ANNO ACCADEMICO 2016-17: I ANNO – infermieri
Inglese Scientifico
Medical abbreviations (acronyms) V
1
2
3
4
5
6
7
8
9
10
11
12
13
Abbreviation/
acronym
FBC
FH
FOB
FUO
GA
GB
GCS
GP
GTN
GTT
GU
H2O
Hb / Hgb
Answers:
1d
2m
3i
4a
5k
6c
7l
8b
9g
10 e
11 j
12 f
13 h
Meaning
a
b
c
d
e
f
g
h
i
j
k
l
m
fever of unknown origin
General Practitioner
gall bladder
full blood count / fluid balance chart
glucose tolerance test
water
glyceryl trinitrate
haemoglobin
faecal occult blood
gastric ulcer
general anaesthetic
Glasgow Coma Scale
family history
14
15
16
17
18
19
20
21
22
23
24
25
26
14
15
16
17
18
19
20
21
22
23
24
25
26
Abbreviation/
acronym
HCA
HDU
Hep B
Hep C
HR
HS
HT
hypo
ICF
ICP
ICS
ICU
IDC
t
n
z
v
o
y
q
p
s
r
u
x
w
Meaning
n
o
p
q
r
s
t
u
v
w
x
y
z
high dependency unit
heart rate
hypoglycaemic attack
hypertension
Integrated Care Pathway
intracellular fluid
Health Care Assistant
intercostal space
hepatitis C
indwelling catheter
Intensive Care Unit
heart sounds
hepatitis B
ANNO ACCADEMICO 2016-17: I ANNO – infermieri
Inglese scientifico
Patient Records
Patient Records contain entries from every member of the patient’s team. As a nurse
you must read all entries in order to plan the patient’s care efficiently.
THE ALEXANDRA HOSPITAL
PATIENT RECORD
DATE & TIME
18.5.2008
22.30 hrs
Hosp. No: 732910
Forename(s): Livia
Surname: Smits
DOB: 10.12.1931
Sex: Female
Add signature, printed name, staff category, date and time to all entries
MAKE ALL NOTES CONCISE AND RELEVANT
Leave no gaps between entries
Mrs Smits c/o chest pain at 22.00 hrs. SHO informed. O2
administered via a mask. BP 220/100, P 120 at 22.05 hrs. SHO
ordered ECG, attended by nursing staff. GTN s.l. administered at
22.05 hrs, chest pain relieved within 2 minutes.
J. Keene (RN) KEENE
Complete the details reported during the hand over:
Mrs Smits _complained of_ chest pain at _10 pm_. The _Senior House Officer_
was informed. _Oxygen_ was administered via a mask. Her blood pressure was
_220 over 100_, and her _pulse_ was _120_ at _10.05 pm_. The _Senior
House Officer_ ordered an _electrocardiogram_, which was done by nursing staff.
_glyceryl trinitrate_ was given, with good effect. The chest pain was relieved within
_2 minutes (a couple of minutes)_.
Listen to the recording of the hand over and check that the answers are
correct.
ANNO ACCADEMICO 2016-17: I ANNO – infermieri
Inglese scientifico
Patient Records
THE ALEXANDRA HOSPITAL
PATIENT RECORD
DATE & TIME
02.03.09
21.00 hrs
Add signature, printed name, staff category, date and time to all entries
MAKE ALL NOTES CONCISE AND RELEVANT
Leave no gaps between entries
Mrs Oondahi appears to be breathing comfortably at the time of
the report and is quite settled. RR is 16, not laboured. O2 @ 3 L/min
via nasal cannulae. Pt lying on two pillows. Pain relieved by
morphine via continuous s.c. infusion. Pain rated at 1/10 at 20.30
hrs. Pt states she is comfortable. Family in attendance all shift.
Husband and children will stay overnight with her.
D. Simpson (RN) SIMPSON
THE ALEXANDRA HOSPITAL
PATIENT RECORD
DATE & TIME
11.00
28/03/08
Hosp. No: 399429
Forename(s): Fatima
Surname: Oondahi
DOB: 05.09.1948
Sex: Female
Hosp. No: 593712
Forename(s): Ronald
Surname: Wilmott
DOB: 15.09.1922
Sex: Male
Add signature, printed name, staff category, date and time to all entries
MAKE ALL NOTES CONCISE AND RELEVANT
Leave no gaps between entries
New admission to the ward with a diagnosis of poorly managed
asthma. Recent URTI treated with antibiotics. Pt. still c/o SOB.
