1. 新职业英语

2. Warming-up Reading A Listening Speaking 4 1 2 3 Reading B 5 Writing 6 Project 7 Vocabulary and Structure 8

3. Warming-up Task 1 Match the pictures with the commonly used methods of disease treatments surgery diet physical exercise oral agent infusion A D B C 口服液 E 输注

4. Warming-up Task 2 Discuss with your classmates to find out the meanings of the proper abbreviations in a typical physician’s order. sig.______________ q.n.______________ p.r.n______________ a.c._______________ q.d._________________ t.i.d.__________________ Rp.___________________ p.c.___________________ b.i.d.__________________ h.s.___________________ 用法，指示 每晚 必要时 饭前 每日 1 次 每日 3 次 取，请取 饭后 每日 2 次 睡前

5. Reading A Task 1 Before reading the passage, see how much you know about the treatment of common chronic and acute diseases by answering the following questions. 1.What are the differences between acute diseases and chronic diseases? 2.What are the most common chronic diseases of older adults? Suggested Answers 1. Acute diseases often begin abruptly and last only a short time. Most people with an acute disease can expect to return to normal health. However, chronic diseases usually develop slowly, last a long time, and are often progressive and incurable. 2. The most common chronic diseases of older adults include arthritis, cardiovascular disease, cancer, diabetes, and obesity. In addition, the following primary health conditions also affect older adults: depression, cognitive decline, pneumonia and influenza, oral health, and orthopedic/hip fractures.

6.  Treatment of Common Chronic and Acute Diseases  Health concerns are usually classified as either acute or chronic. Acute illnesses often begin abruptly and last only a short time. Most people with an acute illness can expect to return to normal health. However, chronic diseases usually develop slowly, last a long time, and are often progressive and incurable.classifiedprogressiveincurable  Chronic Diseases  Chronic diseases, such as cardiovascular disease, cancer, and diabetes, are by far the leading cause of mortality in the world. Treatment includes medication and lifestyle changes such as diet and physical activity, and stress management. Cardiovascular diseases include coronary heart disease, hypertension, congenital heart disease, heart failure, etc. Once diagnosed with CVDs, patients are typically prescribed medication that will regulate cardiovascular functions and are usually taken daily for the rest of their life. Certain treatments are usually started right away if a heart attack is suspected, even before the diagnosis is confirmed. These include: oxygen, aspirin to prevent further blood clotting, nitroglycerin to reduce the workload on the heart, and treatment for chest pain.  Cancer may affect people at all ages, even fetuses. The three most common types of cancer treatment are surgery, radiotherapy and chemotherapy, which aim at removing the cancer cells or destroying them in the body with medicines or other agents. Choice of treatment is influenced by several factors, including the specific characteristics of the cancer, the patient’s overall condition, and whether the goal of treatment is to cure the cancer, keep it from spreading, or relieve the symptoms.relieve Reading A Translation

7. Reading A All forms of diabetes have been treatable since insulin became medically available in 1921, but there is no cure. The insulin injection is a basic treatment of type I diabetes. Type II is managed with a combination of dietary treatment, exercise, medications and insulin supplementation.dietary Acute Disease Treatment for acute diseases usually involves medication of antibiotics, which have direct effects on inflammation. Pneumonia is a common illness which occurs in all age groups. Most cases of pneumonia can be treated without hospitalization. Typically, oral antibiotics, rest, fluids, and home care are sufficient for complete resolution. However, if the symptoms get worse, or complications occur, the person will often have to be hospitalized.hospitalization Appendicitis is a condition characterized by inflammation of the appendix, which has been recognized as one of the most common causes of severe acute abdominal pain. Once a diagnosis of appendicitis is made, appendectomy is usually performed to remove the inflamed appendix. Antibiotics are always begun prior to surgery and as soon as appendicitis is suspected. Normally, the patient stays in the hospital for less than a week and can usually count on being back to a normal routine in three weeks. Once the useless appendix is removed, there is no danger of appendicitis recurring.abdominal Translation

8. 常见急慢性疾病的治疗方法 人们对健康的担忧通常分为对急性病和慢性病的担忧。急性疾病通常发病突 然，并且持续时间较短。大多数急性疾病患者有望恢复健康。而慢性疾病通常 进展缓慢，持续时间较长，并且经常不断地恶化，无法治愈。 慢性病 慢性疾病，如心血管疾病、癌症和糖尿病，是目前全球疾病死亡的主要原因。 针对慢性疾病的治疗包括药物和饮食、身体锻炼等生活方式的改变，以及对压 力的控制。心血管疾病包括冠心病、高血压、先天性心脏病和心力衰竭等。一 旦被诊断患有心血管疾病，患者通常须终身服用医生开具的调节其心血管功能 的处方药物。如果出现心脏病突发的疑似症状，某些治疗措施甚至在确诊之前 就应开始进行。这些治疗措施包括：吸氧、施用阿司匹林以阻止血液凝块的进 一步形成、施用硝化甘油以减少心脏的工作负荷，以及胸痛治疗。 癌症可能危及各年龄段人群，甚至胎儿。三种最为常见的癌症治疗手段为手 术治疗、放射线疗法和化学疗法，其目标在于去除癌细胞，或者通过药物或其 他制剂将癌细胞在患者体内完全消灭。治疗手段的选择受一些因素的影响，包 括所患癌症的特征、患者的整体状况，以及治疗的目的是要治愈癌症、控制其 扩散，还是要缓解症状。 Reading A

