MEDICAL STUDIES

YEAR I, semester 2

2015-2016

Topic 9

THE MODERN HOSPITAL

I. INTRODUCTION
The modern hospital is a complex institution responsible for providing health care to the sick and injured. There are many different kinds of hospitals. They may be
categorized as follows:

economically - profit (private) hospitals owned by a corporation or individual persons where the patient is required to pay for the treatment, hospitalization and
lab tests, and non-profit (public) hospitals which are financed by the state or local government. They frequently have medical schools attached to them and thus
are called teaching hospitals or university hospitals. They are often involved in research activities and provide training for medical students and postgraduates.
according to the type of services they provide - general (community) hospitals who treat patients of all ages with various illnesses and injuries, and specialist
hospitals which provide a specific type of medical service (e.g. childrens hospitals, geriatric hospitals, psychiatric hospitals etc.)
day hospitals - where the patients are treated during the day and return home for the night

II. HOSPITAL DEPARTMENTS AND WARDS

Each modern hospital has a number of departments and rooms designed for special purposes. Here are examples of some of them:

The Emergency Department is where people who have had an accident and have been injured or wounded are taken
The Intensive Care Unit (ICU) or Intensive Therapy Unit (ITU) provide intensive care to seriously ill patients, e.g. after heart infarct or those who need special
postoperative care, e.g. after heart or chest operations
The Out-Patient Department is where patients are treated by specialists without staying in hospital. Out-patient services include consultations, X-rays, laboratory
tedsts and physiotherapy
The Dispensary is the store-room for all the drugs used in the hospital and the place where they are issued to patients or medical staff
The Wards are rooms where in-patients stay while they are in hospital
The Anaesthetic Room is where patients are given anaesthesia before having an operation
The Operating Theatre or the Operating Room (OR) is where operations are performed
The Recovery Room is where patients recover from an operation
The X-Ray Department provides X-ray photographs of patients
The Pathology Laboratory (Path Lab) is where blood and urine tests are made
The Blood Bank is the place where blood needed for transfusions is stored
Medical Records is where information is kept about everyone who comes to the hospital. The information is usually stored in computers.

TASK I:
Translate into English:
1.
Wol by leczona w ambulatorium ni na oddziale wewntrznym.

2.
Pacjent, ktry mia wypadek, zosta przewieziony ambulansem pogotowia ratunkowego na oddzia intensywnej terapii.

3.
Dr Evans jest w sali operacyjnej. Operuje pacjenta z wyrostkiem robaczkowym ju od dwch godzin.

4.
Prosz wezwa anestezjologa do sali do wprowadzenia znieczulenia oglnego.

5.
Pan Smith ley w sali pooperacyjnej. By operowany dzi rano.

6.
Siostro, prosz zaprowadzi tego pacjenta do pracowni radiograficznej.

7.
Siostro, prosz przynie kart pani Smith z archiwum.
..

III. THE HOSPITAL

/listening J.Ciecierska & B. Jenike English for Medicine/

TASK II:
Listen to the recording and repeat the names of services provided by the hospital. Then read the whole text and answer the questions:
The Hightower Hospital serves a population of more than 300,000 . it employs over 2,000 staff and has 490 beds. The Hightower provides all the services expected at a
traditional district general hospital along with some specialist ones such as paediatric surgery and cystic fibrosis treatment.
This is a complete list of clinical services it offers:
Acute Medicine
Acute Pain Service
Anaesthetics
Breast Service
Cancer Care and Oncology
Cardiology
Cardiovascular Risk Clinic
Care of Older People
Clinical Nutrition
Colposcopy
Day Surgery

Dermatology
Diabetes
Diabetic Eye Screening Service
Day Hospital
Emergency Department
Endocrinology
ENT and Audiology
Gastroenterology
General Surgery
Gynaecology
Haemetology

Imaging
Maternity
Nephrology
Neurology
Neurophysiology
Occupational Therapy
Ophthalmology
Orthopaedics
Paediatrics
Palliative Care
Pathology

Pharmacy
Physiotherapy
Podiatry
Rapid Response Team
Respiratory Medicine
Rheumatology
Smoking Cessation
Speech and Language Therapy
Supported Discharge and
Rehabilitation
Urology

