Nursing: Учебное пособие

77 Pages·2018·1.638 MB·Russian

by  Коллектив авторов

БИБЛИОТЕКА ПЕДИАТРИЧЕСКОГО УНИВЕРСИТЕТА

NURSING

Санкт-Петербург

0
Министерство
здравоохранения
Российской Федерации

Санкт-Петербургский
Государственный
Педиатрический
NURSING
Медицинский
Университет

Учебное САНКТ-ПЕТЕРБУРГ
пособие 2018

УДК 614.253.52
1
ББК 51.1(2)
С75

С75 Nursing. Учебное пособие. – СПб.: СПбГПМУ, 2018. – 76 с.

ISBN 978-5-6040615-3-4

Учебное пособие “Nursing” предназначено для работы по подготовке обучающихся в
рамках специальности «Сестринское дело» и направлено на развитие способности к
коммуникации в устной и письменной формах на иностранном (английском) языке для
решения задач взаимодействия на профессиональном уровне, а также способности к
самоорганизации и самообразованию.
Целью данного пособия также является формирование навыков самостоятельной работы
аудиторного и внеаудиторного планов, в связи с чем в данном учебном пособии
представлены различные возможные виды самостоятельной работы, применяемые в рамках
образовательного процесса по обучению иностранному (английскому) языку на
профессионально ориентированном этапе освоения дисциплины.
Т.о. соблюдается основная идея дидактики по подразделению видов самостоятельной
работы на три группы: работа по приобретению новых знаний, работа по приобретению
навыков и умений, работа по приобретению знаний, навыков и умений.
Структура пособия подразумевает последовательность комплексности, что позволяет
использовать его при работе с обучающимися разноуровневого формата подготовки.

Составители: заведующая кафедрой иностранных языков с курсом русского языка
Санкт-Петербургского государственного педиатрического медицинского университета,
кандидат филологических наук, доцент И.И.Могилёва; старшие преподаватели кафедры
иностранных языков с курсом русского языка Санкт-Петербургского государственного
педиатрического медицинского университета М.Ю.Дайнеко, Н.А.Мордвинова.

Рецензент: доцент кафедры немецкой филологии Российского государственного
педагогического университета имени А.И.Герцена, кандидат филологических наук, доцент
Н.В.Пигина.

Ответственный редактор: заведующая кафедрой иностранных языков с курсом
русского языка Санкт-Петербургского государственного педиатрического медицинского
университета, кандидат филологических наук, доцент И.И.Могилёва.

УДК 614.253.52
ББК 51.1(2)

Утверждено учебно-методическим советом Государственного бюджетного
образовательного учреждения высшего профессионального образования
«Санкт-Петербургский государственный педиатрический медицинский
университет» Министерства здравоохранения Российской Федерации

ISBN 978-5-6040615-3-4 © СПбГПМУ, 2018
TEXTS FOR TRANSLATION & DISCUSSION
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I) THE WORK OF A NURSE

1) YOU MUST BE PROUD – YOU ARE A NURSE

The nurses are present at the time of birth and sometimes present when the
person dies. Their whole life is devoted to people. They are responsible for what they
do. They are responsible for what they advise others to do.
The nurses are to have enough knowledge of their work. They should read
medical journals. They are to help their patients at any hour of the day or night. They
must care for the patient even if he has a mortal infectious disease. All patients need
their help, care, patience. And all nurses should follow the moral rules that direct
them in their work and remember the words of Hippocratic Oath: “…I will enter to
help the sick people … but never injure them.”

2) THE WORK OF A NURSE

Every nurse must remember that there are no two identical persons and that
every patient will react to illness in his own way.
That’s why the doctors and the nurses look for new methods of treatment and
new medicines every day.
If the nurse gives the patient a new medicine this patient must be under special
care of the doctor and the nurse.
The observation of the nurse is very important. Careful observation can give
very important information. It will help the doctor make a correct diagnosis and treat
the patient properly.
By the way, research work is carried out not only in laboratories but also in the
wards of the hospitals. Every attentive nurse is a member of the clinical research
team.
The nurses shouldn’t forget about some rules.
Giving medicine they must:
1) Wash the hands.
2) Read carefully the doctor’s instructions.
(Be sure of drug, dose, time, method of giving)
3) Not to substitute one drug for another.
4) Address patients by name not to be mistaken.
5) If the nurses have made a mistake they are to tell the doctor at once.

3) NURSES’ WORK

Those nurses who work at the polyclinics and hospitals have many duties they
are responsible for:
 They help doctors to fill in patients’ cards;
 They note general information about patients;
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 They write down the patient’s name, age, place of work, telephone
number, occupation, address;
 They take notes of the vital signs (patients’ tº, blood pressure …);
 They fill in referral forms for laboratory analyses (tests);
 They take (draw) patient’s blood for analyses;
 They make appointments for the patient’s next visit;
 They carry out various medical procedures prescribed by the doctors;
 They make various tests at the laboratories;
 They give patients injections and infusions at the hospitals;
 They help surgeons dress wounds;
 They give patients drugs which they keep in special drug cabinets.

