetoiletandthenpassasmallamountofurineintothesterilecontainer.Trytocatchthemiddlepartoftheurinestream.Thatswhyitscalledamidstreamurinespecimen.DoyouunderstandwhatImean?Mrs.Brown:Yes,Ithinkso.LetmerepeatwhatIhavetodosoImsureIvegotitright.Ipasssomeurineintothetoiletandthensomemoreurineintothecontainer.翻译Eileen:Yes,thatsexactlywhatIwantyoutodo.Wejustwanttogetthemiddlepartofthestreamofurine.Justonemorethingtightenthelidbeforeyougivemethespecimencontainer,please.Mrs.Brown:Ohright,Icanseewhythatsimportant.Eileen:Mm.Illsendtheurineofftothelabstraightaway,andwellgettheresultstomorrowafternoon.Isthatexplanationclearorwouldyouliketoaskanyotherquestions?翻译Mrs.Brown:No,thanks.Iunderstand.Illgoanddoitnow.Eileen:JustbeforeyoudotheMSU,couldyourepeatthestepsformesoIcanbesureyoufollowedmyexplanation?Mrs.Brown:Yes,ofcourse.FirstI翻译任务案例（艾琳是一位病房护士，正在和患者布朗太太讲解如何留取中段尿标本。）艾琳：好的，我们到了，我已拿来留取中段尿标本所需的全部用物。这是采集尿液的无菌标本容器和一些一次性湿纸巾。布朗太太：好的，那我应该做些什么呢？艾琳：首先，我想让您彻底清洗您的双手，然后，您需要用这些湿纸巾从前向后清洁尿道周围皮肤。好了，那么第一步是？布朗太太：嗯，第一件事是彻底清洗双手，然后用这些湿纸巾清洁尿道周围皮肤。艾琳：嗯，就是这样。您必须确保尿道周围是清洁的，这样的话尿标本就不会被外部细菌污染。布朗太太：那么，接下来我要做什么呢？艾琳：然后，像我这样打开标本容器的盖子，打开盖子时不要碰到盖子的内面，否则您手上的细菌会污染尿标本。就像这样做，保持手指远离盖子的边缘，不要碰到这里的任何部位。我指的是标本容器的内面，您懂我所说的吗？布朗太太：是的，我懂，那相当重要，是吗艾琳：是的，这只是为了避免您手上的细菌污染了尿标本。您能让我看看您如何拿这个标本瓶的吗？布朗太太：当然了，这样拿着，然后打开盖子，不碰触内面。艾琳：太对了，您这样做太重要了，否则我们将得到错误的化验数据。现在到马桶里排尿，然后将少许的尿液排入无菌标本容器里，尽量留取尿的中段部分。那就是我们称它为中段尿标本的原因了。您能理解我所说的吗？布朗太太：是的，我想我理解了。让我复述一下您要求我做的，这样我就可以确定是否能做正确。先向马桶里排少许尿，再将尿液排入容器内。艾琳：是的，这正是我想要您做到的。我们只需要尿液的中段部分。还有一件事，给我标本容器之布朗太太：好的，我明白了它的重要性了。艾琳：嗯，我将直接将标本送往实验室，明天下午就会出结果。解释清楚了吗？或者您还有什么其他的问题？布朗太太：不用了，谢谢！我懂了，现在就去做。艾琳：在您留取中段尿标本之前，您能将步骤复述一遍吗？这样可以确认您是否会按我说的那么做。布朗太太：当然可以，首先我前请盖紧盖子。A. READ THE CONVERSATION ABOVE AND PUT THE FOLLOWING EXTRACTS IN THE CORRECT ORDER.1.Trytocatchthemiddlepartoftheurinestream.2.Youneedtocleantheareaaroundtheurethrafromfronttobackwiththesedisposablewipes.3.Tightenthelidbeforeyougivemethespecimencontainer,please.4.Donttouchtheinsideofthecontainerwhenyoutakethelidoff.5.Washyourhandsthoroughly.5-2-4-1-3B.FIND OUT THE EXPRESSIONS FROM THE CONVERSATION ABOVE TO MATCH THE STRATEGIES BELOW TO CHECK UNDERSTANDING.1、Anurseasksthepatienttorepeattheinformationbacktoher._2、Anurseasksthepatienttodemonstratetheuseoftheequipment._3、Anurseasksforclarificationtoensurethepatientunderstandswhathasbeensaid._Could you repeat the steps for me so I can be sure you followed my explanation? Can you show me how youll hold the specimen jar? Do you see/understand what I mean? 4.Anurseasksthepatienttolistthestepsofaprocedureorprocess._Right, so Step One is? C.FILL IN THE BLANKS WITH JUST OR ONLY TO SOFTEN THE REQUESTS.1.First,Id_likeyoutowashyourhandsthoroughly.2.You_needtomakesuretheareaiscleansotheurinespecimendoesntgetcontaminatedwithanybacteriafromtheoutside.just just 3._doitlikethissothatyoukeepyourfingersawayfromtheedge.4.Its_toavoidbeingcontaminatedbyanybacteriaonyourhands.5.We_wanttogetthemiddlepartofthestreamofurine.just just only D.USE THE FOLLOWING INFORMATION TO CREATE A CONVERSATION ABOUT ASKING FOR AND GIVING INSTRUCTIONS FOR A STOOL SPECIMEN, USING THE STRATEGIES OF CHECKING UNDERSTANDING AND SOFTENING A REQUEST.Mr.Millshasahistoryofstomachtrouble.Recently,hewasadmittedtothehospitalduetohisblackandtarrystools.Instructthepatientwhatstooltestshavebeenorderedandwhy.Furthermore,explaintheproceduretothepatient.Ifarandomspecimenisrequired,tellthepatienttonotifywhenhehastheurgetodefecate.Havehimdefecateintoaclean,drybedpanorcommode.Instructhimnottocontaminatethespecimenwithurineortoilettissue.Thepatientshouldbeaskedtoputonglovesanduseatongueblade,transferthemostrepresentativestoolspecimenfromthebedpantothecontainer,andcapthecontainer.Afterthat,tellthepatienttowrapthetonguebladeinapapertowelanddiscardit,aswellasremoveanddiscardthegloves,andwashhishandsthoroughlytopreventcross-contamination.TASK 3 CONTACTING OTHER STAFFPatientinformation,forexample,testresultsorchangesincondition,isoftencommunicatedtothepatientsdoctorbyphone.Nursesneedtobeclearandconcisewhencommunicatinginformationbyphoneandensurethatallrelevantpatientinformationisathandduringthephonecall. Description翻译任务三 联系其他工作人员患者信息，比如，化验结果或者病情变化通常通过电话传递给患者的医生。