MEDICAL STUDIES

YEAR I, semester 2

2015-2016

The Hightower has one of the busiest emergency services in the area, including a primary care clinic for minor injuries and a dedicated childrens A&E unit offering 24-hour
surgery service. When a patient comes with a heart attack or multiple trauma, the life-threatening condition is immediately assessed, the patient is resuscitated until stable and any
other injuries are reassessed. Then the patient is referred for a more appropriate care.
The Hightower has a clinic for pre-assessment and pre-operative care. At the pre-assessment clinic they agree an admission and discharge date for the patient. A nurse and a
doctor assess a patients fitness for surgery at this stage and blood, weight and ECGs are also taken while patients become more familiar with their surroundings before the
operation which makes them feel at ease. Patients are also screened for MRSA [methicillin-resistant Staphylococcus aureus]. If they test positive, patients receive a treatment plan
and are booked in for another pre-assessment. Patients must test negative for MRSA three times prior to surgery.
More than half of all surgical procedures are performed in a day surgery centre as same-day procedures. These include biopsies, removal of cysts, cataract surgery, gall bladder
removal, hernia and haemorrhoid repair, tonsil and adenoid removal and arthroscopic surgery of the joints.
3,500 babies are delivered each year at the Maternity Unit which includes a Family Suite and a birthing pool. An infant feeding advisor trains staff and offers advice and guidance
to new mothers. Breast-feeding workshops are offered for new mothers and also breast-feeding drop-in clinics.
The Hightower is also a teaching hospital. It provides undergraduate teaching and is renowned for its postgraduate medical courses.

There are two information boards in the Hightower Hospital: below:

LEVEL D
This Minor Injuries Centre offers:
Maternity Unit
Delivery Suite
Ante-Post Natal Ward
Ante Natal Clinic
Neo Natal Intensive Care Unit
Day Care assessment Unit
Pregnancy Ultrasound

- Speedy consultations with an experienced nurse

- Treatment for minor injuries and illnesses e.g.
Sprains bone injuries sore throats
Urine infections - rashes
Earache diarrhea and vomiting

Advice on how to stay healthy and prevent illness

Orthopaedic Wards
Wards D46 & D47

Open seven days a week

1. What kind of hospital is the Hightower?

2. Is there a suitable service for the following patients? What is it called?
a. A woman who has discovered a lump in her breast.
b. A 90-year-old man with mobility problems.
c. A diabetic whose vision is deteriorating.
d. A man who wants to give up smoking.
e. A 40-year-old man with a high blood pressure, occasional pains in the chest and breathlessness on effort.
f. A 50-year-old man with advanced lung cancer which does not respond to treatment.
g. A patient who was admitted with a stroke a couple of weeks ago and now may continue treatment at home.
h. A diabetic patient at risk of foot ulcers.
3. What are the usual steps in the management of emergency cases?
4. What services does the Minor Injuries Center offer? Does it deal with trauma only? Can you get a consultation on Sunday?
5. What patients are seen in a pre-assessment clinic? What is checked there?
6. What is day surgery?
7. What facilities are available to women just about to give birth and to new mothers?

TASK III
Using vocabulary from the passage above, translate the following description of a hospital into English:
Jest to duy szpital stanowicy cz uniwersytetu medycznego. Trudno mwi o rejonie, jaki obsuguje. Jest orodkiem wysoko
specjalistycznym i przyjmuje pacjentw z caego kraju. W zeszym roku liczba pacjentw leczonych w trybie nagym wyniosa 54,300, a u
12,000 pacjentw wykonano planowe zabiegi i badania. W przychodniach przyjto 20,000 pacjentw leczonych ambulatoryjnie. Na oddziale
pooniczym przyjto 3,600 porodw. Wszystkie oddziay chirurgii maj oddziay intensywnej opieki chirurgicznej i pododdziay dzienne. W
ubiegym roku otwarto Orodek Drobnych Obrae. To nieco mylca nazwa, poniewa 7 dni w tygodniu przychodnie oferuj nie tylko
porady i leczenie w przypadkach zranie, zwichni i zama, ale i w lejszych infekcjach grnych drg oddechowych, ukadu oddechowego i
pokarmowego. Mona te uzyska porady, jak zapobiega chorobom. Nie jest wymagane wczeniejsze umwienie wizyty. W niektrych
oddziaach wprowadzono ka przeznaczone dla pacjentw wymagajcych szczeglnej opieki i monitorowania