RR elevated. For CXR and review by Respiratory Team in am.
Started on p/f readings and Pt ed. regarding asthma
G. Delaney (RN) DELANEY
ANNO ACCADEMICO 2016-17: I ANNO – infermieri
Inglese scientifico
Patient Records
THE ALEXANDRA HOSPITAL
PATIENT RECORD
Hosp. No: 619237
Forename(s): Fred
Surname: Cummins
DOB: 17.02.1955
Sex: Male
DATE & TIME
Add signature, printed name, staff category, date and time to all entries
MAKE ALL NOTES CONCISE AND RELEVANT
Leave no gaps between entries
20.05.2008
15.30 hrs
Mr Cummins was hypertensive this am. BP elevated to 180/100
and P 86 at 10.00 hrs. c/o headache. Pt. stated he had no chest
pain. Given paracetamol 1 g with good effect. Headache relieved.
BP checked at 10.30 hrs. BP decreased to 150/85, P 77.
S. Stottle (RN) STOTTLE
THE ALEXANDRA HOSPITAL
PATIENT RECORD
Hosp. No: 213498
Forename(s): Polly
Surname: Lancaster
DOB: 14.06.1942
Sex: Female
DATE & TIME
Add signature, printed name, staff category, date and time to all entries
MAKE ALL NOTES CONCISE AND RELEVANT
Leave no gaps between entries
20.05.2008
21.00 hrs
Mrs Lancaster had a restless night. c/o chest pain at 02.15 hrs.
Night SHO called. BP 215/105, P 92 at 02.20 hrs. ECG ordered and
attended by nursing staff. O2 via mask and GTN administered. BP
dropped to 180/86, P 82 at 02.40 hrs. No c/o further chest pain.
L. Knight (RN) KNIGHT
ANNO ACCADEMICO 2016-17: I ANNO – infermieri
Inglese scientifico
Pain Scales
ANNO ACCADEMICO 2016-17: I ANNO – infermieri
Inglese Scientifico
Medical abbreviations (acronyms) VI
1
2
3
4
5
6
7
8
9
10
11
12
13
Abbreviation/
acronym
IDDM
i.m. / IM
INR
in situ
IU
i.v. / IV
IV Abs
IVC
IVT
K
KCl
L
L/L
Answers:
1e
2i
3a
4m
5b
6l
7d
8j
9c
10 k
11 h
12 f
13 g
Meaning
a
b
c
d
e
f
g
h
i
j
k
l
m
international normalised ratio
international unit
intravenous therapy
intravenous antibiotics
insulin-dependent diabetes mellitus
left
litres per litre
potassium chloride
intramuscular
Inferior vena cava / intravenous cannula
potassium
intravenous
in place
14
15
16
17
18
19
20
21
22
23
24
25
26
14
15
16
17
18
19
20
21
22
23
24
25
26
Abbreviation/
acronym
LA
lap. chole
LOC
LV
M/F
mane
mcg
mg
MI
mL
mmol/L
MRI
MRSA
q
z
t
o
x
p
n
y
s
r
v
u
w
Meaning
n
o
p
q
r
s
t
u
v
w
x
y
z
microgram (microgramme)
left ventricle
in the morning (Latin)
left atrium / local anaesthetic
millilitre
myocardial infarction
level of consciousness
magnetic resonance imaging
millimoles per litre
methicillin-resistant Staphylococcus aureus
male/female
milligram (milligramme)
laparoscopic cholecystectomy (gall bladder)
ANNO ACCADEMICO 2016-17: I ANNO – infermieri
Inglese scientifico
Regional and directional terminology
ANNO ACCADEMICO 2016-17: I ANNO – infermieri
Inglese Scientifico
Listen to Emily, a Ward Nurse, handing over a patient, Mrs Cho.