当通过电话交流信息时，护士需要表达清晰而简明，并且确保在电话沟通时所有的患者相关信息都在手边。任务描述RELATED INFORMATIONTherearemanydifferenttypesofstaffatthehospital.Theyallwearidentificationbadges.Hospital StaffWhile in hospital, patients will be under the care of a consultant. He/she is in charge of a team of doctors, one of whom will look after the patient each day and pay regular visits to check on the patients progress. Doctors翻译相关信息医院里有很多不同的工作人员。他们都佩戴标识徽章。医院工作人员住院期间，患者们将由一名主治医师收治，主治医师带领一个医生团队，其中的一名医生会每天定期巡视病人的病情进展情况。医生Thewardsisterorchargenurserunsthewardandmanagesateamofnurses,oneofwhomwilllookafterapatienteachday,supportedbyhealthcareassistants.Nurses and Healthcare AssistantsModern matrons support ward sisters and charge nurses, and help to improve nursing care. They provide clinical and management expertise and work closely with patients and their carers to involve them in the future of the nursing service. Senior Nurses 翻译护士和护工护士长或主管护士管理病房和护士团队，其中一名护士每天护理患者，同时有护工协助。资深护士资深护士支持病房护士和护士长，且帮助改善护理质量。他们提供临床和管理经验，与患者及其照护者紧密合作，参与患者未来的护理服务。Other StaffWhilestayingonawardapatientmayalsocomeintocontactwithotherhealthcareprofessionals,includingphysiotherapists,occupationaltherapists,radiographers,pharmacists,socialworkersandhospitalvolunteers.n n其他工作人员n n尽管住在病房，患者也可以接触到其他医疗专业人士，尽管住在病房，患者也可以接触到其他医疗专业人士，包括物理治疗师、职业治疗师、放射技师、药剂师、社工和包括物理治疗师、职业治疗师、放射技师、药剂师、社工和医院志愿者。医院志愿者。翻译Some useful expressions for a telephone conversationGoodmorning,isthatdepartment?Yes,canIhelpyou?Well,IdliketospeaktoHoldtheline,please.Sorry,keepyouwaiting.isnothere.MayItakeamessage?Illcallbacklater.Hello,thisisthedepartment.Thisisspeaking.CanItalkto?翻译hasanoperationthismorning.Doyouhaveanythingurgent?Well,Illtellassoonascomesback.MayItakeyourtelephonenumber?IthinkIdbetterletyougo.Illtalktoyoulater.Ihavetogetbacktowork.Illcallyoulatertonight.Itskindoflate.Whydontwetalkaboutittomorrow?Iwontkeepyouanylonger.Ivereallygottogo.IllgetbacktoyouwhenIgettotheoffice.翻译电话对话的一些有用的表达早上好，请问是部门吗？是的，请问有什么要帮助的吗？好的，我想和讲话。请别挂断电话。对不起，让你等这么久，不在这里，我能帮你留言吗？我一会儿再打过来。你好，是部门吗？我是，我能和讲话吗？今天早上有个手术，你有急事吗？好吧，回来我就告诉他我能留你的电话吗？我想我最好让你走，我一会儿再跟你说。我必须要回去工作了，我晚上再打电话给你。现在有点晚了，我们为什么不明天再继续说呢？我不再留你了。我真的要走了，我到办公室后再打电话给你。 Discussion of the nursing topic1.Whathospitalcommunicationsystemsareyoufamiliarwith?2.Whatdoyouthinkarethefeaturesofagoodcommunicationsystem?Hospital communication systems include bleeping or paging. Telephone call is another effective way of communication. Features of a good communication system include: recording time of paging, easy to use, alerting staff member when page has been received. 3.Howistechnologychangingthewaywecommunicateintheworkplace?Mobile phones are often used in place of pagers and email is also used. Technology is also changing the way nurses document patient information; for example, care plans are computerized rather than handwritten. Some hospital pharmacies use a bedside computerized system to order and supply patient medication, reducing the amount of time spent visiting hospital pharmacies to pick up scripts.Common patterns and questions when contacting other staff1.Hello,isthat?2.Itisfromward.3.Imcallingaboutoneofyourpatients,4.Canyouremindme?5.Illcomeoverandwriteupsome6.Imjustonatthemoment.7.Illprobablybeupthereinminutes.Thanks.Seeyou.openPractice of the task(Eileen, the ward nurse, is calling Dr. Blair about one of the patients, Mrs. Brown.)Eileen:Hello,isthatDr.Blair？Dr.Blair:Yes,itis.Eileen: Ohhello,itsEileenfrom8Westhere.Imcallingaboutoneofyourpatients,Mrs.Brown.Dr.Blair:Er,Mrs.Brown?Canyouremindme？Eileen: Yeah,shewasadmittedtwodaysago,erDr.Blair:Yeah,Iremember.Isntsheinfortheremovalofanovariancyst?Eileen: Yeah,thatsthepatient.IthinkshemayhaveaUTI.Shescomplainingoffrequency,urgencyandpainwhenshepassesurine.