4) OUR BEST WARD NURSE

I think that Vera Ivanovna is the best ward nurse. She has been working at our
hospital for many years and everybody respects her very much. In the morning she
always comes into the ward with a smile on her face and every patient, when he sees
her kind smile, feels better. Everything she does in the ward she does quickly and
quietly. If there is a bed-patient in the ward Vera Ivanovna comes up to him at first.
She brushes his sheets or changes them if necessary and shakes the pillow. Then she
brings a basin and washes the patient’s face and hands. The nurse is especially patient
with old people. She makes injections and gives infusions. Vera Ivanovna never hurts
her patients with a rude word, always controls her feelings and nobody heard the
word “incurable” from her. The doctors say “When Vera Ivanovna is at work we
don’t worry. We are sure that everything will be all right.”

II) NURSES OF DIFFERENT INSTITUTIONS

1) I WORK AS A NURSE AT THE HOSPITAL

Many doctors and nurses work at our city hospital. It is very large. The work at
the hospital starts at 6 o’clock in the morning. The nurses begin to take the
temperature of the patients at 6 o’clock. They write it down in the temperature charts.
Then the nurses read the orders of the doctors, give the patients medicines and carry
out the prescriptions of the doctors. They open the windows and air the wards. The
doctors come at 9 o’clock in the morning and begin to examine the patients. Each
ward nurse tells the doctor about her patients. As I am a ward nurse the doctor asks
me about the condition of my patients. Usually I’m glad to tell him that they are well.
But sometimes I have to inform the doctor that the temperature of some of the
patients is high and the doctor prescribes them some new medicines or injections. I
like my profession very much. I know that a lot of the nurse’s work can be learnt by
practice. So I am very attentive and try to observe any changes in a patient’s
condition. But if I make a mistake in my work I go and tell the doctor about it at
once.
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2) I WORK AS A WARD NURSE AT THE CHILDREN’S HOSPITAL

I watch carefully for any changes in the condition of my little patients,
especially for their temperature. I start my working day taking their temperature early
in the morning. I know that a raised body tº of over 38ºC (100ºF) for a child is
abnormal. If the child has fever his body tº will be higher than normal and there may
be sweating. Fever is the body’s natural reaction, it helps the patient fight the
infection. But he may lose a lot of fluid. I must be sure that the ill person has enough
to drink and I am to follow it. I open the window to let some fresh air in, I try to
sponge his body with warm water. I try to do my best. But if the child is not
comfortable, feels listless, vomits or has diarrhea I contact the doctor for advice
immediately.

3) THE WORK OF A LABORATORY ASSISTANT

My boy-friend works at the hospital laboratory. A laboratory assistant must
remember that bacteria with which he is working can produce a lot of diseases. So he
should be very careful when he works with cultures, slides (предметные стёкла) and
all material that may be in contact with living microorganisms.
When he works at the laboratory he should remember the following rules:
1) Microscope slides and cover slips (покровные стёкла) should be put into
disinfectant solution.
2) The laboratory assistant must wear a laboratory coat.
3) He must not moisten labels with the tongue.
4) It is not allowed to eat, drink or smoke in the laboratory.
5) He is to sterilize inoculating needles before and after using.
6) He has to heat them in the flame until red hot.
7) He must always keep test-tubes with cultures in test tube racks (штативы).
8) His hands are to be washed before leaving the laboratory.

4) THE WORK OF A SURGICAL NURSE

When the ambulance brings the patient to the reception ward the nurse-on-duty
records the patient’s initial data.
Two nurses-on-duty wheel the patient on the buggy to the operating room. The
surgical nurse is getting sterile gowns and dressings ready, sterilizing the necessary
set of surgical instruments, preparing the apparatus for blood transfusion, checking up
the presence and state of blood substituting solutions and preserved blood.
The surgical nurse must prepare sterile gowns, dressings and instruments
beforehand. The nurse makes a thorough cleaning of the wound and then puts a
dressing on it. Scalpel, pincers and clamps are the most necessary surgical
instruments. The nurses help the surgeons get ready for the operation. The surgeons
and nurses bare their arms above the elbow, scrub their hands with soap and brush
them under hot running water. Then they rinse their hands twice in a disinfection
solution. After that they sponge the hands with alcohol and paint nails with iodine.
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The nurses help the doctors put on sterile caps and masks and rubber gloves.
The nurses give premedication under the guidance of doctors. The nurses are to
follow the patient’s postoperative course to be satisfactory and uneventful.
When the edges of the patient’s wound are suppurative the nurse washes the wound
with the solution of antibiotics and introduces the solution of antibiotics and dresses the
patient’s surgical wound. The nurse puts a new outer bandage on the wound.

