英语查房2

英语查房2
英语查房2

主要的护理问题

1、自理能力缺陷综合症

2、疼痛

3、潜在的肢体功能障碍

4、

相应护理措施

1、首先做好心理护理,消除患者焦虑心理,其次指导患者建立建侧肢体的自理技巧,并随时巡视病房,满足病人生活需要。

2、卧床休息,患肢制动,必要时遵医嘱用药。

3、骨折早期指导和督促病人加强手指功能锻炼,如握拳、伸指等,同时加强饮食营养。

4、

The main nursing problems

1、Self-care ability deficiency syndrome

2、pain

3、Potential limbs disturbance

4、

nursing measures

1、First of all we should do well in psychological nursing, to eliminate patient anxiety, and guide patients to built up the health side body’s self-care skills,and we should also often visited the ward regularly to meeting patients' needs。

2、Staying in bed ,keeping limb still , and using medicinal when necessary 。

3、guiding and urging the patient to strengthen finger function exercise in the early,such as make a fist、leave fingers,and strengthen the diet at the same time。

外科查房常用英语

最全的医学英语之NO.1 1、抗生素医嘱[Antibiotic order] Prophylaxis 预防性用药 Duration of oder 用药时间 Procedure 操作,手术 Empiric theraphy 经验性治疗 Suspected site and organism 怀疑感染的部位和致病菌 Cultures ordered 做培养Documented infection 明确感染 Site and organism 部位和致病菌Explanation required 解释理由Antibiotic allergies 何种抗生素过敏 No known allergy 无已知的过敏 Drug+dose+Route+frequency药名+剂量+途径+次数 2、医嘱首页[Admission / transfer] Admit / transfer to 收入或转入Resident 住院医师 Attending 主治医师 Condition 病情 Diagnosis 诊断 Diet 饮食 Acitivity 活动 Vital signs 生命体征 I / O 记进出量Allergies 过敏 3、住院病历[case history] Identification 病人一般情况 Name 姓名 Sex 性别 Age 年龄 Marriage 婚姻 Person to notify and phone No. 联系人及电话 Race 民族 I.D.No. 身份证 Admission date 入院日期 Source of history 病史提供者 Reliability of history 可靠程度 Medical record No 病历号 Business phone No 工作单位电话 Home address and phone No 家庭住地及电话 Chief complaint 主诉 History of present illness 现病史 Past History 过去史 Surgical 外科 Medical 内科 Medications 用药 Allergies 过敏史 Social History 社会史 Habits 个人习惯

医学院临床教学查房规范

医学院临床教学查房规范临床教学查房是临床教学的重要组成部分,是培养学生如何观察诊疗病人,学习处理医患关系,学会当一名合格医生的重要教学活动,是培养实习生分析问题和解决问题能力的有效途径之一。通过教学查房,促进毕业实习学生的理论知识与临床实践的结合,提高临床辨证思维、诊断和治疗能力,巩固、深化基本理论、基础知识和基本技能,培养实习生临床分析问题和解决问题的能力。同时通过临床教学查房可促进临床教师教学意识的培养、教学内容的规范、教学水平的提高。临床教学查房具体要求如下 一、教学查房质量要求 1、教学准备:教师和学生都能熟悉患者病情,全面掌握近期病变情况,准备必要的临床影像材料,如心电图、X线片、CT片等。根据教学内容撰写查房教案、制作相应的课件。教师要提前准备备查病人,选择病例要符合大纲要求,要有代表性,以多发病、常见病为主;每次备查病人应在3人或以上。 2、计划目标:教师重视基本理论、基本知识、基本技能的培训,并对教学内容的掌握、熟悉、了解三级要求层次分明。 3、查体指导:注意体格检查示范性指导,加强学生体检规范化训练,及时纠正学生查体中的错误。

4、临床分析:结合病例综合分析收集的资料,正确诊断、制定治疗计划。 5、启发教学:能善于诱导学生的求知欲望,培养临床思维,充分体现学生“学”的主动性,能耐心讲解各种提问,及时纠正学生的不足,引导正确的学习方法。 6、归纳总结:引导学生归纳总结,学习内容和收获。 7、为人师表:礼貌待人,体恤病人,着装大方,谈吐文雅。 二、查房准备: 1、查房主持人:一般要求副高或以上职称的教师担任,具体人员由科室内统筹安排 2、主持教学查房的教师应按照教学大纲要求及根据教研室(科室)安排计划,事先做好准备,撰写教学查房备课方案,准备多媒体课件。教研室(科室)主任应事先听取主持教师准备情况的简要汇报,给予指导和认可。对于新担任此项工作的教师,教研室(科室)或病区可组织集体备课,听取汇报,给予指导。 3、教师应事先精心选择符合教学要求,有一定典型性,或便于对某一症候群进行鉴别分析的病例。一般不选择诊断不明确的疑难杂症。 4、保证教学查房取得预期效果的重要前提是学生的主动参与,教学查房应提前3天以上确定病例,并通知实习学生,要求参加查房的实习学生对病例进行充分的准备。熟悉病