翻译Dr.Blair:Right.Isshefebrile?Eileen:Yeah,hertempsupabit.Shesaroundthirty-sevenpointeight.Shedoesntfeelbrilliantorgeneralmalaise.Dr.Blair:OK.Shesgotfrequency,urgency,painandshesfebrile.CanyoutakeanMSU?AndIllcomeoverandwriteupsomeantibiotics.Eileen: TheMSUsalreadydone,butIllleavethePathologyFormatthedesktobesigned.ThenwecansendittoPathology.Iveencouragedhertoincreaseherfluidintake,too.DrBlair:Great,thanks.Imjuston8Eastatthemoment.Illprobablybeupthereinfifteenminutes.Eileen:Thanks.Seeyou.翻译任务案例（艾琳是一名病房护士，正在与布莱尔医生通话，告知他的患者布朗太太的信息。）艾琳：你好，请问是布莱尔医生吗？布莱尔医生：是的，我就是。艾琳：噢，你好，我是来自西8区的艾琳，我要跟您谈谈您的一位患者布朗太太。布莱尔医生：呃，布朗太太？你能提示我一下吗？艾琳：好的，她两天前被收入院，呃布莱尔医生：是的，我想起来了。是不是因为卵巢囊肿而入院？艾琳：是的，就是那位患者，我认为她可能患有尿道感染。她主诉当她排尿时有尿频、尿急、尿痛。布莱尔医生：好的，她发热了吗？艾琳：是的，体温有点高，大概在37.8。她感觉浑身不适。布莱尔医生：好的，她有尿频、尿急、尿痛和发热。你能采集中段尿标本吗？我一会儿去看看然后开些抗生素。艾琳：中段尿标本已经采集好了，我会把需要签字的病理申请单放在桌上。签字后就可以送往病理实验室了。我已经鼓励她多饮水了。布莱尔医生：太好了，谢谢！我现在在东8区，大概15分钟后到。艾琳：谢谢！再见。A.Read the conversation above between Eileen and Dr. Blair, an SHO, and mark the following statements True (T) or False (F).1.EileencallsDr.BlairtocheckontheresultsofMrs.Brownsurinetest.2.Dr.BlairasksEileentoremindheraboutMrs.Brownsdiagnosis.3.Thedoctorhasdecidednottoprescribeantibiotics.4.AmidstreamurinespecimenhasbeencollectedfromthepatientbutthenurseneedsthedoctortosignaPathologyForm.F she is calling to tell the doctor the patient has frequency and burning when she passes urine T F the doctor will come and write up some antibiotics in fifteen minutes T B. Fill in the blanks with an appropriate word according to the conversation.1.Im_oneofyourpatients,Mrs.Brown.2.She_twodaysago.3.Isntsheinfortheremovalofan_ ?4.Shes_frequency,urgencyandpainwhenshepassesurine.5.TheMSUsalreadydone,butIllleave_atthedesktobesigned.calling about was admitted ovarian cyst complaining of the Pathology Form Use the following information to create a telephone conversation, using the strategies for clarification and checking understanding.Callthedoctoraboutoneofthepatients,whowasadmittedinthemorningbecauseofhishightemperature.Hedidntfeelbrilliantorgeneralmalaise.Besides,hekeptvomiting.Thedoctorsuggestsabloodspecimenshouldbecollectedandtellsthenursehewillcomeoverandexaminethepatient.Task 4 Explaining urinary catheters DescriptionUrinarycathetersarethin,hollowtubeswhichareintroducedintothebladdertoallowurinetodrainoutofthebody.Thecathetermaybeapermanentone(indwellingcatheter),oranintermittentcatheterremovedaftereachcatheterization.Short-termurinarycathetersmaybeinsertedinpatientswhohaveurinaryretention,orhaverestrictedmovementwhichdoesnotallowthemtogetuptothetoileteasily.Long-termurinarycathetersareusedforpatientswhoarepermanentlyincontinent.翻译任务四 解释导尿管的使用 任务描述导尿管是插入膀胱将尿液从身体里引流出来的细空心管子。导尿管有留置性导尿管，也有每次导尿后拔出的非留置性导尿管。短期导尿管可以用于尿潴留患者或者是活动受限制不易起床上厕所的患者。长期导尿管用于永久性尿失禁患者。Related Information Reasons for inserting a urinary catheterRelieveretentionofurine.Closelymonitortheurinaryoutput.Obtainasterilespecimenofurine.Preventskinmacerationwhenaclientisincontinent.Removeresidualurinewhenvoidingdoesnotcompletelyemptythebladder.Allowthedrainageofurineandtokeepthebladderemptyduringoraftersurgeryontheabdominal,pelvicorperinea.Facilitatebladderirrigationprocedures.翻译相关信息 插入导尿管的原因解除尿潴留密切监测尿量获得无菌尿标本防止尿失禁患者皮肤浸渍当排尿不能完全排空膀胱时去除残余尿引流尿液并使腹腔、盆腔和会阴手术期间及术后的膀胱无尿液帮助冲洗膀胱 Inserting of a catheterTheprocedureofcatheterinsertioniscalledcatheterizationandisperformedusingsterileequipmentandaseptictechnique.AsacathetercancausetraumatotheurethralorbladdermucosaandisapotentialsourceofUTI,itisinsertedwhenabsolutelynecessaryandonlybyanRNoramedicalofficer.翻译 插入导尿管插入导尿管的过程被称为导尿，操作时使用无菌用物和采用无菌技术。由于导尿管常能导致尿道和膀胱粘膜损伤，有泌尿道感染的风险，当完全必要时才使用导尿管，且须由注册护士或医师执行。 Sex differencesInmales,thecathetertubeisinsertedintotheurinarytractthroughthepenis.Infemales,thecatheterisinsertedintotheurethralmeatus,afteracleansingusingpovidone-iodine.Theprocedurecanbecomplicatedinfemalesduetovaryinglayoutsofthegenitalia(duetoage,obesity,femalegenitalcutting,childbirth,orotherfactors),butagoodclinicianwouldrelyonanatomicallandmarksandpatiencewhendealingwithsuchapatient.Malesmayhaveaslightlyhigherincidenceofbladderspasms.