9. 自从胰岛素于 1921 年被应用于医学以来，各种类型的糖尿病成为可治 之症，但仍无法治愈。胰岛素注射是 I 型糖尿病的基本治疗手段。 II 型糖 尿病则通过将饮食、体育锻炼、药物、胰岛素补充等治疗手段结合起来 进行控制。 急性病 急性疾病的治疗通常需要使用对炎症有直接作用的抗生素类药物。 肺炎是一种见发于各年龄段的常见疾病。大多数肺炎病例无须住院治 疗。一般情况下，口服抗生素、休息、输液和家庭护理足以将其完全治 愈。然而，如果症状恶化，或出现并发症，患者将必须入院接受治疗。 阑尾炎是以阑尾的炎性反应为特点的病症，它一直被认为是急性腹部 剧痛的最常见原因之一。阑尾炎一经确诊，通常须施行阑尾切除术以去 除发炎的阑尾。对于疑似阑尾炎患者，阑尾炎手术术前应及时施用抗生 素。通常，患者住院不超过一周，而且三个星期内就有望恢复正常的工 作和生活。一旦没有用处的阑尾被切除，就不会再有阑尾炎复发的危险。 Reading A

10. Task 2 Read the passage, and match each paragraph with the corresponding aspect of chronic and acute diseases. Treatment of Common Chronic and Acute Diseases Paragraph 1 Paragraph 2 Paragraph 3 Paragraph 4 Paragraph 5 Paragraph 6 Paragraph 7 Paragraph 8 a. Diabetes b. Cancer c. Pneumonia d. Appendicitis e. Introduction of acute and chronic diseases f. Common ground of acute diseases g. Cardiovascular diseases h. Common ground of chronic diseases e h g b a f c d

11. Reading A Task 3 Match the following terms with the Chinese meanings. 1. cardiovascular disease 2. mortality 3. physical activity 4. heart failure 5. blood clotting 6. dietary treatment 7. complication 8. inflammation 9. abdominal pain 10. appendectomy a. 心力衰竭 b. 并发症 c. 血栓 d. 炎症，发炎 e. 死亡，死亡率 f. 阑尾切除术 g. 腹痛 h. 饮食疗法 i. 身体锻炼 j. 心血管疾病 j e i a c h b d g f

12. Reading A Task 4 Suppose you were a medical assistant, what can you do to provide effective nursing care for patients with chronic diseases? “Chronic diseases are now the major global disease problem facing the world and a key barrier to development, to alleviating poverty, and to implementing the Millennium Development Goals.” —Dr. Lee Jong-wook, Director- General, World Health Organization ( W HO), at the Fourth WHO Global Forum on Chronic Disease Prevention and Control in Ottawa in November 2004 ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ Key

13. Ensure that the patient and the patient’s family understand the diagnosis, the treatment and know where to obtain more information on the chronic disease. Talk with the patients and collaborate with them—they are the ones living with the disease. Work with community members and patients to ensure that appropriate services are available both in institutions and in the community. If appropriate community services are not available, the nurse’s role becomes that of facilitator and advocator. Consider the social determinants of health (e.g., income, employment, education, geographic isolation and social exclusion) in the assessment and treatment of clients with a chronic disease. Become aware of complementary practices available for patients to deal with existing chronic diseases or to prevent them. Determine the complementary practices your patients are using (if any), and assess the impact they may have on other treatments. Advocate increased investment in health promotion and preventive care. Support the development of an integrated approach to chronic disease prevention that focuses on common major risk factors. Reading A

14. classifyprogressiveincurable v. arrange sth. in groups according to features that they have in common e.g. The books in the library are classified according to the subject. Useful expressions: be classified into…: 被分类，归类为 …… be classified as…: 被划分，界定为 …… a. happening or developing steadily e.g. Cancer is a disease caused by the insidious progressive growth of abnormal cells. a. that cannot be cured e.g. The disease from which he died was at that time incurable. relieve v. remove or reduce an unpleasant feeling or pain e.g. Massage helps relieve the tension in one’s muscles. Useful expression: relieve sb. of sth.: 帮助某人减轻 …… （负担）

15. dietaryhospitalizationabdominal a. of or relating to diet e.g. Dietary cure is better than a medical one. n. the act of placing a person in a hospital as a patient e.g. An infection could cause serious problems that might necessitate transfusions and hospitalization. a. of or relating to abdomen e.g. Gastroenteritis is a disease characterized by abdominal pain, headache and fever. Reading A