5) THE WORK WITH PREMATURE INFANTS

The staff of every maternity home which includes physicians well acquainted
with anatomo-physiological distinctions of the newborn and trained pediatric nurses
is fully responsible for the health of all newborn babies. Special care is given to
babies who have sustained birth injuries, or who have been born with asphyxia or
prematurity.
An infant that is born earlier than 280 days after conception is considered to be
premature or preterm infant. Prematurity may result from maternal diseases, artificial
abortions and hard physical work.
The main characteristic features of prematurity are birth weight less than 2,500 g;
crown-heel length less than 45 cm; unproportionally large head; open posterior and
lateral fontanels; skin covered with lanugo. The immunological defences of premature
infants are insufficient, and due to it their resistance to infections is decreased.
There are special wards for premature babies at every maternity home where
particular care is taken of these babies. Usually three hot-water bottles are placed at
the infant’s feet and sides. The bath of the premature baby should be no cooler than
38-39°C, and the room temperature not lower than 20°C. If the premature baby does
not take breast he is given breast milk in a bottle.
According to some authors premature infants with birth weights of
approximately 1,500 g sometimes manifest a certain delay in both growth and weight
for quite a long time. However, investigations carried out by the staff of the Pediatric
Institute of the Russian Academy of Medical Sciences have proved that with
sufficient nutrition and proper care even infants born long before term soon catch up
with full-term babies and subsequently do not differ from them.

6) THE WORK OF A DOCTOR

When a person is ill and his condition is not very poor he goes to the polyclinic.
Many specialists work there …. He goes to the physician. The doctor asks him about
his complaints and examines him. He listens to his heart and lungs, takes his tº, pulse,
measures his blood pressure, examines his throat and makes the initial diagnosis. But
to confirm the diagnosis the physician refers the patient to the laboratory (to make
analyses of blood and urine), X-ray, ECG and administer the proper treatment. He
fills in the patient’s card (case history, medical record). The physician prescribes the
treatment, recommends the patient to remain at home and stay in bed. The patient
receives a sick leave, if necessary, follows the doctor’s recommendations and
recovers soon.
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BASIC NURSING SKILLS

1) HOW TO TAKE THE PULSE

A nurse looks after her patients in the daytime or at night and can see any
changes in the patients’ condition. Many of them are very significant. The nurse must
be very careful when she takes the patient’s pulse. It is not difficult to take the pulse.
The nurse is to put three fingers of the left hand over the radial artery. Many patients
are nervous when they see a nurse or a doctor and the patient’s pulse is faster as a
result. That’s why the nurse must wait a few seconds before she begins to count the
pulse. If the nurse sees any irregularity in the beating of the pulse she is to tell the
doctor immediately about it. Changes in the pulse are very important and the nurse
must be able to see any changes in its beating. The nurse has to note the rate, the
rhythm, the strength of the beating and whether it is deep or shallow.

2) TAKING THE BLOOD PRESSURE

Blood pressure (BP) is the pressure of the blood in the arterial wall. The blood
pressure may be normal, high and low. The normal BP is between 110-140 (the
systolic pressure) over 70-90 (the diastolic pressure). When the nurse checks
patient’s BP she should think of his (or her) age. If a person of 20 has a blood
pressure of 140-150 it is dangerous. And the nurse must immediately take care of
such a patient. But if the same BP has a person of 50 it is not dangerous.
If a person has hypertension he may often complain of headaches, nose
bleeding, heart aches. The doctor, as a rule, prescribes him hypotensive drugs. High
blood pressure often frightens the patient. The nurse can try to calm him.
Hypotension or low BP may be caused by different conditions (anemia, great
fatigue). In all cases it is very serious and the nurse must be very attentive to the
patient.

3) HOW TO START INTRAVENOUS LINES (IV)