翻译Ifbladderspasmsoccurorthereisnourineinthedrainagebag,thecathetermaybeblockedbyblood,thicksediment,orakinkinthecatheterordrainagetubing.Sometimesspasmsarecausedbythecatheterirritatingthebladder,prostateorpenis.Suchspasmscanbecontrolledwithmedicationsuchasbutylscopolamine,althoughmostpatientseventuallyadjusttotheirritationandthespasmsgoaway.翻译 性别差异男性导尿管是经阴茎插入尿路；女性则使用碘伏消毒后插入导尿管。女性因生殖器的解剖位置不同操作流程复杂（因年龄、肥胖、女性生殖器切除、分娩或其他的因素而异）。对待这样的患者，有经验的医师要依靠解剖标志与耐心插入导尿管。男性可能有发生轻度膀胱痉挛的危险。如果发生了膀胱痉挛或集尿袋里没有尿液，则尿道可能被血块、厚的沉淀物堵塞或是导尿管扭曲。有时痉挛是由导尿管刺激膀胱、前列腺或阴茎引起的。此类痉挛可经药物控制，如丁基莨菪碱，但大部分患者能够适应疼痛，痉挛自行消失。 Discussion of the nursing topic1.Areyoufamiliarwiththeuseofurinarycatheters?2.Whatothertypesofpatientmightrequireurinarycatheters?Urinary catheters are thin, hollow tubes which are introduced into the bladder to allow urine to drain out of the body. The catheter may be a permanent one (indwelling catheter), or an intermittent catheter removed after each catheterization. Patients who are immobile because of surgery, suffering from a spinal cord injury, etc. 3.Whataresomeofthecomplicationsthatcanoccurwithcatheterization?4.Areyouawareofanynewprocedures/developmentsincatheterization?Infection and tissue damage. New developments in self-catheterization include catheters with a low-friction outer coating. They are disposable, so more expensive, but carry fewer infection risks. Common patterns and questions when explaining urinary catheters1.Youmeanthat2.DoyoumindifI?3.Howdoesitfeelhere?4.Imighthavetoputinacathetertodraintheurine.5.Wecallthemindwellingcatheters,orIDCsforshort.6.Anindwellingcatheterjustmeans7.Thetubeisinsertedthroughtheurethraandgoesintoyourbladder.8.Wehavetobecarefultouseaseptictechniquewhen9.Youshouldntneeditfortoolongatall. Practice of the task(Jan, the ward nurse, is explaining urinary catheters to her patient, Mrs. Don.)Jan: Didyoubuzz,Mrs.Don?Mrs.Don:Yes.Nurse,Imreallyuncomfortablehere.Um,Ihaventbeenabletousethisbedpanatall.Jan: OK.Youmeanthatyouhaventbeenabletopassanyurine?Mrs.Don:No,Ihaventbeenabletogoforages.翻译Jan: Allright.Letmehavealook.Illjustclosethecurtains.DoyoumindifIfeelyourbladder?Mrs.Don:No,thatsallright.Jan: Howdoesitfeelhere?Mrs.Don:Ow.Oh,itsquiteuncomfortable.Jan: Mm,yourbladderisquitedistended.OK.Now,youvestillgotsomeurinaryretentionafteryouroperation,haventyou?Mrs.Don:YoumeanthatIcantgotothetoilet?Jan: Yes,thatsright.Imighthavetoputinacathetertodraintheurine.翻译Mrs.Don:Isthatthetubewhichgoesintoyourbladder?Iveseenafewaround.Youhavetocarryabagaroundwithyou.Jan: Yes,thatsit.Thebagcollectstheurine.Wecallthemindwellingcatheters,orIDCsforshort.Ivegotoneheretoshowyou.AnindwellingcatheterjustmeansatubewhichisleftinsituImean,leftinplace.Thetubeisinsertedthroughtheurethraandgoesintoyourbladder.Iinflatethelittleballoonontheend,thisonehere,withwater,anditsitsattheneckofyourbladder.Wehavetobecarefultouseaseptictechniquewhenweinsertthecathetertoreducetheriskofinfection.翻译Mrs.Don:Oh.OK.So,er,youputthetubeinandblowthatlittleballoonupsothecatheterdoesntfallout,andyouhavetotakecarehowyouputthetubeinsoIdontgetaninfection.Jan: Thatsexactlyit.Itscalledaseptictechniquebecauseitkeepsequipmentsteriletoavoidcontamination.Thecatheterbagyouretalkingaboutisoneofthese.Itsatransparentbagwhichcollectstheurinethatdrainsoutofthecatheter.Weemptythedrainagebagthreetimesaday.Mrs.Don:OK,wellIhopeIwontneeditfortoolong.Jan: Oh,youshouldntneeditfortoolongatall.翻译任务案例 （简是一位病房护士，正在向她的患者唐太太解释导尿管。）简： 唐太太，您呼叫过我们？唐太太：是的，护士，我这里很不舒服，嗯，我已经完全不能使用便盆了。简： 好的，您意思是您不能排尿了吗？唐太太：是的，我好几年都不能了。简： 好的，让我看看。我将拉上床帘，您介意让我摸一下您的膀胱吗？唐太太：不介意。简： 这里感觉怎么样？唐太太：噢，相当不舒服。简：嗯，您的膀胱相当膨胀。好啦。嗯，手术后您仍有尿潴留，是吗？唐太太：你意思是我不能上厕所吗？简：是的，可能得插入导尿管将尿液引流出来。唐太太：是那根插入膀胱的管子吗？我看见周围有几个人这样子，得带着个袋子活动。简：是的，就是那，袋子是收集尿液的，我们称它为留置导尿管或者简称为IDCs。我拿一根给您看看。留置导尿管就是指留在原地不动的的插管，这根管子经尿道插入膀胱。我用水将末端的气囊，就是这里，充起来，然后固定于膀胱颈。为了减少感染风险，插入导尿管时，我们须小心谨慎，使用无菌技术操作。唐太太：噢，好的，所以说，呃，插入管子，充起末端气囊，这样导尿管就不会脱出，插入导尿管时须小心，那样我就不会感染了。