16. Listening Task 1 Ella Smith wants to visit a gynecologist. [, ɡ a ɪ nə‘k ɑ ləd ʒɪ st] n. 妇科医生 Listen to the conversation and decide whether the following statements are true (T) or false (F). 1. There is no gynecologist in the consulting room right now. 2. Ella forgets taking her registration card. 3. Ella has to wait for about twenty minutes. 4. The nurse suggests Ella go to the waiting room downstairs. 5. Ella will be informed as soon as the doctor is free. F F T F T Script

17. Task 1 Script P: Excuse me, sir. N: Yes? What can I do for you? P: I want to see Dr. Lee, the gynecologist, but I can’t find her consulting room. N: It’s right here. Have you registered already? P: Yeah, here is my registration card. I’m Ella Smith. N: Okay, I’ve found your file. But I’m afraid you have to wait for a while. Dr. Lee is busy now. Would you like to have a rest on the bench over there? P: Alright. How long do you think it might take? N: Maybe twenty minutes. I will call you as soon as she is available. P: Thank you very much. N: You are welcome. Listening

18. Task 2 The gynecologist has prescribed [pri’skraib] v. 开处方，给医嘱 IV abbr. 静脉注射 fluids for Ella. Listen to the conversation and choose the best answer to each question you hear. 1. What IV fluids did the doctor prescribe for Ella? A. Penicillin. B. Azithromycin. 叠氮红霉素 C. Gentamicin. [,d ʒ entə'ma ɪ s ɪ n] 庆大霉素 2. What does the nurse require Ella to show? A. Prescription. [pris’krip ʃ ən]n.[ 医 ] 药方，处方； 处方药 B. Medication sheet. 药物表 C. Registration card. 3. Why cannot the nurse give her the drip immediately? A. Because Ella hasn’t paid for it. B. Because Ella has to take a blood test. C. Because Ella has to take an allergy test. 过敏测试 4. Which allergic response hasn’t been mentioned? A. Dizziness. [‘d ɪ z ɪ n ɪ s] n. 头昏眼花 B. Chest pain. C. Vomiting. 5. How long should they wait for the result? A. Half an hour. B. Twenty minutes. C. Twelve minutes. A B C C B Script

19. Task 2 Script N: Good morning. P: Good morning. I’m Ella Smith. I’m advised to be given penicillin IV fluids here. N: Would you please show me your medication sheet? P: Here you are. N: Ms. Smith, you need to take a penicillin allergy test before administration. P: What’s that? N: Some people are allergic to penicillin so everyone needs to have an allergy test before using it. It can help people avoid allergic response. P: I see. How to do that? N: I will inject a small amount of skin test solution into the superficial layers of your skin. If you feel any discomforts, such as dizziness, shortness of breath or chest pain, please let me know at once. I’ll see the result in about twenty minutes. P: Okay. N: Now please stretch out your right hand. P: Alright. Listening

20. Task 3 Listen to the conversation and fill in the blanks with what you hear. Nurse: Ms. Smith, how are you feeling? Ella: Nothing special. Nurse: Fine, let me have a look. Ah…congratulations! There’s no red or _____spot. You are not _____ penicillin. Ella: Well, great! Nurse: I will ______for you right now. Ella: I’m a little nervous. Please be tender. Nurse: ______. I will be very careful. Please _______ your fist. Ella: Alright. Nurse: Please relax! It won’t be that painful. Ella: You’re right. Never felt a thing. Why don’t you make the fluids drop more quickly? Nurse: The IV fluids must be given slowly so as not to_______ you. Ella: Oh, I see. Nurse: Would you like to lie on that_________? I can help you get there. Ella: Yeah, thank you! swollen allergic to connect the drip Take it easy clench overload couch

21. Listening Task 4 A nurse is giving instructions to Mr. Hill after applying a plaster cast 石膏绷带；石膏模型 to him. Listen to the conversation and answer the following questions. be aware of, circulation, swollen, leaflet ['li ː fl ɪ t] 小叶，传单 1.How could Mr. Hill relieve the tight feeling of the plaster? ______________________________________________ 2. What should Mr. Hill do if he feels severe tight pain? ______________________________________________ 3. When could Mr. Hill walk on the plaster? ______________________________________________ 4. Why should Mr. Hill keep his toes moving at all times? ______________________________________________ 5. What’s the abnormal state of the toes? _______________________________________________ Lie down and raise the leg on one or more pillows. Report to the hospital at once. He has to wait till he is given permission to walk on the plaster. Because it can improve the circulation. The toes become swollen, blue, pale, cold or difficult to move. Script

22. Task 4 Script P: Miss Wang, the plaster feels a little tight. Is that all right? N: Yeah, it just lasts for some time after application. P: How can I relieve the feeling? N: You could lie down and raise the leg on one or more pillows. But if you still experience any severe tight pain after doing this, please report to us at once. P: Okay. Is there anything else I need to be aware of? N: Don’t wet or heat the cast. P: Alright. I will be careful. N: Do remember that you could not walk on the plaster until given permission to do so. P: I promise! N: Try to keep your toes moving at all times, as it improves your circulation. If the toes become swollen, blue, pale, cold or difficult to move, please come back immediately. P: I wish it wouldn’t occur to me. N: Here is a leaflet. You may get more instructions about care of the cast and your leg. P: Thanks a lot. Listening