MEDICAL STUDIES

YEAR I, semester 2

2015-2016

TASK IV:
The following is a presentation of the Teaching Hospital of the Medical University of Biaystok. Translate it into English:
UNIWERSYTECKI SZPITAL KLINICZNY W BIAYMSTOKU
Uniwersytecki Szpital Kliniczny w Biaymstoku powsta 15 grudnia 1962 roku. Ma prawie 50 lat dowiadcze i osigni diagnostyczno-terapeutycznych. Dynamiczny rozwj
nauki doprowadzi do utworzenia wielu nowych, specjalistycznych jednostek medycznych oraz znacznego wzrostu iloci i jakoci wiadczonych usug. W styczniu 2006 zosta
uruchomiony Szpitalny Oddzia Ratunkowy.
Szpital jest wyposaony w najnowoczeniejsz aparatur i urzdzenia i sta si baz dydaktyczn i naukow dla klinik Uniwersytetu Medycznego w Biaymstoku. Zabezpiecza
szeroki wachlarz wiadcze zdrowotnych, od procedur prostych do wysokospecjalistycznych. Posiada okoo 830 ek. Rocznie leczy stacjonarnie ponad 35 tysicy pacjentw
rocznie. Czci szpitala s rne przychodnie specjalistyczne przyjmujce pacjentw leczonych ambulatoryjnie.
Kadr szpitala stanowi specjalici o najwyszych kwalifikacjach medycznych. Szpital zatrudnia ponad 1800 pracownikw, w tym 36 profesorw, 33 doktorw habilitowanych i
192 doktorw nauk medycznych. Personel pielgniarski liczy ponad 740 osb, w tym ponad 260 pielgniarek i poonych posiada wyksztacenie wysze.

I. KLINIKI
1.

Klinika Reumatologii i Chorb Wewntrznych

13. I Klinika Chirurgii Oglnej i Endokrynologicznej

2.

Klinika Endokrynologii, Diabetologii i Chorb

14. II Klinika Chirurgii Oglnej i Gastroenterologii

Wewntrznych

15. Klinika Kardiochirurgii z Blokiem Operacyjnym

3.

Klinika Gastroenterologii i Chorb Wewntrznych

16. Klinika Chirurgii Naczy i Transplantacji

4.

Klinika Kardiologii z Oddziaem Intensywnego Nadzoru

17. Klinika Chirurgii Klatki Piersiowej

Kardiologicznego

18. Klinika Ortopedii i Traumatologii

5.

Klinika Alergologii i Chorb Wewntrznych

19. Klinika Ginekologii z Blokiem Operacyjnym

6.

Klinika Hematologii z Pododdziaem Chorb Naczy

20. Klinika Perinatologii i Poonictwa ze Szko Rodzenia

7.

Klinika Neurologii z Pododdziaem Udarowym

21. Klinika Neonatologii i Intensywnej Terapii Noworodka

8.

Klinika Anestezjologii i Intensywnej Terapii z Blokiem

22. Klinika Chirurgii Szczkowo-Twarzowej i Plastycznej

Operacyjnym

23. Klinika Rehabilitacji

Klinika Neurochirurgii

24. Klinika Rozrodczoci i Endokrynologii Ginekologicznej

9.

10. Klinika Okulistyki

25. Klinika Kardiologii Inwazyjnej z OIOK i Pracowni

11. Klinika Otolaryngologii

Hemodynamiki

12. Klinika Urologii

26. Klinika Nadcinienia Ttniczego

II. ZAKADY
1.

Zakad Diagnostyki Biochemicznej

2.

Zakad Diagnostyki Hematologicznej

3.

Zakad Diagnostyki Klinicznej

4.

Zakad Diagnostyki Mikrobiologicznej i Immunologii Infekcyjnej

5.

Zakad Medycyny Nuklearnej

6.

Zakad Radiologii

MEDICAL STUDIES

YEAR I, semester 2

2015-2016

TASK V:
a. Read the text describing various hospital services:
Hospital A
The hospital has 12 theatres and 2 recovery units. These theatres provide services for a large number of specialties including Arterial,
Colorectal, ENT, Max Fax, Ophthalmology, Complex Elective Orthopaedic, Orthopaedic Trauma, Renal and Renal Transplants, Upper GI,
Breast and 24-hour Emergency Surgery
Hospital B
We are a very large Teaching Hospital with an unusually impressive range of specialties. The hospital provides a comprehensive and specialist
range of acute, regional and tertiary services: Renal Services, Specialist Acute Hospital Care for Older People, Respiratory/Acute Medicine, A
& E and Non-Surgical Oncology
Hospital C
We offer both walk-in and appointment services to patients
Hospital D, Paediatric Unit
This newly designed child-orientated unit sees approximately 20,000 children each year. The unit comprises 11 cubicles, two of which are used
for adolescents.
Hospital E, Paediatric Oncology Unit
This unit comprises 23 inpatient beds (two dedicated high dependency beds, a busy Paediatric Ambulatory Care Unit (PACU) and Childrens
Outpatients Departments. We coordinate the care from the tertiary centres to local hospitals and into the community.
Hospital E, Neonatal and Childrens Intensive Care Unit
This is a busy neonatal unit comprising 12 intensive/high dependency cots and 11 special care cots, plus two intensive care/high dependency
cots. The two units run in collaboration, with excellent facilities and are situated in the purpose built Womens and Childrens Wing. In
addition to caring for our medical babies , we also provide the regional services for neonatal and paediatric surgery and Rhesus disease of the
newborn.