英文查房医学词汇(原创)

先查病房, 然后去教室分析病情 病房 请大家跟着我 迎来新朋友 小组 外国留学生 第一床 住院医师 主治医生 丰富的经验 肾上腺[?'dri:n?l] 垂体[pi'tju:it?ri] 下丘脑 专科医师 肾上腺腺瘤Adrenal adenoma[,?di'n?um?] 钾potassium [p?'t?sj?m] hypokalemia[,haip?uk?'li:mj?] 睾丸testicular[te'stikjul?] male hypogonadism[,haip?'ɡ?un?diz?m, -'ɡ?n-] 刺激试验 代谢病科室 并发症 月经来潮 氯化钾 过度排除 判断 浓度 总量 单位 条件 摄入不足 胃肠道 汗 运动员 化验 异常转移 碱中毒 呼吸性 低钙血症 阳离子Check the ward, then go to the classroom to analyze the condition Ward Please follow me Usher in a new friends Group Foreign Students the first bed resident fellow Rich experience Adrenal [?'dri: n ?l] Pituitary [PI 'tju: it ?ri] Hypothalamus [, haip ?u 'θ? l ?m ?s] specialist Adrenal adenoma Adrenal adenoma [, ?di 'n ?um ?] Potassium [p ?'t ? sj ?r] Hypokalemia [, haip ?UK ?'li: mj ?] Testicular testicular [te 'stikjul ?] Male hypogonadism [, haip ?'ɡ?UN ?diz ?m,-' ɡ?n- Stimulation test Metabolic disease department complications Menstrual cramps Potassium chloride Excessive exclude Judgment Concentration Total Unit Condition Insufficient intake of Gastrointestinal tract Sweat Athlete Assay Abnormal transfer Alkalosis Respiratory Hypocalcemia Cation

教学查房规范

临床教学查房规范 查房前准备: 1、教学查房人员准备:查房主持医师、下级医师,规培学员。教学查房所在科室的实习生、研究生、进修生无特殊原因必须参加,病例的管床医师也必须参加,查房主持医师所管的下级医师尽可能参加。观摩人员包含:医院教学管理人员(或考官)、非本科室的医生及研究生,如查房主持医师的上级医师参加,做为观摩人员参加。 2、病例的准备:一般由总住院医师选择有教学意义的典型病例,病例应选择本专业的多发病、常见病种,且经过治疗有明显治疗效果的患者,要提前做好患者的思想工作,得到患者的配合与理解。 3、教学查房前2天,查房主持医师通知规培学员要做好该病种资料的复习。教学查房前查房主持医师及规培学员应熟悉患者及病情,并做好相关准备工作,病历、记录本、检查报告、影像片、查房用的器械等(血压计、体温表、听诊器、叩诊锤、手电筒、刻度尺、压舌板、棉签、笔等) 一、教学查房质量要求 1、教学准备:教师和学生都能熟悉患者病情,全面掌握近期病变情况,准备必要的临床影像材料,如心电图、X线片、CT片等。根据教学内容撰写查房教案、制作相应的课件。教师要提前准备备查病人,选择病例要符合大纲要求,要有代表性,以多发病、常见病为主;每次备查病人应在3人或以上。 2、计划目标:教师重视基本理论、基本知识、基本技能的培训,并对教学内容的掌握、熟悉、了解三级要求层次分明。 3、查体指导:注意体格检查示范性指导,加强学生体检规范化训练,及时纠正学生查体中的错误。 4、临床分析:结合病例综合分析收集的资料,正确诊断、制定治疗计划。 5、启发教学:能善于诱导学生的求知欲望,培养临床思维,充分体现学生“学”的主动性,能耐心讲解各种提问,及时纠正学生的不足,引导正确的学习方法。 6、归纳总结:引导学生归纳总结,学习内容和收获。 7、为人师表:礼貌待人,体恤病人,着装大方,谈吐文雅。 二、教学查房具体内容: 1、查房主持人:一般要求主治医师或以上职称的教师担任,具体人员由科室内统筹安排; 2、主持教学查房的教师应按照教学大纲要求及根据教研室(科室)安排计划,事先做好准备,撰写教学查房备课方案,准备多媒体课件。教研室(科室)