Answer the following questions:
1. What is Mrs Cho’s present medical problem?
A. Myocardial infarction
C. High blood pressure
B. Low blood pressure
D. Uncontrolled diabetes
2. What was Mrs Cho’s past medical problem?
A. Myocardial infarction
C. High blood pressure
B. Low blood pressure
D. Uncontrolled diabetes
3. Mrs Cho is in bed number 6?
YES
NO
4. Can Mrs Cho manage her ADLs at home by herself?
YES
NO
5. Has Mrs Cho been depressed?
YES
NO
6. Was Mrs Cho’s medication changed before?
YES
NO
7. Was Mrs Cho’s BP at 10 am 200/105
YES
NO
8. Was Mrs Cho’s pulse 88 at 10 am?
YES
NO
9. Was Mrs Cho given oxygen by cannulae?
YES
NO
10. Is Mrs Cho going home tomorrow?
YES
NO
Listen to Emily again and check your answers:
Emily: Right, now Mrs Cho in bed number 5. Mrs Cho was readmitted yesterday
because of uncontrolled hypertension. You’ll probably remember her from last
week. She went home, but couldn’t manage her ADLs by herself. Her daughter
had to come in every morning to give her a shower and help her during the day.
She’s been quite depressed about it, according to her daughter. She presented to
the Unit with uncontrolled hypertension, despite a change in medication. She has a
past history of MI this year in June. Um… this morning she complained of chest pain.
The SHO was called. Her BP at the time… er, that was at 10 am… was 210 over
105, and her pulse was 100. She had an ECG done, and was given GTN
sublingually. We gave her some O2 via the mask, and she seemed to settle. She’s in
for cardiac catheterisation tomorrow to assess the extent of the damage to her
heart. I’ve booked the porter already. Strict fourth hourly obs., BP and pulse, and
report any chest pain immediately, of course. She’s had no chest pain this shift.
ANNO ACCADEMICO 2016-17: I ANNO – infermieri
Inglese Scientifico
Listen to Jenny, a Ward Nurse, handing over a patient, Mrs Small.
Answer the following questions:
1. Was Mrs Small admitted just after 2 am the day before?
YES
NO
2. Was Mrs Small admitted with poorly managed hypertension
YES
NO
3. Does Dr. Fielding want to take Mrs Small off all of her drugs?
YES
NO
4. How long will Mrs Small be in hospital for?
A. Two days.
B. Three days.
C. Four days.
D. Five days.
5. Was Mrs Small hypertensive on admission?
YES
NO
6. Was Mrs Small’s BP 173 over 101 at 6 am yesterday?
YES
NO
7. Did Mrs Small have chest pain that morning?
YES
NO
8. What did Dr. Fielding come to see her about?
A. Her admission to the ward.
C. Her low blood pressure.
B. Her discharge from the ward.
D. Her chest pain and high blood pressure.
9. Did Jenny do Mrs Small’s ECG?
YES
NO
10. What did Jenny do just before the handover?
A. She called Dr. Fielding.
C. She did Mrs Small’s ECG.
B. She did Mrs Small’s Obs. again. D. She gave Mrs Small GTN sublingually.
Listen to Jenny again and check your answers:
Jenny: All right, now I’ll just let you know about Mrs Small’s BP. As you know, she
was admitted just before 2 am yesterday with poorly managed hypertension.
She’s quite elderly and trying to manage at home, but the previous medication wasn’t
working well for her at all. Dr. Fielding wants to put her on something else and
wants to monitor her blood pressure in hospital over 3 days. If you look at her Obs.
Chart from yesterday, you’ll see that she was quite hypertensive on admission. BP
was 173 over 101, pulse 86. At 6 am her BP was about the same, 175 over 90,
and pulse 76. During the morning shift at 10 am, she shot up to 210 over 130, with a
pulse of 112. She had some chest pain too. Dr. Fielding came up to see her about
the chest pain and high BP. He did all of the usual things for her ECG, GTN
sublingually, and she settled a bit by 2 pm. By 2, her BP was 195 over 90, and her
pulse was 97. I took her Obs. again at 3 pm, just before handover. She’s gone
down to 180 over 85, with a pulse of 86. Dr. Fielding’s happy with that, but just keep
an eye on her, will you?
Jenny has also completed the Observation Chart for Mrs Small:
Observation Charts
Observation Charts are records completed by the nursing staff when they undertake
observations of patients, which include the date and time, and the observations, such
as patient temperature, pulse, respiration rate, and blood pressure, in order to
monitor the patient’s care efficiently. The charts can also include comments where
relevant, and must be signed by the member of staff who carries out the
observations.