b. Now find in the descriptions the expressions which mean:

1. a hospital that is affiliated to a medical school, in which medical students receive practical training
2. maxillo-facial surgery
3. the treatment chosen by the patient rather than urgently necessary
4. of short duration, but typically severe
5. a centre offering the most specialized level of health care
6. the service available for patients without the need for an appointment
7. a small partitioned off area of a room
8. tailored to specified needs (in combination as in child-)
9. exclusively allocated to or intended for a particular service or purpose
10. a bed for patients requiring close monitoring and special nursing care because of severity of the condition
11. the treatment and care not necessitating admission to hospital
12. a small bed with high barred sides for a baby or a very young child
13. infants suffering from disorders which do not require a surgical intervention.

TASK VI:
Using available sources of information and your general knowledge, describe/define the following types of care:
1. primary care

2. secondary care

3. tertiary care

MEDICAL STUDIES

YEAR I, semester 2

2015-2016

Topic 10

VITAL SIGNS - TAKING THE PATIENTS

TEMPERATURE, PULSE, RESPIRATIONS
AND BLOOD PRESSURE (TPRs & BP)
GENERAL DESCRIPTION

Vital signs are measurements of the body's most basic functions. Vital sign monitoring is a fundamental component of nursing care. Accuracy
in taking vital signs is necessary because treatment plans are developed according to the measurement of the vital signs. Variations can
indicate a new disease process or the patients response to treatment. They may also indicate the patients compliance with a treatment plan.
Although taking vital signs is a task commonly performed by a nurse, it is never to be taken casually or lightly, and it should never be rushed
or incompletely performed. Concentration and attention to proper procedure will help ensure accurate measurements and quality care of the
patient. The five main vital signs routinely monitored by medical professionals and healthcare providers include the following:
body temperature
pulse rate
respiration rate (rate of breathing)
blood pressure
pain
The patients temperature, pulse, respiration (TPRs) and blood pressure should be taken and recorded on the chart regularly because they
represent a valuable picture of the patients condition and progress.

I. TEMPERATURE

What is body temperature? Body temperature is maintained and regulated by two processes functioning in conjunction with one another: heat
production and heat loss. The delicate balance between heat production and heat loss is maintained by the hypothalamus in the brain. The
hypothalamus monitors blood temperature and will trigger either the heat loss or heat production mechanism with as little as 0.04F change
in blood temperature.
What is the mechanism of maintaining body temperature?
a. when body temperature falls
the hypothalamus sends nerve impulses to stimulate shivering
blood vessels are constricted to reduce heat loss
b. when body temperature rises
the hypothalamus sends nerve impulses to stimulate sweating
blood vessels are dilated to increase heat loss
The normal body temperature of a person varies depending on gender, recent activity, food and fluid consumption, time of day, and, in
women, the stage of the menstrual cycle.
Normal body temperature can range from 97.8 F to 99 F (which is an equivalent of 36.5C to 37.2C) for a healthy adult.
Body temperatures are classified as follows:
-

mild
moderate
fever (pyrexia)
high fever

37.10C 37.70C
37.80C 38.50C
38.60C - 390C (caused by inflammations, infections, wound infections, a cold)
39.10C - 39.90C (with symptoms such as: flushed warm skin, thirst, restlessness, convulsions)

A patient whose body temperature is normal is called an afebrile (apyrexial) patient.

A patient whose temperature is above normal is called an febrile (feverish, pyrexial) patient.
Hypothermia is a condition when body temperature drops to 35 0C.
A collapse is a state when body temperature falls below 350C and is very dangerous as it may lead to death.
A person's body temperature can be taken (or: measured, obtained, checked, recorded) in any of the following ways:
orally (by mouth)
axillary (by axilla)
rectally (by rectum)
by ear
by skin
In children, the temperature is normally taken by rectum, and is higher than in adults.

MEDICAL STUDIES

YEAR I, semester 2

2015-2016

TASK I: Translate the following questions into English. Then answer them:

1. Dlaczego wan rzecz jest mierzenie parametrw yciowych? Jakie jest ich znaczenie w diagnostyce

2. Na co wskazuj zmiany temperatury ciaa?

3. W jaki sposb podwzgrze utrzymuje waciw temperatur ciaa?

4. Jakie czynniki wpywaj na temperatur ciaa?

5. Jak mona sklasyfikowa temperatur?

6. W jakich miejscach temperatura jest zazwyczaj mierzona?

7. Jakie czynniki mog powodowa gorczk?

8. Jakie objawy towarzysz bardzo wysokiej gorczce?

TASK II: Translate into English:

1. Temperatura ciaa mierzona jest w czterech miejscach: w ustach, pod pach, w odbycie lub w uchu.

2. Wewntrz ciaa, tj. w odbycie , temperatura jest najwysza.

3. Jeeli temperatura jest wysza ni 37.7 0C , stan ten nazywany jest gorczk.

4. Zapaci nazywamy stan gdy temperatura opada poniej 35 0

5. Termometry do mierzenia temperatury w odbycie maja krtkie, tpo zakoczone baki.

6. Temperatura wszystkich pacjentw powinna by mierzona co najmniej dwa razy dziennie.

TASK III: Choose one of three options to complete the sentences:

1. The temperature in the axilla is the .
a)

highest

b) medium

c) lowest

2. The subnormal temperature is below .

a) 36.3 0C

b) 35 0C

c) 34 0C

3. The person is in the state of collapse if body temperature is lower than .

a) 36.3 0C

b) 35 0C

c) 34 0C

4. may occur when the temperature is 42.2 0C or higher.

a) heart attack

b) heat stroke

c) heat collapse

5. The oral thermometer has a bulb.

a) short and round

b) long and pointed

c) long and thin

6. Patients temperatures should be recorded at least .

a) once a day

b) twice a day

c) three times a day

7. The thermometer should be kept in the mouth for . .

a) 3-5 minutes

b) 5-8 minutes

c) 10 minutes

MEDICAL STUDIES

YEAR I, semester 2

2015-2016

II. PULSE RATE

Pulse rate is the number of beats per minute. The pulse is the vibration of each wave of blood going through the arteries as the heart beats.
The pulse rate consists of two phases of the heart action and can be felt when compressing an artery. As the heart contracts, it increases
pressure on the arterial walls. The increased pressure passes through the arteries in a wave-like movement resulting in a slight expansion of
the arterial wall (contraction).When the heart relaxes (relaxation), the pressure is decreased in the arteries, resulting in the wall returning to its
previous position. One contraction and one relaxation of the heart is equal to one heart cycle or heart beat. The pulse and heartbeat rate are
usually identical in healthy individuals. You can feel it by placing your fingers over one of the large arteries that lie close to the skin, especially
if the artery runs across a bone and has very little soft tissue around it.
There are eight common arterial pulse sites :

Radial

Brachial

Temporal

Femoral

Carotid

Popliteal

Apical (listening to the heart directly)

Pedal (dorsalis pedis)

TASK I: Match the sites of taking the pulse with the names of the arteries:
1.

wrist

a.

femoral pulse

2.

foot

b.

popliteal pulse

3.

head

c.

apical pulse

4.

neck

d.

tibial pulse

5.

heart

e.

temporal pulse

6.

thigh

f.

radial pulse

7.

arm

g.

pedal pulse

8.

knee

h.

brachial pulse

9.

ankle

i.

carotid

The pulse rate is an indicator of how fast the heart beats. It is affected by several factors :

age - a normal pulse for infants range from 90 to 170 and the rate gradually decreases up to age 14 when it is equal to the normal
adult pulse rate of 60 to 100.
body build and size - a short, fat person may have a higher rate than a tall, slender person.
blood pressure - as the blood pressure decreases, the pulse will frequently increase.
medications - stimulants will increase the pulse rate; depressants will decrease the pulse rate.
exercise and muscular activity - an increase in pulse rate will occur with increased activity to meet increased oxygen and nutrient
demands. A regular aerobic exercise program can lower the resting pulse. A person, who exercises a great deal, such as an athlete,
will develop bradycardia that is a normal, health condition. The body slows the heartbeat to compensate for the greater volume of
blood pumped with each beat.
food intake - digestion increases the pulse slightly.
elevated body temperature - the pulse increases approximately 10 beats per minute for every 1 0 F (0.560 C) increase in body
temperature. These conditions cause a temporary increase in the heartbeat and pulse.
emotional status - fear, anger, and anxiety will all increase the pulse rate while relaxation and rest will decrease it
pain - when the patient is in pain, the pulse rate will increase.
gender women have a slightly higher average rate than men

A normal pulse beat should correspond with the persons age, should be strong and have a regular rhythm.
An abnormally slow pulse rate is called bradycardia.
An abnormally fast pulse rate is called tachycardia.
Irregular pulse rhythm is called arrhythmia.
A weak pulse rate may be a sign of heart failure, shock, obstructed blood circulation or peripheral circulatory disease.
Any pulse rate below 50 and above 100 beats per minute indicates a serious problem when medical assistance should be sought.

MEDICAL STUDIES

YEAR I, semester 2

2015-2016

TASK II: Choose the correct answer to complete the sentences.