Nurses must learn how to deliver IV therapy or Intravenous Therapy correctly
because if they do not, they are putting the lives of their patients in danger. The process
of using intravenous lines involves injecting liquids into the veins. Many nurses use a
drip chamber so that air does not enter the patient’s blood stream. IV lines are used for
medication delivery, blood transfusions, electrolyte imbalance correction, and fluid
replacement. It is so important that nurse know how to use IVs because in some cases
the use of IVs is the only way to administer certain medications and to perform
procedures such as lethal injections and blood transfusions.
Steps on How to Start an IV
Nurses should use the following steps to start an IV:
1. The first step in the process is to find a good vein to insert the IV. The large
vein located in the bend of the elbow is most often used, but nurses can also find
good vein sites on the forearm, feet, scalp, hand, and wrist if necessary.
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2. Have a fellow nurse prepare the tubing and the fluid bag while the nurse that
will insert the IV prepares the sight.
3. The nurse should now apply a tourniquet just a few inches above the site,
securing it for easy removal after inserting the catheter.
4. Make sure that the vein is secure and wipe the area with an alcohol pad.
5. Now is the time to choose a catheter size. Children and the elderly generally
use a smaller catheter, but an 18 gauge should work for most patients. Nurses should
use larger gauges in emergency situations.
6. Carefully remove the cap on the catheter with one hand, and tightly pull the
skin around the IV site with the free hand. Keep the catheter as parallel to the skin as
possible and insert the needle. A hint of blood in the catheter’s applicator will
indicate that the nurse hit the vein directly, and he or she should continue to advance
the catheter.
7. While still advancing the catheter, the nurse should now remove the catheter
according to the manufacturer’s instructions. Do not forget to secure the needle for
the safety of everyone involved.
8. Remove the tourniquet to prevent discomfort and tissue death.
9. Using the fingers, apply pressure to the vein just above the catheter so that
back bleeding does not occur.
10. The nurse should now apply tape to the area around the catheter while
attaching the IV tubing.
11. Open the IV line and fluid should be dripping into the chamber if the
process was successful. Look for leaking and swelling at the IV site. If this occurs,
the process was unsuccessful.
12. Additional secure the IV line with additional tape. Nurses should adjust the
drip rate accordingly for the patient.

4) HOW TO DRAW BLOOD

As nurses enter the clinical setting, they will have to know how to draw blood as
part of their clinical skills experiences. It may be necessary to draw a patient’s blood
for a number of reasons, and it is necessary to draw blood from patients in a manner
in which does not cause them any pain or complications.

Introduction on the Purpose of Drawing Blood
There is no way that nurses will be able to get around drawing blood during
their clinical skills nursing experiences. The process of drawing blood may look
easier than it is, but there is a precise manner in which to draw blood from patients.
The process of drawing blood can be very dangerous for patients when their nurse
lacks precise blood drawing skills. Taking the proper steps to draw blood protects the
health and safety of patients and the nurse assigned to draw their blood. A successful
blood drawing begins with a nurse using precision in their blood drawing skills.

Steps on How to Draw Blood
1. Place on a sterile pair of gloves before drawing the patient’s blood.
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2. Make sure that the patient is completely comfortable. Ask the patient a series
of questions to verify his or her identity. After checking the identifying information
against the information provided by his or her doctor, use the identification
information to make the specimen tubes before drawing the blood.
3. Gather the necessary supplies (alcohol swabs, tubes, tourniquet, etc.) to draw
the patient’s blood and have them ready in the order of their use.
4. Drawing the patient’s blood from the large vein located in the crook of the
elbow is the best choice since the vein is close to the skin’s surface. In some cases,
nurses may have to choose a vein in another part of the body in order to get a good
draw.
5. Tightly place a tourniquet on the patient’s upper arm to prepare the location.
Only tie the tourniquet tight enough to make the vein bulge. Pat the vein and find the
best location in which to draw blood.
6. Gently and quickly insert the needle into the chosen vein with a smooth
motion so that the patient experiences the least amount of pain during the process.
7. Insert the specimen tub into the holder while maintaining the steadiness of
the needle. The tube will fill with the exact amount of blood needed for the specimen.
Manually pull the back of the syringe to fill the vacutainer with blood if using the
needle and syringe.
8. After collecting the last blood specimen, pull out the needle at the exact
angle that is was inserted. Immediately apply gauze to the wound after removing the
needle and apply a light amount of pressure to prevent bleeding.
9. Dispose of the used needle immediately after using on the patient.
10. Lightly swish the blood in the tubes to ensure that the specimens mix
thoroughly.
11. Take one last opportunity to ensure that the blood specimens are labeled
accurately before sending the specimens to a lab.

5) HOW TO GIVE AN INTRAMUSCULAR INJECTION

A nurse, while in nursing school, learns how to give IM (intramuscular)
injections. Nurses must prepare to handle many different types of medical care for
patients of all ages. One of the many procedures that nurses perform is the
intramuscular injection (IM). The process can be very painful if not conducted in the
proper manner. Serious medical issues can arise if intramuscular (IM) injections are
not performed correctly. It takes a great deal of skill and practice to perform
intramuscular injections on patients so nurses must get all the practice that they can in
order to master this nursing skill.

How to Give Intramuscular (IM) Injections
Intramuscular injections are part of medical procedures in which medications are
injected directly into the muscles. There are certain medications that can only be
administered from injections into the patient’s muscles. Depending of the amount or
type of medication, intramuscular injections may be necessary. Intramuscular injections
are provided for patients who need fast acting medications administered to them.
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