23. Speaking Task 1 Work in pairs. Suppose a patient is waiting outside the consulting room. Make a conversation between the patient and a nurse. Practice making requests and responses with the help of the expressions below. Sample

24. Task 1 Sample Dialog P: Excuse me, miss. N: Yes? What can I do for you? P: I want to see Dr. Lee. Is this her consulting room? N: Yeah. Would you please show me your registration card? P: Sure. No problem. N: Okay, I’ve found your file. But would you mind waiting for a while? Dr. Lee is busy now. P: Never mind. Well, I wonder if you could call me when she is available. N: Yes, of course. P: Thank you very much. N: You are welcome. Speaking

25. Task 2 Work in group. Practice explaining penicillin allergy test to your group members. The following points should be included: purpose, method and responses. You may refer to the expressions below. Sample

26. Task 2 Suggested Answers Penicillin is effective for treating bacterial infections. But if you are allergic to penicillin, taking these drugs can be dangerous. In order to avoid allergic response, you have to take a penicillin allergy test. Nurse will inject a small amount of skin test solution into the skin. After 20-30 minutes, if an allergy is present, it will produce a red, raised spot, called a wheal, at the test site. In a very few cases, if you feel dizzy, short of breath or chest pain, you should notify the doctor immediately. If the test is negative, penicillin can be administered. Speaking

27. Task 3 Work in pairs. Practice helping a patient make an appointment with a doctor. You may refer to the expressions given below. Nurse Patient Greet Require the patient to show medication sheet. Comfort the patient & give instructions while giving IV fluids. Charge for the registration Greet & want to have IV fluids. Express anxiety. Ask for making the fluids drop more quickly. Express appreciation. Sample

28. Task 3 Sample Dialog N: Good morning. P: Good morning. I’m Jim Brown. I’m advised to be given IV fluids here. N: Would you please show me your medication sheet? P: Here you are. N: Okay. I will connect the drip for you right now. P: I’m a little nervous. N: Take it easy. I will be very careful. Please clench your fist. P: Alright. N: Please relax! It won’t be that painful. P: You’re right. Never felt a thing. Why don’t you make the fluids drop more quickly? N: Your IV fluids must be given slowly so as not to overload you. P: I see. Thank you very much! Speaking

29. Task 4 Work in groups. Brainstorm all the tips of taking care of the plaster cast and limbs. Then make a conversation between a nurse and a patient with the expressions. Dos Don’ts _______________________ ____________________________ Lie down and raise the leg on pillows. Report to the hospital immediately if severe tight pain is felt. Keep toes moving at all times. If the toes become swollen, blue, pale, cold or difficult to move, come back to the hospital. Don’t wet or heat the cast. Don’t walk on the plaster until given Permission

30.  Physician’s Order Sheet  PATIENT’S NAME: Mr. James Smith DATE: 3/17/2009  DATE OF BIRTH: 5/21/1959 TIME: 10:50 a.m.  Diagnosis: Type II Diabetes (T2D)  Drug Allergies: None  Diet: ADA diet (balanced carb, low fat, HS snack)balanced  Medication:  Insulin: Lantus®  Dose: Start at an average dose of 10 units once daily and adjust according to the need to a total daily dose ranging from 2 to 100 units. Regular insulin subcutaneous given 30 minutes before meals.ranging Reading B Translation

31. Reading B Translation

32.  Guidelines for Correction:  For blood glucose less than 80 mg/dl, use Hypoglycemia Protocol below:  1. Give 15 grams of fast-acting carbohydrate (4 oz fruit juice/non-diet soda,  8 oz nonfat milk, or 3-4 glucose tablets).  2. Check finger stick glucose every 15 minutes and repeat above if blood  glucose is less that 80 mg/dl  3. Call physician.  Record all insulin given and glucose results on Blood Glucose  Monitoring Record.  Oral Agent: Continue oral hypoglycemic agents and add 10u NPH at bedtime  Labs:  Blood Glucose Monitoring:  AC/HS, or q 6 hours if NPO, and PRN hypoglycemic symptoms  Fasting Lipid Profile  Albumin/ Creatinine RatioRatio Reading B Translation

33.  Patient Education:  Need to be aware of the importance of more frequent testing of blood sugars and monitoring for symptoms during the next 24 hrs after an episode of hypoglycemia (if the next hypoglycemia episode is within 24 hrs, glucose levels can drop much lower before hormonal counter-regulation and autonomic symptoms occur).episode  Assess family’s knowledge of glucagon administration and hypoglycemia treatment.  Call Physician For:  A. Blood Glucose over 400 or 2 times consecutively over 300.  B. BS<70 more than two times consecutively or more than once on any one day.consecutively  C. Insulin adjustment order for: starting/ending NPO, change in tube feeding, change in steroid dose.  Follow-up:  Call in blood sugars weekly for further insulin titration instructions.  Document progress on Diabetes Encounter Form and Insulin Adjustment Tracking Form.  Keep physician informed of progress every 3 - 4 weeks.  PHYSICIAN NAME: Thomas Kim. M.D.  SIGNATURE:_______________ Reading B Translation