简： 完全正确。它称为无菌技术是因为它使用无菌用物来避免污染，刚刚谈到的集尿袋也是其中之一，它是一个透明的袋子，收集从导尿管引流出来的尿液，我们每天三次将袋子放空。唐太太：好的，希望我需要它的时间别太久。简： 噢，您应该不需要使用太长时间。A. Read the conversation above and answer the following questions.1.WhatisMrs.Doncomplainingof?2.WhatisJangoingtodotorelieveMrs.Donsproblem?3.Whatisusedtocollecttheurine?Not being able to pass urine (urinary retention) Insert an indwelling catheter A drainage bed B. Use the statements in the box(a-d) to fill in the blanks.a.equipmentsteriletoavoidcontaminationb.whenapatientcantpassurinec.atubewhichisleftinsitu,orinplaced.atransparentbagwhichcollectstheurinethatdrainsoutoftheurinarycatheter1. Urinary retention is _.2. An indwelling catheter (IDC) is _.3. Aseptic technique keeps _.4. A catheter drainage bag is _.bcadC.Use the following information to create a conversation about explaining urinary catheters, using the strategies for clarification, checking understanding, and softening instructions. Mr.Davidhasbeenadmittedtotherenalwardforrenalfunctiontests.Now,hehasgotsomeurinaryretention.Instructthepatientthathisbladdershouldbefelttoseewhetheritisdistendedornot,basedonwhichthenursehastodecidewhetherornottoputinacathetertodraintheurineforhim. Ifacatheterisneeded,explaintothepatientthereasonwhyheneedsit.Furthermore,describetothepatientthaturinarycathetersconsistofatubethatgoesintohisbladderandabagthatcollectstheurine.TheyarecalledindwellingcathetersorIDCsforshort.Showthepatienthowtheywork.Andinstructthepatientabouttheproceduresofinsertingacatheter.Tellthepatientyouwillusetheso-calledaseptictechniquetoavoidcontamination.Makesurethatthepatientunderstandsheshouldntneeditfortoolong.openTask 5 Reading a pathology report DescriptionPathologyReportscontaininformationabouttheanalysisofspecimens,presenceofinfectiveagents,cellswhicharevisibleundermicroscopy,andthesensitivityoftheorganismstovariousantibiotics.翻译任务五 查看病理报告 任务描述病理报告含患者的标本分析结果、微生物感染、显微镜下可见细胞和机体对各种抗生素的敏感性信息。Related InformationHow to deal with Pathology Reports by nursesNursesconsultPathologyReportsbeforegivingmedication.Theyrefertotheminordertocheckonresultsofspecimenswhichhavebeentested,andtocheckbloodresults,forexampleforanaemia.Basedonthereports,nursesareabletomakecorrectassessmentsforthecareoftheirpatients.翻译 Particularinterestistakeninthecaseofswabsorspecimenswhicharesuspectedofbeinginfectedbyso-calledsuperbugs,suchasMRSA,astheseinfectionsaredifficulttotreatandcanrepresentlong,costlystaysinhospitalforthepatient.Iftheresultisabnormalandthecaseisserious,nursesarerequiredtophonethedoctorimmediately.翻译相关信息 护士如何处理病理报告给药之前，护士会查询病理报告，核查已送检化验标本的结果，以及血液化验结果，如贫血。基于病理报告，护士对患者的护理能做出正确评估。尤其要关注怀疑被称之为超级细菌感染的药签或标本，如耐甲氧西林金黄色葡萄球菌，这些感染很难治疗且患者住院时间长，花费大。如果结果异常且情况严重，护士要立即电话告知医生。 MRSAMRSA(methicillin-resistantStaphylococcusaureus)istheacronymforanyofthe17strainsofStaphylococcusbacteriawhichareresistanttooneormoreantibiotics.ThetreatmentofMRSArequiresmuchhigherdosesofantibioticsthanusuallyprescribed.Thereisgreatconcernaboutthefutureofthetreatmentofsuperbugsasbacteriaseemabletomutateveryefficientlyandresistancetoantibioticsisincreasing.Over-useofantibioticsinthepast,oftencausedbyconsumerdemandforantibioticsforanyinfection,bacterialornot,mayalsohavecontributedtothemutationofdifferentstrainsofMRSA.翻译 耐甲氧西林金黄色葡萄球菌耐甲氧西林金黄色葡萄球菌是17株金黄色葡萄球菌中的任何一种细菌的首字母缩略，这些细菌对一种或多种抗生素有耐药性。治疗这些病菌比常用抗生素的剂量要高得多。未来超级细菌的治疗引起了极大关注，这些细菌似乎变异很快，对抗生素的耐药性正在增加。过去，人们发生感染，无论是否为细菌感染，都要求使用抗生素，这种过度使用促成了耐甲氧西林金黄色葡萄球菌不同菌种的变异。 A typical laboratory report Atypicallaboratoryreportisdividedintothefollowingsections:TheDiagnosisThisusuallyappearswiththebodysite,surgicalprocedure,andfinaldiagnosis.Examplesofsurgicalproceduresincludebiopsy,excision,andresection.翻译 典型的实验室报告 典型的实验室报告由以下几个部分组成： 诊断 这一部分通常包括解剖部位的描述、外科手术方式和最终诊断。外科手术的方式有活体组织病理检查、摘除术和切除术。 