I am a nurse. I work at a therapeutic hospital. Many doctors and nurses work at the hospital. Our hospital is very large. Work at the hospital begins at 6 o’clock in the morning. The nurses begin to take the patients’ temperature at 6 o’clock. They write it down in temperature charts. Then the nurses give the patients medicines and carry out other prescriptions of the doctors. They open the windows and air the wards. The sometimes I tell the doctor that the temperature of some of the patients is high and the doctor prescribes some new medicine or injections. I like my profession very much. I know that much 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. 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. Sometimes I tell him that they are well. And
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bed – patient – лежачий больной
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sitting patient – сидячий больной
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up – patient – ходячий больной
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in – patient – стационарный больной
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out – patient – амбулаторный больной
Text Many aspects of obstetric physical examination are unique.
The assessment of pregnancy should begin with a general examination of a pregnant woman. The general examination includes first of all the woman’ s height and weight. Then the body mass index (BMI) can be calculated, because some antenatal and perinatal complications are associated with a BMI less 20 and more 25. The thyroid gland and breast should also be examined. Auscultation of the heart sound and lungs is essential. Many detected conditions, such as a cardiac murmur, breast lumps and others may have significant implications on the course of her pregnancy and health. Sometimes more detailed examinations are indicated in a diabetic or hypertensive woman. The measurement of maternal blood pressure (BP) is of great importance in pregnancy.
An abdominal examination (palpation and auscultation) is another important step of physical examination of a pregnant woman. It may indicate the shape and size of the uterus. The uterine size is objectively measured and expressed as height. The highest point of the fundus of the uterus should be palpated. It is important because the number of fetuses may be determined. By palpation the pelvic presentation of the fetus is examined as well.
All the examination findings are necessary for understanding of a woman clinical condition. They should form the basis for further investigations if needed.
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assessment - оценка
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pregnancy - беременность
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pregnant - беременная
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height - рост
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weight - вес
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antenatal - утробный, до рождения
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perinatal - перинатальный
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thyroid - щитовидный
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essential - необходимый, важный
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murmur - шум (в сердце)
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lump - зд. нарушение
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significant - значительный, существенный
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implication - зд. значение, смысл
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to indicate - требовать, указывать
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measurement - измерение
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uterus - матка
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shape - форма, очертание
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fundus - дно
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fetus - плод
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to determine - определять
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presentation - зд. предлежание
Ex.1 Find English equivalents. Найдите английские эквиваленты.Акушерский физикальный осмотр; общий осмотр; должен включать; рост и вес; можно посчитать
; осложнения; тон сердца; требуется; указывать на; размер матки; дно матки; также определяется; клиническое состояние женщины; основа для дальнейших исследований.
Ex.2 Find Russian equivalents. Найдите русские эквиваленты.
A pregnant woman; are associated; a thyroid gland; an implication; blood pressure; an abdominal examination; is measured; the highest point; presentation of the fetus; if needed.
Ex.3 Answer the questions.Ответьте на вопросы.
1. What does the general examination of a pregnant woman include?
2. What does BMI mean?
3. Is heart sound auscultation essential?
4. What detected conditions may have significant implication?
5. What is necessary for a diabetic or hypertensive woman?
6. What may abdominal examination reveal?
7. Why is it important to palpate the fundus of the uterus?
8. Why are all the examination findings necessary?
Text
Labour is divided into three stages.
The first stage begins with onset of pains and ends with the full dilatation of the cervix. It is the stage of dilation. At this stage uterine contractions occur from time to time.
The second stage begins after full dilatation of the cervix and ends with expulsion of foetus.
The third stage begins after the expulsion of the foetus and ends with the expulsion of the placenta and membranes.
When the uterine contractions become more strongly the pregnant woman suffers of pains and discomforts very much. She fears for her baby and herself. An obstetrician may give some medicine or anesthesia to the woman, if it is necessary. A role of a midwife is very important at that time. She must be very attentive and polite to the woman, she must try to calm, support and help her. The midwife must remember that she is responsible for the health and life of the pregnant woman and her baby.
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labour - роды
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birth - роды
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dilatation - расширение, раскрытие
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contraction - мн.ч. схватки
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cervix - шейка
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expulsion - выталкивание, изгнание(плода)
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foetus - утробный плод
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placenta - детское место, послед, плацента
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membrane - плева ,оболочка, пленка
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to deliver - родить; принимать (роды)
Ex.1 Find English equivalents. Найдите английские эквиваленты.на подготовить; как можно удобнее; какие-либо проблемы; должна поддерживать; отдохнуть и расслабиться; если необходимо; головки ребенка начинает появляться; это даст ей силы.