34. 医 嘱 单 患者姓名 : Mr. James Smith 就诊日期 : 3/17/2009 出生年月 : 5/21/1959 就诊时间 : 10:50 a.m. 临床诊断 : II 型糖尿病 药物过敏史 : 无 饮食 : 标准糖尿病饮食（均衡的碳水化合物，低脂肪，临睡前加餐） 药物治疗 : ● 胰岛素：来得时注射液 ® 剂量： 初始剂量平均为 10 单位，每日一次，可根据需要在 2 至 100 单位之间 调整用量。饭前 30 分钟常规皮下注射。 Reading B

35. 饭前 : 建议常规胰岛素用药时间应间隔 4 小时以上。 血糖值 中等剂量 （每日需要 40-80 个单位胰岛素） <80 遵照下述原则校正 80-150 无需注射胰岛素 150-199 1 单位 200-249 3 单位 250-299 5 单位 300-349 7 单位 350-399 8 单位  400 应与医生取得联系 Reading B

36. 校正原则： 如血糖低于 80 毫克 / 分升，应使用下述低血糖症治疗方案： 1. 摄入 15 克速效葡萄糖源 (4 盎司果汁或含糖苏打水， 8 盎司脱脂牛奶，或 3- 4 片葡萄糖药片 ) 。 2. 每隔 15 分钟检测一次微量血糖，如血糖低于 80 毫克 / 分升，重复上述过程。 3. 与医生取得联系。 在血糖监测记录中记录胰岛素用量和血糖值。 ● 口服药物：继续服用口服降糖药，并且睡前增加服用 10 单位的中性鱼精 蛋白胰岛素 检查项目： ● 血糖监测： 饭前或临睡前，如禁食每隔 6 小时监测一次, 需要时长期监测低血糖症症状 ● 空腹血脂谱 ● 白蛋白对肌氨酸酐比率 Reading B

37. 患者教育： ● 应意识到在低血糖症发作后 24 小时内频繁监测血糖值和相关症状的重要性 （如在 24 小时以内低 血糖症第二次发作，血糖将在对抗胰岛素的反调节激素分泌前出现更大幅度 的下降） ● 评估家庭成员关于胰高血糖素施用方法和低血糖症治疗的知识 如出现下述情况，应及时与医生联系： A. 血糖值超过 400 毫克 / 分升或连续两次超过 300 毫克 / 分升 B. 血糖值连续两次以上或同一天内不止一次低于 70 C. 调整胰岛素用量请求：开始或停止禁食，改变管灌饮食，改变类固醇剂量 跟踪记录： ● 每周将血糖值打电话告知医生，以进一步确定胰岛素滴定治疗方案 ● 在诊断评估表和胰岛素用量调整记录卡上记录治疗进展 ● 每隔 3-4 星期将治疗进展告知医生 医生姓名： Thomas Kim. M.D. 签字： ____________________ Reading B

38. Task 1 Matching the following terms with their Chinese meanings. 1. physician’s order 2. blood glucose 3. low fat 4. daily dose 5. oral agent a. 每日剂量 b. 血糖 c. 口服药物 d. 医嘱 e. 低脂 d b e a c

39. Reading B Task 2 Read the passage and decide whether the following statements are true (T) or false (F). 1.Regular insulin subcutaneous should be given sixty minutes before meals. 2. It is recommended that regular insulin be given at least four hours apart. 3. If the blood sugar is higher than 400 mg/dl, the patient should call the physician. 4. If the blood sugar is less than 80 mg/dl, the patient had better take oral hypoglycemic agents. 5. The patients should realize the importance of more frequent testing of blood sugars and monitoring for symptoms during the next 24 hrs after an episode of hypoglycemia. F T T T T

40. Reading B Task 3 Translate the following short passage into Chinese. Need to be aware of the importance of more frequent testing of blood sugars an monitoring for symptoms during the next 24 hrs after an episode of hypoglycemia (if the next hypoglycemia episode is within 24 hrs, glucose levels can drop much lower before hormonal counter-regulation and autonomic symptoms occur). _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ 应意识到在低血糖症发作后 24 小时内频繁监测血糖值和相关症 状的重要性（如在 24 小时以内低血糖症第二次发作，血糖将在对 抗胰岛素的反调节激素分泌前出现更大幅度的下降）。

41. balancedrange a. keeping or showing a balance so that different things or different parts of sth. exist in equal or correct amounts e.g. The program presented a balanced view of the two sides of the conflict. v. vary between two particular amounts, sizes, etc. e.g. Estimates of the damage range between $1 million and $5 million. Useful expression: range from…to… : 从 …… 到 …… 范围内变化 Reading B

42. medium a. in the middle between two sizes, amounts, lengths, temperatures, etc. e.g. There are three sizes—small, medium and large. Reading B

43. ratio n. the relationship between two groups of people or things that is represented by two numbers showing how much larger one group is than the other e.g. The ratio of applications to available positions currently stands at 100 ∶ 1. Useful expression: the ratio of…to…: …… 与 …… 的比例 Reading B