TheGrossDescriptionThisdescribestheactualappearanceofthetissuespecimenasviewedbythepathologistseyes.Apathologistsometimesdictatesasummaryofsectionswherethesiteofeachsampleoftissueisindicated.Notethatinsomecases,orientationofthespecimenisimportantifalatersurgicalprocedureoradditionaltreatmentisplanned.Thepathologistoftenutilizesspecialinksordyestomarkthemargins.Notealsothatmeasurementsandweightsaregiveninmetricterms.Thepathologistmaysubmitallofthetissueorifthetissueisverylarge,suchasauterus,representativesectionsmaybesubmitted.翻译 总体描述 此部分描述了病理学家眼睛看到的组织标本的实际外观。病理学家有时会概述各人体组织标本各截面的情况。有些情况下，若随后安排外科手术或额外治疗，标本定位非常重要。病理学家经常使用特殊油墨或染料在边缘空白处标记。也要注意测量其长度和重量的度量标准。病理学家可能会提交所有组织切面报告；如果组织非常大，如子宫，会提交具有代表性的切面报告。 TheMicroscopicDescriptionThemicroscopicdescriptionistherecordofwhatthepathologistviewsunderthemicroscope.Itisherewherethelanguagebecomeshighlytechnical.CommentSomepathologistsaddacommenttothediagnosis.Otherschosetointegratetheinformationinthecommentsectionwiththediagnosis.翻译 Eitherwayisacceptable.Thecommentsectionmayincludefurtherclarifyinginformationaboutthediagnosisorinformotherphysiciansthatotherstudiesarepending.Forexample,thetumorisgradedandthereaderisinformedthatadditionalstudiesforhormonereceptorshavebeenordered.Acommentaboutphysiciannotificationisalsoincluded.翻译 显微镜描述 显微镜描述是病理学家在显微镜下的观察记录，描述的语言具有高度的专业技术性。 意见 有些病理学家会对诊断给出意见。有些病理学家将意见和诊断放在一起。两种意见方式都可以接受。意见栏里包括需进一步明确诊断的信息或者告知医生其他待定检查意见，如确定肿瘤分级，通知查看之人要已追加激素受体的检查，诊断意见也包括对医生通知书的意见。 Discussion of the nursing topic1.AreyoufamiliarwithPathologyReports?2.Whatsortofinformationdotheycontain?3.Whendonursesrefertothem?4.AreyoufamiliarwithPathologyReportsonline,e.g.,onthehospitalintranet?5.Whenwouldanursephoneapatientsdoctoraboutapathologyresult?(Open) (Open) Pathology Reports contain information about the analysis of specimens, presence of infective agents, cells which are visible under microscopy, and the sensitivity of the organisms to various antibiotics.They are consulted before giving medications: to check on results of specimens which have been tested and to check blood results, for example, for anaemia. The nurses will phone the doctor if an abnormal result comes in, particularly if it is serious. Common patterns and questions when talking about the result of the Pathology Report1.Iameagertoknowabouttheresultof2.YourPathologyReporthasbeensenttotheward,andIvegotapapercopy.3.Well,couldyoutellmewhatisthereportfor?4.Thepurposeofthattestistoseewhetherthereisanyinfectionin5.Pathologyrefersto6.MicrobiologyisthestudyofPractice of the task (Ann, the ward nurse, is talking with Mr. Smith, a patient, about the result of his Pathology Report.)Ann: Illpullthecurtainsaroundsowecanhaveaprivatechatnow.Well,howareyoutoday,Mr.Smith?Mr.Smith:Imfine,butIameagertoknowabouttheresultofmyurinetestdoneyesterday.Ann: Well,thatswhatIcomeherefor.YourPathologyReporthasbeensenttotheward,andIvegotapapercopy.Wouldyouliketohavealookatit?Mr.Smith:Ofcourse,thanks.翻译(After a while)Mr.Smith:Idontquiteunderstandsomemedicaltermsinthereport.Couldyouexplainthemtome?Ann: Oh,itsmypleasure.Mr.Smith:Well,couldyoutellmewhatthereportisfor?Ann: Well,thestudyofdiseasesiscalledpathology.YoururinespecimenhasbeensenttothePathologyLaboratoryforCultureandSensitivityTest.Thepurposeofthattestistoseewhetherthereisanyinfectioninyoururinarytract,orinotherwords,toseewhetheryouvegotadiseaseornot,soitiscalledaPathologyReport.翻译Mr.Smith:Oh,Isee.Pathologyreferstothestudyofdiseases.Then,whatisthemeaningofmicrobiology?Ann: Microbiologyisthestudyofmicro-organisms,thatis,organismswhichcannotbeseenbythenakedeyes.Mr.Smith:Youmeanwecannotseethesubstancesintheurinewithournakedeyesbecausetheyaretootiny.Wehavetousemicroscopetodiscoverthem.Ann: Yes,thatsright.Weuseamicroscopetovisualizethepresenceofmicrobesinspecimens.Themethodiscalledmicroscopy.Aswecanseefromthereport,thepresenceofleucocytesanderythrocytesarevisualizedthroughmicroscopy.Mr.Smith:Yes,Inoticedit,butIhavenoideawhattheyrepresent.