1. The best site for taking the pulse beat is the patients .. .
a) elbow
b) wrist
c) knee
2. When taking the pulse, the fingers are put over the pulse.
a) middle and ring b) ring and small c) index and middle
3. The .. has its own pulse.
a) thumb
b) index finger c) middle finger
4. In an adult the normal pulse is beats per minute.
a) 55 -65
b) 65-80
c) 80-90
5. The pulse rate usually . with age.
a) remains the same
b) increases
c) decreases
6. The pulse rate below per minute indicates a serious health problems.
a) 50 beats
b) 80 beats
c) 100 beats

TASK III: Translate into English:

1. Ttno mierzone jest na nadgarstku dwoma palcami: wskazujcym i rodkowym.
.
2. Oprcz uderze ttna na minut, naley zanotowa jego charakter i rytm.
.
3. Ilo uderze ttna zaley od stanu emocjonalnego pacjenta, np. wzrasta przy zdenerwowaniu, niepokoju i zoci.
.
4. Normalne ttno u dorosych wynosi 65 80 uderze na minut i powinno mie regularny rytm.
.
5. Ttno jest miar pracy serca i caego ukadu krenia
.
6. Prosz mierzy temu pacjentowi ttno co p godziny.
.
7. Jeli ttno bdzie szybsze ni 100 uderze na minut, prosz mnie natychmiast zawiadomi.
.

MEDICAL STUDIES

YEAR I, semester 2

2015-2016

III. RESPIRATION
Assessment of a patients respiration as a vital sign is usually performer on a doctors order. The patient should not be
aware that his/her respirations are being taken as respiration is a process that can be controlled.
The function of respiration (breathing) is the exchange of the gases oxygen and carbon dioxide. External respiration
occurs when oxygen is drawn into the lungs when breathing in, and carbon dioxide is expelled from the lungs when
breathing out. Internal respiration occurs when oxygen is used by the cells for cellular function. Carbon dioxide is a
by-product of cellular function and is expelled via exhalation as a waste product. One inspiration (inhalation - drawing
in of the air) and one expiration (exhalation - expelling air) together equals one respiration. The respiration rate is the
number of breaths a person takes per minute. The rate is usually measured when a person is at rest and simply
involves counting the number of breaths for one minute by counting how many times the chest rises. Respiration
rates may increase with fever, illness, and with other medical conditions. When checking respiration, it is important to
also note whether a person has any difficulty breathing.
Normal respiration rates for an adult person at rest range from 15 to 20 breaths per minute. Respiration rates over 25
breaths per minute or under 12 breaths per minute (when at rest) may be considered abnormal. A healthy child has a
faster breathing rate - between 20 and thirty per minute.
Respiratory rate is the number of respirations per minute. The normal respiratory rate varies with age, activities,
illness, emotions, and drugs. The average respiration rate to pulse rate is 1:4, one respiration to four pulse beats.
Respiratory rhythm refers to the pattern of breathing. It can vary with age, with adults having a regular pattern, but
infants having an irregular pattern. Rhythm may be altered by laughing and sighing. Depth of respiration is the
amount of air that is inspired and expired with each respiration. In the resting state, the amount should be consistent.
Depth is noted by watching the degree of rise and fall of the chest wall when measuring respiration rate.
When assessing respiration, you must observe rises and falls of the chest and note the following:
- rate - the number of breaths per minute,
- rhythm - the breath is regular or irregular,
- depth - the respiration is shallow, moderate or deep
- effort - the breath is easy, with effort or laboured,
- sound - the breath is quiet/normal, or abnormal (diminished, with crackles, wheezes, rales, rhonchi), or absent (no
breath sounds).
Abnormalities of the respiration rate may be found in the rate, depth, rhythm, and sounds of respiration. Some rate
abnormalities include :
tachypnoea - the rate is regular but over 20 breaths per minute (faster than normal)

bradypnoea - the rate is regular but less than 12 breaths per minute (slower than normal)

apnoea - there is an absence of respiration for several seconds this can lead to respiratory arrest.

dyspnoea- difficulty in breathing, the patient gasps for air/is short of breath.

Cheyne-Stokes respiration the breathing is shallow, very slow and laboured with periods of apnoea. This
type of breathing is often seen in the dying patient.

hyperpnoea (hyperventilation) - patients may breathe rapidly due to a physical or psychological cause, for

example if they are in pain or panicking. Hyperventilation reduces the carbon dioxide levels in the blood,
causing tingling and numbness in the hands; this may cause further distress. In adults, more than 20 breaths a
minute is considered moderate, more than 30 breaths is severe

MEDICAL STUDIES

YEAR I, semester 2

2015-2016

TASK I: Translate the following questions into English and then answer them:
1. Jakie podstawowe terminy medyczne zwizane z oddychaniem s powszechnie uywane w jzyku angielskim?