44. episodeconsecutively n. an event or a short period of time during which sth. specific happened e.g. It refers to a neurologically mediated fainting episode that is usually brought on by stress or pain. ad. happening one after the other without interruption e.g. He was absent consecutively for five days. Reading B

45. Writing Task 1 Informed consent is the process by which a fully informed patient can participate in choices about his or her health care. The patient, or guardian, must understand the potential risks and benefits of the treatments and legally agree to accept the risks in writing. Furthermore, the risks andpossible side effects must be explained in easy-to-understand language. It is generally accepted that complete informed consent includes a discussion of the following elements: (1) the nature of the decision or procedure; (2) reasonable alternatives to the proposed intervention; (3) the relevant risks, benefits, and uncertainties related to each alternative; (4) assessment of patients’ understanding; (5) the acceptance of the intervention by the patient.

46.  Informed Consent Form  Patient Personal Data  Name: Mr. James Smith DOB: 05/21/1970  Surgery Physician: Thomas Kim. M.D.  Surgery Procedures  1. Clinical Disease/Condition: Acute Appendicitis  2. Surgery: Appendicectomy  3. The following procedure will be performed:  Removal of the appendix through a cut on the lower right side of the abdomen.  Risk of This Procedure  There are some risks/complications, which include:  (a) Deep bleeding in the abdominal cavity. This may need fluid replacement or further surgery.  (b) Infections such as pus （脓） collections can occur in the abdominal cavity. This may  need surgical drainage.  (c) The wound may become thickened and red.  (d) Adhesions (bands of scar tissue) may form and cause bowel obstruction. This can be a  short term or a long term complication and may need further surgery.  (e) Increased risk in obese people of wound infection, chest infection, heart and lung  complications and thrombosis. Writing

47.  Doctor’s Statement  1. I have already verbally explained to the patient in a way that he/she can understand,  information concerning this surgery, as well as related information, especially the following:  Reason for this surgery, surgical procedure & area, surgery risk and success rate,  possibility of blood transfusion;  Any complications and possible treatments;  Other replacement treatments and possible consequences if the surgery is not performed;  Temporary or permanent symptoms that might result following the surgery;  I have told the patient all of the related information regarding the surgery.  2. I have given the patient/substitute decision-maker an opportunity to  ask questions about any of the above matters;  raise any other concerns which I have answered as fully as possible.  3. I am of the opinion that the patient/substitute decision-maker understood the above  information.  Signature of Physician: ＿＿＿＿＿ Date: 04/08/2009 Time: 10:35 a.m. Writing

48. Patient’s Statement I acknowledge that: 1. The doctor has explained my medical condition and the proposed procedure. I understand the risks of the procedure, including the risks that are specific to me, and the likely outcomes. 2. The doctor has explained other relevant treatment options and their associated risks. 3. The doctor has explained my prognosis （预后） and the risks of not having the procedure. 4. I was able to ask questions and raise concerns with the doctor about my condition, the procedure and its risks, and my treatment options. My questions and concerns have been discussed and answered to my satisfaction. 5. I understand that the procedure may include a blood transfusion. 6. I understand that if organs or tissues are removed during the surgery, that these may be retained for tests for a period of time and then disposed of sensitively by the hospital. 7. The doctor has explained to me that if immediate life-threatening events happen during the procedure, they will be treated accordingly. 8. I understand that no guarantee has been made that the procedure will improve the condition, and that the procedure may make my condition worse. Writing

49.  For reason of all of the above statements, I hereby consent to the surgery.  Name of Patient/Substitute Decision-maker: Mrs. James Smith  Signature: ＿＿＿＿＿＿＿  Relation with Patient: wife  Patient’s Address: 1122 Lawrence Street, Washington  Tel No.: (202) 797-3086  Date: 04/08/2009 Time: 11:00 a.m. Writing

50. Task 2 Fill in the Informed Consent Form for surgery below according to the following information. Situation: Jessie Brown, a 50-year-old lady, who lives in 36 Ritan road, Chaoyang District in Beijing, went to hospital on May 11, 2008 because of cloudy lens 晶体混浊 in the left eye. The eye surgeon, Susan Johnson, has recommended cataract [‘kætərækt] n. 白内障 surgery because the lens in the Ms. Brown’s left eye has become cloudy making her difficult to see well enough to carry out the usual daily activities. Cataract surgery is to remove the natural lens and implant an intraocular [, ɪ ntrə' ɑ kjəl ɚ ] lens 人工晶状体 in the eye. After careful consideration, Ms. Brown decided to take the surgery.