英语护理查房

护理查房2014.9.4 17床,,男,岁,因“”于月日入院。目前诊断:。现予1级护理,饮食,保肝护胃,利尿抗感染等治疗。患者血常规结果显示:。 目前患者精神疲倦,面色晦暗,巩膜黄染。上腹部轻压痛,腹部稍膨隆,双下肢轻度水肿,轻微活动后即感气促。尿少,推注“呋塞米”之后尿量可至1200ml/天,大便正常。 主要护理问题: 1、疼痛 2、体液过多:与肝功能减退、门静脉高压引起水钠潴留有关 Too much body fluids: hypohepatia caused water sodium retention, portal hypertension 3、营养失调低于机体需要量:与肝功能减退、门静脉高压引起食欲减退、消化和吸收障碍有关。 Malnutrition less than body requirements: the liver function and portal hypertension caused disorder characterized by loss of appetite, digestion and absorption. 4、活动无耐力:与肝功能减退、大量腹水有关 Decrease of active tolerance : related to liver function impairment, a large amount of ascites 5、有皮肤完整性受损的危险:与营养不良、水肿、皮肤干燥、瘙痒及长期卧床有关。 A risk of impaired skin integrity: with malnutrition, edema, skin is dry, itching, and stay in bed for about for a long time. 6、有体液不足的危险:与腹泻和长期使用利尿剂有关 Danger of lack of body fluids: associated with diarrhea and long-term use of diuretics

如何组织教学查房

如何组织教学查房 一、教学查房意义 定期开展针对住院医师的教学查房活动,是促进住院医师成长的重要的床边教学形式。教学查房集中体现了一个医院、一个科室和一位带教医师的医疗水平和教学水平,其重要性突出表现在:一是完成好住院医师规范化培训的重要环节和手段;二是书本知识和临床实践结合的重要途径;三是潜移默化、言传身教的重要课堂;三是培养临床师资、建立教学梯队的重要之路。因此,各住院医师规范化培训基地应高度重视教学查房这种教学形式,营造氛围,形成制度,规范运作,务求实效。 二、教学查房要点 (一)教学查房前的准备 带教医师方面: 1.病例准备。选择原则:有教学意义的典型病例;有利于培养临床思维能力,需进一步明确诊断或有治疗意义的病例。 2.教学准备。包括教学内容、重点与难点、教学方法与手段、作业与参考文献。若需要,可准备PPT。 参加教学查房的住院医师的准备: 1.要准备汇报病例的所有资料,包括查房病历、辅助检查资料等; 2.查房前要到病人床边看病人,要求住院医师带着问题参加查房。 (二)教学查房的流程

1.开场白:由主持教学查房的带教医师向参加查房的全体人员简要说明此次教学查房的目的和注意事项。 2.主管住培生汇报病历(一般在办公室,限定时间5分钟左右),包括简要汇报病史、体格检查、辅助检查中的主要发现;提出初步诊断和问题。这个时间,带教医师可进一步核对病历。 3.带教医师床旁核对病史和体格检查。要求带教医师基本功要过硬!首先,带教医师通过在病人床旁核对重要的病史、补充询问遗漏的病史,向住培生们传授病史采集的技巧和方法,强化住培生们问诊的基本功训练。其次,请住培生首先做重点体格检查。带教医师补充遗漏的部分,纠正不规范的体格检查操作手法,借此机会,手把手地指导住培生体格检查,并有针对性地进行规范示教。再次,通过床边与患者的交流,如了解患者对治疗的依从性,进行必要的指导,根据具体情况解答患者的疑问,感谢患者的配合,说明下一步将对患者进行的检查和治疗计划。指导住培生医患沟通的技巧。 4.讨论(一般在医生办公室进行) 讨论的每一步骤应先由住培生进行分析,随后由带教医师进行补充、纠正和指导。 一是小结病例特点。带教医师对病历书写进行检查主点评,指出不足之处;避免简单重复病历,但要求条理清晰;对重要的特征性的辅助检查进行判读。 二是诊断与鉴别诊断(强化临床思维训练)。提出初步诊断(强调规范和完整的诊断)、诊断依据(要求条理清晰,重点突出);提出鉴