翻译Ann: Leucocytes,orwhitebloodcellscanindicateinfection.Iftheamountofwhitebloodcellsinyoururineiselevated,itreflectsthatyoumayhavegotaninfection.Mr.Smith:Soyoumean,elevatedwhitebloodcellscanrepresentinfectioninmyurine.Ann: Yes.Thatsright.Erythrocytes,orredbloodcells,differentfromleucocytes,transportoxygenintheblood.Theresultshowsthatyourerythrocytesareincreased,whichisabnormal.Mr.Smith:Oh,Igotit.Erythrocytesarealsocalledredbloodcellswhichtransportoxygenintheblood.Itdoesnogoodiftheyareincreased.翻译Ann: Andyouhavetopayattentiontobacteria1+here.ThepresenceofbacteriaintheurinestronglysuggeststhatyouhaveaurinarytractinfectionorUTIforshort.Mr.Smith:Well,Iknow.Whatsthemeaningbyantimicrobialshere?Ann: Medicationswhichattackmicrobesinthebodyarecalledantimicrobialdrugs.Theresultofyourantimicrobialsisnotdetected,whichistosay,youhadnottakenanyantimicrobialdrugsbeforeyoudidyourMSU.Mr.Smith:Thatsexactly.Ihaventtakenanydrugsbeforemyurinetest.Anotherquestion,whatsthemeaningofcultureinthisreport?翻译Ann: Thepathologistsfirstgrowthepopulationofmicrobesinalaboratoryandthenanalyzeit.Thisprocessiscalledculture.Microbes,whichincludevirusesandbacteria,areinfectiveagents.Mr.Smith:So,proteusmirabilisisakindofbacteriumthatisculturedbythepathologist?Ann: Yes.Andlookatthese.Ampicillin,cephalexin,trimethoprimandnitrofurantoinareallthenamesofantibiotics.Thereportshowsthatthebacteriainyoururineissensitivetosuchdrugs,whichmeansthedoctorcanstarttreatmentwithoneoftheseantibiotics.Mr.Smith:Oh,thankyouforyourcarefulexplanations.Now,IhavefullyunderstoodthisPathologyReport.ThepathologistmadeacommentthatImayhaveaUTI,andthedoctormaytreatmeusingoneofthesedrugs,likeampicillin.翻译 任务案例 （安是一位病房护士，正在同患者史密斯先生谈论病理报告的结果。）安：我把床帘拉上，这样我们现在可以私下聊聊。您今天感觉怎么样，史密斯先生？史密斯先生：我很好，但我很希望知道我昨天做的尿液化验结果。安：好的，这就是我来这里的原因。您的病理报告已经送到病房，我这里有一份打印本，您想看看吗？史密斯先生：当然了，谢谢！（过了一会儿）史密斯先生：我看不懂报告中的医学术语，你能解释一下吗？安：噢，很乐意啊。史密斯先生：好的，你能告诉我这份报告的目的是什么吗？安：好的，对疾病的研究称为病理学。您的尿标本被送往病理学实验室做培养和敏感性实验。实验的目的是为了查看您的尿道是否有感染，换句话说，查看您是否患有疾病，所以它被称为病理报告。史密斯先生：噢，我明白了。病理学是指对疾病的研究。那么，什么是微生物学？安：微生物学是对微生物的研究，也就是肉眼看不到的生物。史密斯先生：你的意思是因为尿液中的物质太小，我们肉眼看不到，得通过显微镜来发现它们。安：对的，我们使用显微镜来使标本里存在的微生物可见，这个方法称为显微法。从报告中我们可以看出，通过显微镜可见白细胞和红细胞。史密斯先生：是的，我注意到了，但是我不知道它们代表什么。安：白细胞表明感染，如果您尿中的白细胞数量升高，它反映您可能有感染。史密斯先生：所以，你的意思是白细胞升高代表尿中有感染。安：是的。红细胞与白细胞不一样，起到运输血液中氧气的作用。这份结果显示您体内的红细胞升高，属于异常。史密斯先生：噢，我明白了。红细胞运输血液中的氧气，如果升高就不好了。安：您注意看这里的细菌1+，尿中细菌的存在有力地证明了您患有尿道感染。史密斯先生：好的，我知道了。这里抗菌药物的意思是什么？安：对付体内微生物的药物被称为抗菌药物。抗菌药没有被检出，就是说，在留取中段尿标本前您没有使用任何抗菌药物。史密斯先生：完全正确，我在做尿液检验前没有服用任何抗菌药物。还有一个问题，报告中的培养是什么意思？安：病理学家首先在实验室里培养细菌的数量，然后加以分析，这个过程称为培养。微生物，包括病毒和细菌，是感染因子。史密斯先生：所以奇异变形杆菌是病理学家培养的一种细菌？安：是的，看这些，氨苄西林、头孢氨苄、甲氧苄啶和呋喃妥因以及相同名称的抗生素，报告显示尿中的细菌对这类药物敏感，意思是医生可以使用其中一种来开始治疗。史密斯先生：噢，谢谢你细心的解释，现在我完全看懂了这个病理报告。病理学家给出意见，我可能患有尿道感染，医生可能会使用其中一种药给我治疗，比如氨苄西林。A. Read the conversation above and answer the following questions.1.WhatisthePathologyReportfor?2.Whatkindoftestwasperformed?3.Whattypeofspecimenwascollected?4.Whatsthedefinitionofmicrobiology?A urine test Microscopy MSU Microbiology is the study of micro-organisms, that is, organisms which cannot be seen by the naked eyes. 5.Whatsthefunctionoferythrocytes?6.Whatdoyouthinkproteusmirabilisisthenameof?7.Whatkindofdrugsareampicillin，cephalexin，trimethoprimandnitrofurantoin?8.WhatcommentdidthepathologistmakeaboutMr.Smithsspecimen?Erythrocytes are also called blood cells which transport oxygen in the blood. A bacterium Antibiotics That it showed a possible UTI B. Use the statements (a-j) in the box to fill in the blanks (1-10) .a. he can start treatment with the antibioticb. transport oxygen in the bloodc. The population of microbes which is grown in a laboratoryd. indicate infectione. The presence of bacteriaf. The study of micro-organismsg. which include viruses and bacteriah. visualise the presence of microbes in specimensi. which attack microbes in the bodyj. The study of diseases 1.Elevatedleucocytes,orwhitebloodcells,can_.2.ThebacteriainMr.Smithsurineissensitivetoampicillin,so_.3._intheurinestronglysuggeststhatMr.SmithhasaUTI.4.Microbes,_,areinfectiveagents.5.Medications_arecalledantimicrobialdrugs.6._,thatis,organismswhichcannotbeseenbythenakedeyeiscalledmicrobiology.7.Redbloodcells,alsocallederythrocytes,_.8._iscalledpathology.9.Microscopyistheuseofamicroscopeto_.10._andanalysedbyapathologistiscalledaculture.daegifbjhcC.Use