51. Informed Consent Form Patient Personal Data Name:_______ DOB: 12/09/1959 Surgery Physician:_____________  Surgery Procedures 1. Clinical Disease/Condition:__________________ 2. Surgery:_____________ 3. The following procedure will be performed: Risk of This Procedure 1. Complications of removing the natural lens may include: 2. Complications associated with local anesthesia injections around the eye may include: Writing Jessie Brown Susan Johnson decreased vision caused by the cataract cataract surgery and implantation of intraocular implants removal of the natural lens of the left eye and implantation of an intraocular lens in the eye hemorrhage [‘hemər ɪ d ʒ ] (bleeding); perforation [,p ɜː fə’re ɪʃ n] 穿孔 of the eye; clouding of the outer lens 外透镜 of the eye; swelling in the central area of the retina[‘ret ɪ nə] 视网膜, which usually improves with time. These and other complications may occur whether or not an IOL is implanted and may result in poor vision, total loss of vision, or even loss of the eye in rare situations. Additional surgery may be required to treat these complications. perforation of the eye, destruction of the optic nerve, interference with the circulation of the retina, droopy eyelid 眼皮下垂, respiratory depression 呼吸抑制, hypotension, cardiac problems 心脏问题, and in rare situations, brain damage or death.

52.  Doctor’s Statement  1. I have already verbally explained to the patient in a way that he/she can understand, information concerning this surgery, as well as related information, especially the following:  Reason for this surgery, surgical procedure & area, surgery risk and success rate,  possibility of blood transfusion;  Any complications and possible treatments;  Other replacement treatments and possible consequences if the surgery is not  performed;  Temporary or permanent symptoms that might result following the surgery;  I have told the patient all of the related information regarding the surgery.  2. I have given the patient/substitute decision-maker an opportunity to ask  questions about any of the above matters raise any other concerns which I  have answered as fully as possible.  3. I am of the opinion that the patient/substitute decision-maker understood the above  information.  Signature of Physician:______ ___ Date: ___/____ /_____ Time:________ Writing Susan Johnson 04 29 2009 9 ∶ 30 a.m.

53.  Patient’s Statement  I acknowledge that:  1. The doctor has explained my medical condition and the proposed procedure. I understand the risks of the procedure, including the risks that are specific to me, and the likely outcomes.  2. The doctor has explained other relevant treatment options and their associated risks.  3. The doctor has explained my prognosis and the risks of not having the procedure.  4. I was able to ask questions and raise concerns with the doctor about my condition, the procedure and its risks, and my treatment options. My questions and concerns have been discussed and answered to my satisfaction.  5. I understand that the procedure may include a blood transfusion.  6. I understand that if organs or tissues are removed during the surgery, that these may be retained for tests for a period of time and then disposed of sensitively by the hospital.  7. The doctor has explained to me that if immediate life-threatening events happen during the procedure, they will be treated accordingly.  8. I understand that no guarantee has been made that the procedure will improve the condition, and that the procedure may make my condition worse. Writing

54.  For reason of all of the above statements, I hereby consent to the surgery.  Name of Patient/Substitute Decision-maker:____________________  Signature:_______________ Relation with Patient:______________  Patient’s Address: __________________________________________  Tel No.:__________________________________________________  Date: ______/______ /_________ Time:_________________ Writing Jessie Brown wife 36 Ritan road, Chaoyang District, Beijing 12034567 04 29 2009 9 ∶ 30 a.m.

55. Project Project Guidelines This project aims to gain deep insight into the nursing intervention in the diagnostic procedure. The overall tasks are divided into three steps. Step One looks at collecting the information about the patient’s physical status. Step Two focuses on the implementation of diagnostic tests. Step Three centers on medication administration and completion of records on the nursing note. Please follow the Task Description to complete your work. Instruction

56.  Task Description  Step One  Organize a small group with 2 students (acting the role of nurse and patient,  respectively) in your class;  The nurse gathers the necessary and relevant information from the patient;  Direct the patient’s visit to the appropriate consulting room.  Step Two  Check with the patient about the doctor’s order of the diagnostic tests.  Assist in the implementation of the diagnostic tests.  Step Three  Check the prescriptions against the doctor’s orders in written form;  Administer medications to the patient (make sure that the patient understand the  dose, frequency of the drug); and administer injection or intravenous therapy, as  required;  Record the procedure in nursing notes;  Take turns to play each role for the whole procedure mentioned above;  Have a discussion of the details of the nursing intervention during the diagnostic  procedure and give a presentation to the whole class. Project

57. Objective: The purpose of this project is to help students gain deep insight into the nursing intervention in the diagnostic procedure. It refers to activities carried out by the nurse to deliver effective care to the patient as a support for the medical diagnosis in the outpatient department. Suggestions: The whole procedure is patient-centered, which involves three major steps of assessment, nursing diagnosis, implementation. Step 1: Assessment Phase The students should carry out a complete and holistic nursing assessment of every patient’s needs, regardless of the reason for the encounter. This will ensure that the students direct the patient’s visit to the appropriate consulting room. Step 2: Diagnosis Phrase The students should be aware that nursing diagnoses are part of a movement in nursing to standardize terminology which includes standard descriptions of diagnoses, interventions, and outcomes. Standardized terminology will help nursing become more scientific and evidence-based. Project

58. Step 3: Implementation Phase The purpose of this stage is to help students get more details about how to administer medications or other therapies to the patient. The students should keep in mind that the methods of implementation must be recorded in an explicit and tangible format in a way that the patient can understand. Clarity is essential as it will aid communication between those tasked with carrying outpatient care. Please note that the entire process must be recorded or documented in an agreed format in the patient’s care plan in order to allow all members of the nursing team to perform the agreed care and make additions or changes where appropriate.