2. Kiedy wykonywane s pomiary oddechu?

3. Jakie warunki musi spenia pacjent, aby pomiary mogy zosta uznane za wiarygodne?

4. Jak wyglda procedura pomiaru oddechu?

5. Jakie s prawidowe wartoci oddechowe u dzieci i dorosych?

6. Jakie cechy naley obserwowa podczas pomiaru oddechu?.

7. Jakiego przyrostka uywa si w medycynie w odniesieniu do oddychania? Podaj kilka przykadw.

TASK II: Write Polish words next to the following:

1. oddycha =
2. oddychanie =
3. oddech =
4. ukad oddechowy =
5. wdycha =
6. wdech =
7. wydycha =

8. wydech =
9. pomiar oddechu =
10. niedotlenienie =
11. brak tchu/zadyszka =
12. bez tchu =
13. zaburzenia oddechu =

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MEDICAL STUDIES

YEAR I, semester 2

2015-2016

IV. BLOOD PRESSURE

Blood pressure (BP) is a measurement of the pressure exerted by blood on the walls of blood vessels. Blood pressure
is measured because it gives doctors an idea of how well the cardiovascular system is working.
Blood pressure is recorded with two numbers, such as 120/80 mm Hg (read: 120 over 80 millimeters of mercury).
The upper number (110) is called the systolic pressure and indicates the pressure the ventricles exert when they are
contracting. The lower number (70) is called the diastolic pressure and indicates the pressure when the ventricles are
relaxing. The resting blood pressure of 120/80 is considered to be normal. Values higher than 120/80 are are
considered to be high, and lower than that low.
Normal blood pressure varies from one person to another (arterial systolic blood pressure ranges between 110-130
mmHg, and diastolic between 70-9- mmHg).
FACTORS INFLUENCING BLOOD PRESSURE VALUES:

age - children normally have lower blood pressure at birth (80/60), which gradually increases until the age of
18 when it becomes equal to the normal adult pressure. Older adults frequently have higher blood pressure
due to a decrease in blood vessel elasticity.
sex - men have higher blood pressure than women of the same age.
nutrition - research has shown that diet affects the development of high blood pressure (hypertension). The
DASH (Dietary Approaches to Stop Hypertension) eating plan is recommended if your blood pressure is high
or if you are at risk for high blood pressure. DASH is a combination diet that is low in fat and rich in fruits
and vegetables. It is low in cholesterol and saturated fat, high in dietary fiber, potassium, calcium and
magnesium and moderately high in protein.
body build- blood pressure is usually elevated in an obese person.
alcohol - alcohol is a drug, and regular over-consumption can raise blood pressure dramatically, as well as
cause an elevation upon withdrawal.
exercise - muscular exertion will temporarily elevate the blood pressure. A regular exercise program can
eventually decrease the resting blood pressure. Regular exercise, along with an active lifestyle, may decrease
blood pressure.
smoking - smoking causes peripheral vascular disease (narrowing of the vessels that carry blood to the legs
and arms), as well as hardening of the arteries. These conditions clearly can lead to heart disease and stroke
and are contributing factors in high blood pressure.
pain - physical discomfort will usually elevate the blood pressure.
emotional status - fear, worry, or excitement can elevate the blood pressure
disease states and medication- some disease conditions and/or the medications influence the blood
pressure.

HOW BLOOD PRESSURE IS MEASURED

Two pieces of equipment are needed to take the blood pressure: a sphygmomanometer and a stethoscope. Before
taking blood pressure , the patient is asked to sit down with his right arm uncovered to the shoulder. A soft rubber
cuff is put around the patients arm and the stethoscope is placed over the brachial artery. The cuff is inflated until the
brachial pulse disappears. The cuff is then slowly deflated until the first pulse beat is heard. This is recorded as the
systolic pressure. The deflation of the cuff is continued until the last pulse sound is heard. This is recorded as the
diastolic pressure.

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MEDICAL STUDIES

YEAR I, semester 2

2015-2016

TASK I: Write short definitions of the terms below:

- blood pressure
- systolic pressure
- diastolic pressure .

- hypertension
- hypotension
- sphygmomanometer

TASK II: Translate into English:

1. Jednym z obowizkw pielgniarki jest mierzenie cinienia krwi.

2. Wyrnia si dwa rodzaje cinienia krwi: skurczowe i rozkurczowe.

3. Normalne cinienie rozkurczowe rwne jest 2/3 cinienia skurczowego.

4. Pacjent cierpi na dusznic bolesn, niedokrwienn chorob serca, a osuchiwanie wykryo szmer zastawki dwudzielnej.

5. W przypadku znacznego nadcinienia, cinienie krwi musi by mierzone regularnie i notowane na karcie chorobowej pacjenta.