Ex.2 Find Russian equivalents. Найдите русские эквиваленты.Into three stage; full dilatation; after the expulsion of the foetus; become more strongly; must be very attentive; an obstetrician; for the birth; during her pregnancy; during her labour; the task of the midwife; the infant’s head appear.
Ex3 Answer the questions. Ответьте на вопросы:1. What stages is labour divided?
2. What is the second stage?
3. Does a pregnant woman suffer from pains during labour?
4. Is the role of the midwife important at that time?
5. Must the midwife help the woman during pushing?
6. At what case must a pediatric team be present during labour?
7. What are the duties of the midwife during the woman’s delivery?
Text Obstetric history-taking is a skill for good clinical practice. Competence in this area requires a deep knowledge. A carefully taken obstetric history provides good results of a physical examination of a pregnant woman because many important details of her pregnancy can be revealed.
An obstetrician should ask a name of the woman, age, number of pregnancies, including the current one (or gravidity) and parity (number of births). The
expected date of delivery (EDD) can be calculated from
last menstrual period (LMP) by the rule: add one year and seven days to the LMP and subtract 3 months. Then it is necessary to inquire about her health and that of her fetus. After 20 weeks it is inquired about fetal movements. Then the obstetrician asks of the current problems if there are any. Much attention should be paid to laboratory tests and ultrasound scans.
A medical worker (obstetrician) should reveal the facts and any significant events of the previous pregnancies which may have influence at the current pregnancy, such as maternal complications, mode of delivery, birth weights and the life and health oh babies. It may be relevant to know some medical conditions because they may have a significant impact on the pregnancy. Heart disease, epilepsy, bronchial asthma, thyroid disorders, insulin-dependent diabetes and other medical conditions may have significant impact on the pregnancy. Alternatively pregnancy may have an impact on the medical condition.
During pregnancy the use of drugs should be noted because allergic complications may occur.
It is important to reveal hereditary illness or congenital defects, and it may be of concern to the couple. Appropriate counseling and investigations may be organized. It is time to discuss about stopping to smoke or to reduce alcohol intact. Social aspects such as childcare arrangements and plans for breast-feeding and contraception can be discussed at this point.
The summery of obstetric history should include main details that will impact on the investigations to be carried out and the proposed plan of a pregnancy management.
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Obstetrics - акушерство
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Obstetrician - акушерка
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Obstetric - акушерский
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to require - требовать
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to provide - обеспечивать
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to reveal - выявлять
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gravidity - беременность
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parity - способность к деторождению
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delivery - роды
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to subtract вычитать
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to inquire - спрашивать, узнавать
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fetus - утробный плод
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ultrasound - ультразвук
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antenatal - предродовой, преднатальный
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maternal - материнский
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mode - способ
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relevant - уместный
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epilepsy - эпилепсия
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bronchial asthma - бронхиальная астма
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thyroid - щитовидная железа
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diabetes - диабет
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hereditary - наследственный
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congenital - врожденный
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counseling - консультация, совет
Ex.1 Find English equivalents. Найдите английские эквиваленты.Клиническая практика; глубокие знания; физикальное обследование; беременная женщина; можно посчитать; менструальный период; необходимо; большое внимание; выявить факты; значительное влияние; аллергические осложнения; наследственные болезни; врожденные дефекты; пара; грудное вскармливание; ведение беременности.
Ex.2 Find Russian equivalents. Найдите русские эквиваленты.Competence in this area; provides good results; examination of a pregnant woman; number of pregnancies; her fetus; fetal movements; the current problems; may have influence; mode of delivery; may be relevant; medical conditions; significant impact; it may be concern; alcohol intake; can be discussed; investigations to be carried out.
Ex.3 Answer the questions.Ответьте на вопросы. 1. What can be revealed by the physical examination of a pregnant woman?
2. What should an obstetrician ask a pregnant woman?
3. How can EDD be calculated?
4. Are laboratory tests important for the pregnant woman examination?
5. May medical conditions impact on the course of the pregnancy?
6. Is it important to reveal hereditary illnesses and congenital defects? Is it concerned only a pregnant woman?
7. Is smoking and alcohol dangerous for a pregnant woman?