59. Vocabulary and Structure Task 1 Match the following terms with their Chinese meanings. 1. by far 2. stress management 3. right away 4. heart attack 5. cancer cell 6. normal routine 7. according to 8. tube feeding a. 压力管理 b. 立即，马上 c. 心脏病发作 d. 正常生活 e. 依据，按照 f. 管灌饮食 g. 到目前为止 h. 癌细胞 g a b c h d e f

60. Task 2 Fill in the blanks with words or phrases from Reading A and Reading B that match the meanings in the right column. The first letters are already given. c_____ lasting for a long period of time or marked by frequent recurrence, as certain diseases d_____ any of several metabolic disorders marked by excessive discharge of urine and persistent thirst h_____ abnormally elevated blood pressure c_____ the treatment of disease using chemical agents or drugs that are selectively toxic to the causative agent of the disease, such as a virus, bacterium, or other microorganism h_____ the act of placing a person in a hospital as a patient h_____ an abnormally low level of glucose in the blood r_____ cause a lessening or alleviation of i_____ impossible to cure; not curable i_____ a localized protective reaction of tissue to irritation, injury, or infection, characterized by pain, redness, swelling, and sometimes loss of function c_____ of, relating to, or involving the heart and the blood vessels Vocabulary and Structure hronic iabetes ypertension hemotherapy ospitalization ypoglycemia elieve ncurable nflammation ardiovascular

61.  Task 3 Fill in each blank with the appropriate form of the word given in brackets. 1. In this store, you can find a wide variety of TV sets with prices (range)______ from $500 to $1,000. 2. The employee was fired due to his poor (perform) _______ in the past year. 3. The fund is for (relieve) _______distress among the flood victims. 4. (continue)_________ exposure to sunlight is harmful to the skin. 5. I don't need a nutritional (diet)________ supplement. 6. You should continue to lead a healthy life, such as eating a (balance)_______ diet. 7. A newspaper told the sad story of a seven-year-old boy with a (n) (cure) _____illness. 8. The following day his chest got worse and this led to his (hospital)__________. 9. We are often attracted to another person because of their (physical) ______ appearance, and sometimes because of their ideas, opinions and goals. 10. It also affects the kidneys and upsets (hormone)_________ balance. Vocabulary and Structure ranging performance relieving Continuous dietary balanced incurable physical hormonal hospitalization

62.  Task 4 Complete the following sentences with the words or phrases given below. Change the form if necessary. Vocabulary and Structure recognize adjust prior to balance relieve aware involve aim classify at least 1. Living without a(n) _______ is like sailing without a compass. 2. Nick’s job as a public relations director ________ spending quite a lot of time with other people. 3. You will have ______ to yourself to a completely new life in the United States when you get there. 4. He was so much changed that I could hardly________ him. 5. James is not ______that his own faintness is his greatest enemy. 6. The books in the library are_______ by subject. 7. All the arrangements should be completed ________your departure. 8. A _______diet provides nutrition for your body. 9. To go abroad to study, you should________ master the language. 10. Drugs help to__________ the pain. aim involves adjust recognize aware classified prior to balanced at least relieve

63.  Task 5 Complete the following sentences by translating the Chinese into English, using the words or phrases given in brackets.  1. ________________________ （酸雨被认为是） one of the most serious global environmental problems. (recognize as)  2. Before his departure, he was advised by his parents to ____________________ （尽快适应新的环境）. (adjust to )  3. The country’s economy ____________________ （在一定程度上依赖于原材 料的进口）.(count on)  4. _________________________ （他知道） the possibility of a recurrence of his illness. (be aware of)  5. The Bronze Age is __________________ （以青铜制作武器和工具为特征）. (be characterized by) Vocabulary and Structure 1. Acid rain is recognized as 2. adjust himself to the new condition as soon as possible 3. counts to some degree on the import of raw materials 4. He was aware of 5. characterized by weapons and implements made of bronze

64.  Task 6 Prefix “rhin-”:  Example: rhinalgia 鼻痛 rhinesthesia 嗅觉 rhinencephalon 嗅脑 Complete the sentences with the words given below. rhinopharynx rhinoscope rhinorrhagia rhinoplasty rhinitis 1. ______are more commonly seen in children than in adults, one reason for which is that kids tend to get hurt more easily and some have the habit of picking nose. 2. Radiology treatment is often used to deal with cancer of_________, that is, malignant tumors in the areas of nose and throat. 3. Inflammation of the mucous membrane that lines the nose is called__________. 4. If you consult your doctor because of nose problems, your doctor may use a________ to check your nasal passage. 5. ________is widely used in modern surgery to help those who are not pleased with the shape of their noses, in order to make their nose bridges higher. Vocabulary and Structure Rhinorrhagia rhinopharynx rhinitis rhinoscope Rhinoplasty

65. Thank You!新职业英语