6. Prosz podwin rkaw do ramienia, zmierz panu cinienie krwi.

TASK III: Choose the best option to complete the sentences:

1.The blood pressure is the highest in the .. .
a) capillaries

b) veins

c) arteries

2.Blood pressure is measured in .. .

a) micrometers Hg

b) millimeters Hg

c) centimeters Hg

3.The normal systolic pressure for an adult is . Mm Hg.

a) 100 -110

b) 110 -130

c) 130-160

4. Diastolic pressure is the blood pressure. .

a) at the heartbeats

b) between the heartbeats c) both at and between heartbeats

5. Diastolic pressure is about .. the normal systolic pressure.

a) one-third of

b) the same as

c) two-thirds of

6. . is not a risk factor of hypertension

a) atherosclerosis

b) sedentary lifestyle

c) allergy

7. The cuff is inflated until the brachial pulse and slowly deflated
until the first pulse beats are heard.
a) appears

b) disappears

c) reappears

TASK IV:
Read the following descriptions of hypertension and hypotension. Then, using various sources available, give a brief talk about these two
conditions and their consequences for a patient.
Hypertension is a condition in which blood pressure is consistently high (over 140/80). This may be caused by an accumulation of fatty material in blood
vessels resulting in a condition known as atherosclerosis, or hardening of the arteries. Hypertension may also be caused by stress, smoking, obesity, heredity,
or a diet high in salt and fats.
Hypotension is the opposite of hypertension. The person has a low blood pressure. This is usually caused by low blood volume due to diarrhea, kidney
problems, or haemorrhage (extreme blood loss).

12

MEDICAL STUDIES

YEAR I, semester 2

2015-2016

Below are some useful words and phrases used when talking about vital signs measurements:
Vital signs

Body temperature
The patient has

The patient has

The patient is
Fever may be

On oral reporting:

a normal body temperature/normothermia

[36.80C 37.20C]
no/a low/high/decreased/increased/reduced/elevated/
subnormal/abnormal temperature
a low grade/high grade/mild/moderate fever
[37.20C 400C]
severe pyrexia/hyperpyrexia/hyperthermia
[>41.10C]
hypothermia
[<350C]
feverish/[a]febrile/[a]pyrexial
normothermic/hypothermic/hyperthermic
constant/continued/intermittent/relapsing/remittent/
Undulating
temperature/ 380C = thirty eight centigrades
thirty eight degrees Celsius

Blood pressure
The patient has

The patient is

a [normal] blood pressure of [110 130/70 90 mmHg]

right/left arm sitting/lying/standing
a hypertension of [>130/90 ]
a hypotension of [<110/70 ]
normotensive/hypertensive/hypotensive at []

The recorded value, e.g. BP 120/82 mmHg

On oral reporting:

may be read as:

Blood pressure is one twenty over eighty two millimeters of

mercury.
Blood pressure one twenty over eighty two.

Pulse
The pulse may be
The patient may have
The patient is
The pulse rhythm is
character
volume

On oral reporting:

carotid/radial/brachial/femoral, popliteal/posterior tibial/

dorsalis pedis
a normal pulse rate of [60 -80 beats/min]
a tachycardia [>100/min]
a bradychardia [<60/min]
tachycardic/bradycardic, with the pulse rate of []
tachycardic/bradycardic at []
regular/irregular/irregularly regular/regularly irregular
absent/thready/weak/normal/slow rising/collapsing/
bounding
normal/increased/decreased/alternans/paradoxus
pulse 92 [pulse ninety-two]

Respiratory rate
The adult patient may have eupnoea/normal respiratory rate [16 -18/min]
tachypnoea [>18/min]
bradypnoea [<15/min]
orthopnea /apnoea
The patient may be
eupnoeic/tachypnoeic/bradypnoeic/orthopnoeic/apnoeic
On oral reporting:
respiratory rate/respirations 42 [forty-two]
Vital signs are also described as to their severity.
The measurement shows

There is

a[n] normal/abnormal [pulse/blood pressure/respiratory rate/

body temperature]
abnormally low/high
slow/fast/rapid
elevated/increased
reduced/decreased
slightly/mildly/moderately/markedly/considerably/
significantly/severely decreased/increased at []
a[n] mild/rapid/sudden/dramatic rise/fall/drop in [VS]

Systolic pressure shows

was
Pulse rate was

a[n] rise/increase/decrease/drop of []
increased/decreased by []
increased/decreased from [] to []

Vital signs are

BP

is

(taken from ENGLISH FOR MEDICINE by J. Cieciersks & B. Jenike )

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