英文护理查房

Lumbar disc herniation in nursing rounds Patient data:Patients with Zheng Baorong, female, 54 years old, a chief complaint of low back pain 8 years, increase with double lower limbs pain numbness and weakness in 2 months The patient is now history:The patient said in 8 years ago five apparent inducement appear gradually lower back pain, lower limb swelling and discomfort, fatigue after the increase of rest after remission, and occasional pain, line of symptomatic treatment, symptoms can be relieved, then still recurring symptoms. 2 months ago the exacerbation of symptoms and gradually appeared in both the lateral lower leg and foot pain, posterolateral, lower extremity weakness, pain like stabbing, burning, was continuing, especially with the double foot is heavy, night is obvious, the intense pain affect sleep, oral pain because of poor efficacy, and double the dorsum of the foot, foot numbness, consciously plantar " on the cotton ". The patients for further treatment to the hospital, outpatient investigation to " lumbar disc herniation " for the diagnosis of wards. In the course of the disease in patients without obvious fever, night sweats, fatigue symptoms, right foot fracture after long time bed double lower limb muscle atrophy, and decreased body weight of about 10kg, poor sleep, diet, two times can be. Characteristics of disease:Lumbar disc herniation is refers to the degeneration of intervertebral disc, fibrous ring rupture, the nuclear organization salient stimuli and compression of the nerve root and cause a syndrome. Traditional Chinese medicine books without lumbar intervertebral disc protrusion in the name of. Lumbar disc corresponds to an amphiarthrosis, is covered by hyaline cartilage plates, annulus fibrosus and nucleus pulposus composition, distribution in the lumbar spine bone room. Lumbar intervertebral disc degenerative changes or trauma induced by fibrous ring rupture, nucleus pulposus prolapse from rupture, compression lumbar nerve, and leg radioactivity pain, so the medical profession that lumbar disc herniation is a " low back and leg pain, rheumatism " category. Here's Bian Tingting to introduce the symptoms of lumbar, lumbar disc herniation patients the most common symptoms are pain, low back pain, sciatica performance, typical sciatica is at the back of the thigh, hip, leg lateral to the heel or foot back pain radiation. According to clinical statistics, about 95% of the lumbar disc herniation patients have varying degrees of pain, 80% patients with lower extremity pain. Especially low back pain, lumbar disc herniation not only is the most common symptom, is also one of the earliest symptoms. The pain occurs mainly due to the prominent, degeneration of nucleus pulposus on adjacent tissues ( mainly for sinus vertebral nerve and spinal nerve root stimulation and oppression, and at the same time ) in the nucleus pulposus in glycoprotein and other biological material overflows, the release of histamine and other local chemical inflammation, induced by chemical and mechanical nerve root

临床教学查房规范

临床教学查房规范 This model paper was revised by the Standardization Office on December 10, 2020

临床教学查房规范 教学查房是实习中培养学生如何观察、诊疗病人,学习处理医患关系,怎样当一名合格医生的一项重要教学活动,是培养学生分析问题和解决问题能力的有效途径之一。通过教学查房,应使学生掌握临床工作基本规则,如:病史采集与归纳分析、体格检查与病人的沟通技巧、病情演变与检查结果的分析、合理的医嘱以及正确的病程记录等。具体规范如下: 一、凡有临床教学任务的科室,每1周至少安排一次教学查房。事先应明确具体的时间,准备好充实的内容。 二、教学查房时间应与医疗查房时间错开,尽量减少对日常医疗工作的影响。病区在工作安排中应保证学生和主持教师能按时实施此项工作,避免随意更换时间和内容。 三、教学查房主要由主治及以上医师主持,也可根据病区情况由教学经验丰富的高年住院医师主持。 四、教师应事先精心选择教学大纲范围内有一定典型性或便于对某一症候群进行鉴别分析的病例。一般不选用诊断不明确的疑难杂症。 五、根据教研室(科室)的安排,各临床科室主持教学查房的教师应事先作好准备,撰写教学查房教案。教研室(科室)负责人应事先听取主持教师准备情况的简短汇报,对新担任此项工作的青年教师,教研室可组织集体备课听取汇报,并给予指导。 六、保证教学查房取得预期效果的重要前提是学生的主动参与。教师应事先告知学生所查的病例,教学查房前实习生或轮转生应熟悉病人及病情,复习有关理论知识,并做好相关准备工作,如所查病历、各项检查报告及所需器材等。 七、查房形式:1、讲解式;2、提问式;3、启发式:4、讨论式。查房时可根据具体情况综合运用。 八、教学查房时,参加人员应按以下顺序进出病房(附教学查房站位参考示意图): 1、进病房顺序:⑴→⑵→⑶→⑷→⑸→⑹→⑺ 2、出病房顺序:⑺→⑹→⑷→⑴→⑶→⑵→⑸

英语查房

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