UNIT 4

Treating a
Patient
Lecturer: Nurse Marina Panago

March 2016
Contents

▹Medical Focuses
Wounds
Pain
Pulse
▹ Types of Medication
▹ Health Idioms
 1
Medical Focus:
Wounds
How can they be described?
What characteristics can they
present?
 “
A wound is an injury to the body, that
usually causes damage to the
underlying tissues
 How can
wounds Observe wound itself and surrounding skin

be Descibe wound Descibe surrounding

described according to: skin by saying if it is:
▹ Type of tissue ▹ Healthy
present (granulating, ▹ Broken
epithelising, sloughy ▹ Inflammed
or necrotic) ▹ Dry
▹ Odour ▹ Desquamative
▹ Presence of
Discharge (Pus or Surgical Wounds
blood) ▹ Clean
▹ Contaminated/
Infected
 Exercise
Describe the following wounds
What kind of wound is this?
▹ Surgical wound

How would you describe

the wound?
▹ Clean

How would you describe

the surrounding skin?
▹ Healthy
▹ No signs of inflammation
or infection
What kind of wound is
this?
▹ Traumatic Wound
▹ Ulcer

How would you describe

the wound?
▹ Sloughy

How would you describe

the surrounding skin?
▹ Inflammed
 2
Medical Focus:
Pain
How can pain be measured?
How can it be described?
What questions to ask to assess pain?
How can pain
be Pain Score
measured?
Pain can be measured using various types of pain
assesment scales

On adults:
▹ Numeric Pain Scale – Scale from 0 to 10 (being 10
the maximum pain possible)
How can pain
be Pain Score
measured?
Pain can be measured using various types of pain
assesment scales

On Children (3 years old or more):

▹ Wong-Baker FACE Pain Raiting Scale
How can pain
be Pain Score
measured?
Pain can be measured using various types of pain
assesment scales

On Infants or Non-Verbal Patients:

▹ Behavioural Signs: Facial expression, body
activity/motor movement and crying/verbalisation
FLACC: Faces, Legs, Activity,Cry,Consolability
Observational Tool

▹ Physiological Indicators: Heart rate, respiratory rate,

oxygen saturation (mainly on neonatal patients)
 FLACC
Pain
Observation
Tool
How can pain be described?
What types of pain can we
encounter?
How can pain
be Types of Pain
described?
▹ Acute pain – sudden onset of pain
▹ Chronic pain – lasts for a long time (associated with
chronic illness)
▹ “Achy pain/dull pain” – continuous pain but not very
strong
▹ “Sore” – Painful and unconfortable (usually result of injury,
infection or too much exercise)
▹ “Burning pain” – Painful, like that part of your body is
burning or touching something hot
▹ “Sharp pain” – sudden and severe pain
▹ “Stabbing pain” – sudden and very strong pain - knifes
▹ “Throbbing pain” – stops and starts in time with your heart
How can pain
be Types of Pain
described?
▹ “Stinging pain” – irritating and burning pain
▹ “Tingling pain” – like a lot of sharp points going into you
▹ “Tender” – if a part of the body is tender it means that
has been injured and is painful when touched
▹ “Chapped” – skin or lips can be chapped, feeling dry
and painful (mainly due to cold weather)
▹ “Thumping pain” – severe pain
▹ “Tight” – when it feels like a part of your body is being
squeezed (normally localised on the chest)
▹ “Torturous” – extreme pain
▹ “Unbearable/unendurable” – when you cannot cope
with the pain
▹ “Agonising/Excrutiating” – unbearable pain
What questions can we ask to
assess pain?
 What kind of
questions Pain Assessment
should we ask
to assess ▹ Location
“Where is the pain located?” or “Where is it painful?”
pain?
▹ Level of Pain/Intensity
“What would you say that your pain level is from 1 to 10, being
10 the worst pain possible?” or “How bad is your pain?”
▹ Onset of Pain
“Did the pain start suddenly or have you had it for while?”
▹ Duration of Pain
“How long have you had this pain for?” or “When did the pain
start?”
▹ Kind of Pain
“How would you describe your pain?” or “What kind of pain do
you feel?”
Exercises
Pages 67-70
 3
Medical Focus:
Pulse
What types of pulse are there?
How can pulses be described?
What types of
pulse are Types of Pulse
there?
According to their location:

▹ Pedal – found on the top of the foot

▹ Popliteal – behind the knee when the leg is bent at
an angle of 120º
▹ Brachial - in the elbow cavity on the inside of the
arm
▹ Tibial – found behind the ankle
▹ Carotid – found in the neck
▹ Temporal – In front of the ear on the temples
▹ Femoral – found in the groin
▹ Radial – found at the wrist, near the thumb
Localisation of Pulses
What types of
pulse are Types of Pulse
there?
According to their speed: According to their rhythm
(regularity of the pulse):
▹ Tachycardia – pulse
lower than 60 bpm (slow ▹ Regular
pulse) ▹ Irregular
▹ Bradycardia – pulse
greater that 100 bpm
(rapid pulse)

According to their force (strength):

▹ Thready – weak pulse

▹ Bounding – strong pulse
 3
Medical Focus:
Medication
What types of medication are there?
 Types of
Medication What types of medication you know?
▹ Analgesics ▹ Anti seizure (Barbiturates,
▹ Antibiotics Benzodiazepines etc.)
▹ Antihistamines ▹ Inhalers
▹ Anticoagulants ▹ Laxatives
▹ Antipsychotics
▹ Anti-inflammatories
▹ Antidepressants
▹ Anti-anxiety or Anxiolytics
▹ Beta-Blockers
▹ Diuretics
▹ Narcotics
▹ Sedatives
 What types of
medication are Medication Groups – Exercise page 81
there?

Antibiotics Antiacids Antihistamines Antipsychotics

ACE Inhibitors Benzodiazepines Beta-Blockers Inhalers

Medication
Mucolytics Laxatives
after a MI
Health Idioms
 “
In every language there are typical
expressions that people use to describe
daily situations. Health has it’s own
idioms as well …
Health Expressions that mean good health:

Idioms ▹ “I am feeling as fit as a feedle”

▹ “I am fighting fit”
▹ “I have got a clean bill of health”

Expressions that mean you are OK, but not 100% healthy:

▹ “I had a bit of a cold but I can’t complain”

Expressions that mean you are recovering from illness:

▹ “I was knocked out for a few days but now I’m back
on my feet”
▹ I’m well on the way of recovery”
Health
Expressions that mean bad health:
Idioms
▹ “I am feeling under the weather”
▹ “I am going down with something”
▹ “I am feeling a bit off-colour”
▹ “I am in bad shape”
▹ “I am feeling poorly”

Expressions that mean you are in severe pain:

▹ “I have got a splitting headache”

▹ “My back is killing me”
▹ “The/My dogs are barking” – Pain in your legs/feet
Health Other interesting expressions:
Idioms ▹ “The patient opened his bowels/had a bowel
movement” – O paciente defecou
▹ “The patient passed urine” – O paciente urinou
▹ “I want to wee/pee” – Quero urinar
▹ “I need to go number 1” – Preciso de urinar
▹ “I need to go number 2” – Preciso de defecar

Words worth knowing:

▹ NBM (Nil By Mouth) – Em jejum

▹ Sick bowl – Bacias de cartão para vómito
▹ Theatre – Bloco Operatório
▹ Scrub Nurse – Enfermeiro de Bloco
Health
Words/Expressions worth knowing:
Idioms
▹ Ward – Serviço
▹ Bay – Enfermaria
▹ Handover – Passagem de Turno
▹ TTO’S – Medicação para levar para casa
▹ MI – Miocardial Infarction
▹ CVA/Stroke – Cerebro Vascular Accident
▹ CAP – Community Acquired Pneumonia
▹ CT Scan – TAC
▹ MRI – Ressonância Magnética
Health
Observations/Vital Sign Monitoring
Idioms
▹ OD Obs – Once a day Observations
▹ BD Obs – Twice a day Observations (Every 12 hours)
▹ TDS Obs/6º Obs – Three Times a Day Observations/Six
Hourly obs – Vital sign monitoring every 6 hours
▹ QDS Obs/4º Obs – Four Times a Day Observations/Four
Hourly obs – Vital sign monitoring every 4 hours
▹ 2º Obs – Two Hourly Observations (Vital sign monitoring
every two hours)
▹ 1º Obs – One hourly Observations (Vital sign monitoring
every hour)