THE ALEXANDRA HOSPITAL
OBSERVATION CHART
Date
Time
4/3/08 02.00
T
Hosp. No: 324710
Forename(s): Gladys
Surname: Small
DOB: 15.11.1935
Sex: Female
P
86
R
18
BP
173/101
4/3/08 06.00 364 75
4/3/08 10.00 364 100
18
175/95
20
210/120
J. Hardcastle (RN)
4/3/08
14.00
36
4/3/08
15.00
36
3
36
Comments
Sign name
J. Plant (RN)
J. Plant (RN)
3
95
18
185/90
J. Hardcastle (RN)
4
76
16
170/85
J. Hardcastle (RN)
However, she also made some mistakes in the Observation Chart.
Listen again to Jenny, and correct the mistakes in the Observation Chart
above.
Jenny: All right, now I’ll just let you know about Mrs Small’s BP. As you know, she
was admitted just before 2 am yesterday with poorly managed hypertension. She’s
quite elderly and trying to manage at home, but the previous medication wasn’t
working well for her at all. Dr. Fielding wants to put her on something else and wants
to monitor her blood pressure in hospital over 3 days. If you look at her Obs. Chart
from yesterday, you’ll see that she was quite hypertensive on admission. BP was 173
over 101, pulse 86. At 6 am her BP was about the same, 175 over 90, and pulse 76.
During the morning shift at 10 am, she shot up to 210 over 130, with a pulse of 112.
She had some chest pain too. Dr. Fielding came up to see her about the chest pain
and high BP. He did all of the usual things for her ECG, GTN sublingually, and she
settled a bit by 2 pm. By 2, her BP was 195 over 90, and her pulse was 97. I took her
Obs. again at 3 pm, just before handover. She’s gone down to 180 over 85, with a
pulse of 86. Dr. Fielding’s happy with that, but just keep an eye on her, will you?
ANNO ACCADEMICO 2016-17: I ANNO – infermieri
Inglese scientifico
The locomotive system
(to accompany the DVD of Body Worlds)
An essential vital function of the body is movement. It is made possible by our
locomotive system, which consists of bones, muscles and joints. The bones taken as a
whole, namely the skeleton, form the internal framework of the body. With its more
than 200 bones and 100 articular joints, it provides the body with stability, support
and flexibility.
Each joint is enclosed by a membranous capsule that stabilises it. We can find
cartilage wherever elasticity is required by the skeletal system, for example, in the
area of the sternum. Here the cartilage permits the rising and falling movements of
the thorax during breathing.
The surfaces of joints are also covered with cartilage. This reduces friction. Here we
see a bent knee joint. The surface of the cartilage is as smooth as glass. If we look
deeper, we see the cruciate ligaments; here the outer collateral ligaments, and here
the inner and outer meniscus. If the joint is arthritic, the cartilage will be increasingly
lost, either through inflammation or wear. This knee joint already shows severe signs
of abrasion on the on the articular surfaces. Knee and hip joints are especially prone
to arthritis, because they are subjected to stress caused by individual’s body weight,
and to severe wear during the course of a lifetime. In more extreme cases, a worn out
joint can be replaced by a prosthesis. A prosthesis is designed to emulate the natural
joint in form and angle of inclination. It is cemented into the bone by means of a long
shaft, and is usually made of stainless steel, titanium or Teflon.
Nearly every bone has a hard compact outer zone, or cortical substance, and a core of
spongy bone, or trabecular. The latter is configured according to physical demands,
and forms lines of tension depending on the force of pressure and contraction. This
structure lends bones substantial stability, while at the same time remaining
lightweight. The human skeleton only weighs an average of 10 kg; nevertheless, it is
stronger that reinforced concrete of the same size, that will probably weigh four to
five times as much.
Bone fractures can heal well, thanks to the unique capacity of bones to regenerate.
However, to mend properly, the bone fragments have to be securely immobilised, so
that they cannot move. For this reason, with bone fractures, stainless steel screws,
wires and plates are frequently used to join the fragments firmly, as can be seen in
this exhibit. Surgical spreaders serve to keep soft tissue away from the bones during
an operation. With complicated fractures, external fixators are used, such as shown
here in the lower leg, and here in the wrist section. The screws are secured to the
bone through the skin.
On the right side of the chest, we can see a pacemaker. The electrode of the
pacemaker is inserted from behind the collarbone into a vein, until it reaches the
heart, where it is secured. At the back of this specimen, we can see an operation on
the spinal column. Two neighbouring vertebrae have been fused together with the aid
of screws and connection pieces. Such surgical procedures are sometimes necessary
with slipped discs.