the following information to create a conversation, explaining the following Pathology Report to the patient, using the strategies for clarification and checking understanding.Mr.LondondidanMSUspecimenyesterday.Now,thenursehasgotapapercopyoftheresultofhisPathologyReport.Explaintothepatientwhatthereportisforandinterpretthemedicaltermsinthereport.Makesurethat,aftertheexplanation,thepatientunderstandswhatthereportisaboutandwhateachofthemedicaltermsstandsfor.Tellthepatient,accordingtothereport,hemighthaveaurinarytractinfection.Pathology ReportName: Jack LondonLab No.: 1594268 Micro No.: ABC258Collected: 17:30 21-Feb.-2012UrinemicrobiologyRegistered:07:12 22-Feb.-2012Specimen:MUSWardofcollection:14Microscopy:Leucocytes40106/LRR(10)Erythrocytes20106/LRR(10)Otherbacteria1+Antimicrobials: NotdetectedCulture:Proteus mirabilis10/LAmpicillinSensitive Cephalexin ensitiveTrimethoprim SensitiveNitrofurantoin SensitiveComment:PossibleUTITask 6 Giving an oral report of the case Read the following medical document and then complete the tasks.Attached Hospital and Medical Center47 Yuquan South Road，Xiaogan 432000 0712-2852116 PATIENT NAME: Bob Wells CASE NUMBER: 36457BTDATE OF BIRTH: 02/15/19XX DATE:03/17/20XXINPATIENT PROGRESS NOTEHospital for recurrent chest pain.HISTORY OF PRESENT ILLNESS: The patient has a long history of stable angina pectoris. He had a positive treadmill stress test in 1997. Thallium test in 1999 showed reversible ischemia. In June 1993 he underwent cataract surgery, and during his postoperative care he developed severe chest pain. An ECG at that time showed ischemic ST changes in the anterior leads. Subsequent coronary angiography revealed a 91% focal stenosis left anterior descending coronary artery. The patient then underwent angioplasty of this lesion. The 91% stenosis was dilated to a 22% stenosis. The patient had an uncomplicated course.Over the last 8 days the patient has had at least four episodes of chest pain, all relieved by rest or a single nitroglycerin tablet. He had an episode yesterday while repairing his chair, which lasted almost 5 minutes before subsiding after a second nitroglycerin table. He went to his cardiologist office yesterday. Eletrocardiography was performed, which showed marked anterior T-wave inversion in the anterior leads and he was immediately sent to this hospital for future evaluation. Atherogenic risk factors for his age include hypercholesterolemia and hypertension; he also smokes half a pack of cigarettes per day. He is not a diabetic. His family history reveals a sister who has had a coronary bypass graft.PHYSICAL EXAM:On exam today, blood pressure is 136/90. He has tachycardia with a pulse of 118. He is no acute distress. His lungs are clear and he has regular rhythm without a murmur. There is no edema or distention of neck veins.Joanna Smith , MDSignature任务六 口头汇报病人病情附属医院及医疗中心玉泉南路47号，孝感，432000 0712-2852116 患者姓名: Bob Wells 住院号: 36457BT出生日期: 19*年2月15日 日期: 20*年3月17日_病人住院进程记录胸痛复发住院现病史：病人长期患有稳定型心绞痛，1997年作过平板运动心电图测试，呈阳性。1999年同位素检查显示有可逆性局部贫血。1993年6月，做过白内障手术，术后出现严重胸痛。当时心电图显示前导联中缺血性ST段变化。随后做了冠状动脉造影，左冠状动脉前降支91%局限性狭窄。为此患者做了动脉整形术。91%的狭窄处被扩张到22%。患者获得预期效果。在过去八天里，病人经历四次胸痛，都通过休息或是服用硝酸甘油片剂得到缓解。昨天在修理椅子时犯胸痛，服用第二片硝酸甘油胸痛平息前，持续了五分钟。昨天看了心脏科医生，做心电图，发现前导联前T波倒置，立即住院作进一步检查。对于患者这个年龄，致动脉粥样硬化危险因素包括血胆脂醇过多和高血压。患者吸烟，每天半包。无糖尿病。有一妹妹，做过冠状动脉旁路移植术。体检：今检查，血压136/90mmHg。心动过速，脉搏118次/分。无急性面容。肺音清晰，心律正常无杂音。皮肤无水肿，无颈静脉曲张。医生：Joanna Smith , MD签名： A.Found out the words that you dont know in the medical document above and list them in the following chart. Look them up in the dictionary and write down their English definitions and Chinese meanings. An example is given.stable angina pectoris: a heart condition marked by paroxysms of chest pain due to reduced oxygen to the heart稳定型心绞痛 openB. Work in pairs to give an oral report to your partner.open