The second meeting of online learning

A.Reading

Physical examination

The physical examination is performed for all women during the’pre-conceptional

visit or the first pregnancy visit. The elements of the physical examination include : general
appearance and nutrition: head and neck, heart and lungs, breasts, abdomen, pelvic area
tenderness, extremities and back, neuromuscular ; and pelvic evaluation – speculum and
bimanual examination, clinic pelvimetry.

At each follow-up visit, the patient should be given an opportunity to ask question
about her pregnancy or comment on changes that she has noted. The physical exam should
include general appearance, nutrition, blood pressure, weight (including pattern of weight
gain), uterine size, heart rate of mother and fetus, and cervical check after 40 weeks. The
cervical check should include dilatation effacement, fetal presentation, and station. The
findings of this exam should be carefully documented and should be assessed during each
visit. The patient should be asked about fetal movement at each visit. Urine should be
checked to detect protein and glucose. Any change in the pregnancy risk assessment should
be recorded after each evaluation and an appropriate management plan outlined. Continual
risk assessment should be a standard part of the ante-partum care.

B.IMPERATIVE

When you do physical examination to your clinic, you will give some insruction.Below are
some instructions using imperative that commonly a health care givers such as a midwifes or
nurses give when they doing physical assessments

 Have a seat please

 Roll your sleeve up please
 Stand on this scale please
 Say ninety nine
 Say ah please
 Put this thermometer in your arm please
 Let me have your wrist please
 Roll your blouse up please? I need to check your abdomen
 Lower your trouser please
  Bend your knee please

Minor Problem

Minor Problem Suggestion

1.Nausea -It is normal.it’s caused by the change of the
hormones during gestation.
-l need to refer you to an internist.
2.Backache -it’s normal.it’s caused the changing center
of
gravity during pregnancy.
3.Heartburn -Just avoid bending over while
housekeeping.
-Just knee when taking something from
ground.
-Sleep with more pillows
4.Constipation -Drink a lot of water
-consume fresh fruit,vegetables
-Drink a glass of warm water in the
morning.
-Do mild exercise,such as walking.
5.leg cramp -just sit,hold the knee straight
6.white vaginal discharge -keep personal hygiene
-wash with plain water twice a day
-give a mild cream.
7.Varicose vein -Rest with vertical againts the wall for short
time
-make circling movements with ankles.

C. GRAMMAR FOCUS :Degrees of comparison

The degrees of comparison

-Positive degree : is shown with”as.......as

The process of delivery takes as long as the previous one.

-The comparative degree is usually known wih more+adjective+er

and the irregular form of comparative,and the

word”than”,....er and....er .

No more than one hour we should reach the hospital.

Your abdomen will be bigger and bigger during your pregnancy.

-Superlative degree is shown with the+superlative form [est]

POSITIVE COMPARATIVE SUPERLATIVE
Little Littler / Less Littlest / The least
Few Fewer Fewest
Careful More carefully The most carefull
Successful More succesful The most succesful
Far further/farther furthest/farthest
Long Longer Longest
Expensive More expensive The most expensive
Task 1: put the words in brackets into a correct comparative form.

1.When a woman is pregnant,the hormons of pregnancy have [ greater

] than the mechanical effects.

2.Individuals nowdays have [ high ] expectations of marriage and [ least] prepared than

their parents to tolerate an unsatisfactory relationship.

3.The abnormality rate among babies of diabetic mothers is up to

five times [ high ] than among Those. Those of non diabetics.

4.It has been suggested that midwifes should be [ many ] involved

with the confirmation of pregnancy.

5.As labor progress a mother may feel [ little ] confindent in her

ability to cope with contractions.

6.Pregnant women pass [great ] amount of urine than non-pregnant

woman.

7.Normally all the glocose is reabsorbed,if there is already [ many ]

than sufficient in the blood.

8.Most men are now ready to take [great ] share in household Tasks.

9.Two-handed grip to asses the pelvis is favored because it is [

comfortable ] for the woman and gives the most information for

the midwifes.

10.Anterior position of the fetus is [favorable ] to deliver than

posterior position.

D. PRACTICE
Task 2: Answer all of these questions and read your answer in front of the class.

1.Give your advice to the situation and illustrate it below.

A. Man is hit by a car

B. A lady vomits blood

C. A man looks weak

D. A blind man is going to cross the street

2.How to face a hopeless a patient?

3.What is your advice to your patient when she is in pregnancy?

4.Give your suggestions in improving the quality of indonesian

health students?

5.What should you do if you found one of your friend cannot

speak English at all?

Task 3: Translate into good English

1. Ny.Ratna,Anda harus istirahat total selama tiga hari.

2. Sebaiknya Anda mengunjungi bagian saraf dilantai dua.
3. Ingat! Jangan bekerja terlalu keras Nyonya Dewi.
4. Menurutmu,saya harus bagaimana?
5. Saya pikir sebaiknya Anda berkonsultasi dengan dokter.
6. Pak,Anda mengalami masalah dengan lambung anda,anda diminta untuk
menghindari makanan yang asam.
7. Saya akan menjelaskan program diet yang sesuai dengan kebutuhan anda.
8. Apakah porsi makananya cukup untuk ibu?
9. Apakah anda alergi terhadap makanan laut?
10. Ini daftar pilihan menu ,silahkan pilih untuk sarapan anda besok.
11. Selamat makan.
12. Anda harus membatasi diri dalam mengkonsumsi minuman soft drink.
13. Anda harus mengurangi konsumsi karbohidrat.
14. Dokter mendiagnosis anda mengalami serangan jantung,saya menyarankan bapak
banyak mengkonsumsi banyak buah-buahan.
15. Mengapa makan siangnya tidak dihabiskan?

E.ROLE PLAY
TASK 3 : Antenatal Care
Doctor : Ibu-ibu..Anda tampak segar dan cantik..saya senang
anda hadir lagi disini disini hari ini.
Miss M :Topik hari ini apa,dokter?”
Doctor :Topik kita hari ini ialah perawatan antenatal,artinya
sebelum kelahiran bayi.Hal ini adalah Menjaga diri
anda sebelum bayi lahir.Anda harus makan yang
baik..tidur cukup..jauhkan obat-obat yang berbahaya.
Miss M : Apa contohnya?”
Doctor : Jangan sekali-sekali menyentuh alkohol dan jangan
merokok!Kalau anda ikuti nasihat ini,bayi anda akan
mendapatkan kesempatan terbaik untuk mulai awal
kehidupan.Anda akan mendapatkan tenaga anda lebih
cepat setelah melahirkan dan mempunyai tenaga lebih
untuk menyusui.kami diklinik ini mempunyai
perawatan antenatal yang diselenggarakan oleh
perawat kami untuk anda.Daftarkan diri anda
untuk pertemuan mingguan seperti ini.”
Miss M : Sebaiknya kapan,Dokter?”
Doctor : Ya..segera setelah seorang wanita tahu bahwa dirinya
hamil.”
Miss M :”Apa sebenarnya tujuannya,Dokter?”
Doctor :”Untuk memeriksa dan menjaga supaya anda tetap
sehat..bahwa bayi anda tetap sehat..bahwa bayi anda
tumbuh dengan baik..tentu untuk mendeteksi setiap
masalah sedini mungkin sebelum mempengaruhi
kesehatan anda dan bayi anda..yaa untuk memastikan
bahwa anda sehat selama hamil dan kemudian
melahirkan bayi yang sehat...datanglah sebulan sekali
..dan dua kali sebulan di akhir kehamilan.
Miss M : Terima kasih ,Dokter.