Bone disease can affect the entire organism. This severe deformation is usually
caused by a hereditary dysfunction of bone formation. The internal organs have to
adapt their shape and dilation to the unusual form of the torso.
Contractions performed by individual muscles that are attached to the bones set the
skeleton in motion. These two specimens stem from one and the same body. The
skeleton has been removed, while the muscular system has been displayed
separately. Skeletal muscles generally have a broader, more fleshy, origin and bridge
one or more joints from one end to the other. They transmit their pulling power to the
bones via strong inelastic tendons.
This body shows once again the two systems of the locomotive system separately
from one another; namely, in one half of the body the muscular system, and the
skeletal system in the other half. Moreover, this half allows us to see the internal
organs. We can clearly see that the lung has been blackened by years of smoking.
(music)
ANNO ACCADEMICO 2016-17: I ANNO – infermieri
Inglese scientifico
The nervous system
(to accompany the DVD of Body Worlds)
A fine network of nerve fibres extends from head to toe. These nerve fibres monitor
and regulate all of the bodily functions. They emerge directly from the brain, or from
the medulla oblongata, and branch out to the rest of the body in ever-finer nerve
fibres. They transmit information in the form of weak electrical signals.
The brain is the body’s control centre that regulates every though and nearly every
movement. It processes sensory impulses, and enables us to have consciousness,
feelings, memory and language. This exhibit has been given the position of a pensive
chess player, because it shows how the human organism has been innervated. The
pose is intended to highlight the particular character of this plastinate, its anatomical
identity. The aesthetic impression we get is indeed intentional. The reason is that the
results of plastination should at the same time appeal to both the mind and the
emotions. That is, it should impart knowledge, and awaken in us an awareness of
Nature.
In this opened cranial cavity, we can see the cerebrum; below it, the cerebellum,
which is responsible for coordinating our movements and our sense of balance. The
spinal cord is connected to the brain. The peripheral nerves emanate from the spinal
cord, and extend from there to the muscles. From the lower part of the spinal cord,
the sacral nerves run down to meet in bundles to form the sciatic nerve. This in turn
extends over the ileum, and along the posterior part of the thigh, where it branches
again in the popliteal space behind the knee.
When we fold back the cheek bone and temporalis, or temporal muscle, we can see
the cranial nerves emanating from the brain. Here is the trigeminal nerve, as it leads
to the eye, as well as to the upper and lower jaws. It also supplies the mucus
membrane of the upper jaw orifice, shown here exposed, which is often a source of
inflammation.
The brain lies in the cranial cavity, like a walnut in its shell, completely protected from
mechanical influences on all sides. Just under the cranium, there is the cerebral
cortex, whose numerous convolutions and recesses extend well into the white matter.
In a cross-sectional brain slice, the grey matter of the cerebral cortex and basal
ganglia can easily be distinguished from the white matter. Grey matter consists of
nerve cells that emit and process impulses. White matter is nerve tissue, consisting
chiefly of nerve fibres. Inside the brain, there is a complex system of cavities, in which
fluid circulates. Here beneath the corpus collosum, we can look into the right lateral
cavity, and the third and fourth ventricles. This fluid serves as a shock absorber to
withstand the jolts to which the brain is often subjected.
When normal flow is obstructed, the fluid congests in the ventricles, and causes them
to become distended. With babies, such obstructions can also cause the skull to
enlarge abnormally, because at this age, the sutures of the skull have not yet
completely ossified. In such cases, it is referred to as water on the brain, or
hydrocephalis. The obstructions are usually caused by congenital malformation,
inflammatory processes, or as in this case, bby tumour growth.
The brain only accounts for about 2% of total body weight, but it requires 20% of the
total blood supply. If the flow of the blood to the brain were to interrupted for only 10
seconds, we would lose consciousness. In this brain, we can see a massive
haemorrhage, resulting from a stroke. The blood permeates the brain matter, and in
conjunction with the region affected by the stroke, dysfunctions can occur, such as
loss of speech or paralysis. Should vital centres be affected, a stroke can also be fatal.
Strokes account for 15% of all deaths.
On this frontal brain slice we can also see a deep black haemorrhage caused by a
stroke, especially on the right hemisphere.