UNIT 1

ADMISSION TO HOSPITAL
Language function : Asking Personal Data
Language focus : to be, question word questions

VOCABULARY

surname
last name
family name
first name
next of kin
civil state

Useful Expression

THE QUESTIONARE TO FILL IN THE ADMISSION FORM

St. Marry Medical Center Hospital Reg. No :

Admission Card Ward/Dept :

SURNAME (IN BLOCK LETTERS) FIRST NAME (S)

 What ‘s your surname?  What’s your first name?
 How do you spell it?  How do you spell it?
 Surname, please!

ADDRESS & TELEPHONE NO. DATE OF BIRTH

 Where do you live?  When were you born?
 Are you on the phone?  Your date of birth, please!

CIVIL STATE OCCUPATION

Married (In the case of a child, father’s occupation)
Single  What is your occupation?
Widow  What’s your father occupation?
Others
 Are you married?
 What is your status?

RELIGION NAME & ADDRESS OF NEXT OF KIN

 What is your religion?  Who’s your nearest relative?
 Who is your next of kin?
Note : In some states, it’s not appropriate to ask  Do you live at the same address?
this question. It is necessary to follow the
custom.

NAME & ADDRESS OF G.P TELEPHONE NUMBER

 Who is your family doctor?  Whom can I give message?
 His address?  Any contact person in emergency case?
 What’s his address?
 SURGEON OR PHYSICIAN IN CHARGE OF CASE
 Who is the doctor in charge of your case?
 Do you know the doctor in charge of your case?

Activity 1
A casualty. A man got into an accident. He was hit by a motorcycle when he was crossing the street. He
was transferred to the ER, by ambulance. He is conscious. After an X-Ray, the doctor diagnoses that he
has fractures in his right leg.

Nurse : Good afternoon.

Mr. Raharja : Good afternoon, Nurse.
Nurse : OK. Mr. Raharja. You have a fracture in your right leg. You need to have a couple of
days of treatment. The doctor suggests that you be hospitalized for the treatment.
Now I need you to fill in the admission form.
Mr. Raharja : Sure, Nurse.
Nurse : Your complete name, please?
Mr. Raharja : Danu Raharja.
Nurse : Are you married?
Mr. Raharja : Yes.
Nurse : Who is your next of kin?
Mr. Raharja : It’s my wife.
Nurse : Whom should I contact in this case?
Mr. Raharja : Just contact my wife.
Nurse : OK. That’s enough Mr. Raharja. Thank you.

Activity 2
Translate into communicative English.
1. Siapakah nama anda? What's your name?
2. Apakah anda sudah menikah? Are you married?
3. Dimana alamat anda? Where do you live?
4. Pakah anda membawa surat rujukan dari dokter umum? Did you bring a referral letter from a general
doctor?
5. Apa pekerjaan anda? What ia your occupation?
6. Siapa kerabat dekat anda yang bisa kami hubungi? Who are your nearest relative that we Van
contact?
7. Kapan anda lahir? When were you born?

Activity 3
 Make a conversation between a Nurse and a patient.
 Refer to the admission form.
PATIENT ADMISSION FORM
PERSONAL DETAILS

Name : Mrs. Herawati Susanto

Address : Jl. Semeru No. 15 Semarang
Name of GP : Dr. Gunawan Wibisono
Next of kin : Rendy Nugraha (son)
Patient’s understanding of admission : Investigation of chest pain

MEDICAL INFORMATION

Relevant medical history :

Varicose veins
Pains in chest increasing over past three months
Allergies : None
Bowels : Suffers from constipation
Urinary : Urinates a lot, especially at night-interferes with sleep
(Female patients) Menstruation : Periods stopped 7/8 years ago
Hearing : OK
Vision : Wear glasses
Oral : Wears dentures-upper and lower
 UNIT 2
ASKING AND TELLING ABOUT A MEASUREMENT

THE FORMULA TO CONVERT FAHRENHEIT TEMPERATURE TO CENTIGRADE TEMPERATURE

(Fahrenheit – 32) x 5/9 = Centigrade/Celsius

(F – 32) x 5/9 = C
Example:
Change 212˚F to C.
212˚ - 32 = 180
180 x 5/9 = 900/9 = 100˚C

THE FORMULA TO CONVERT CENTIGRADE TEMPERATURE TO FAHRENHEIT TEMPERATURE

(Centigrade x 9/5) + 32 = Fahrenheit

(C x 9/5) + 32 = F

Example :
Change 100˚C to F.
100 x 9/5 = 900/5 = 180
180 + 32 = 212˚F

Activity 1
Convert the following temperatures and report the results.
1. 98.6˚ F = ˚C
2. 102.4˚ F = ˚C
3. 95.2˚ F = ˚C
4. 37˚ C= ˚F
5. 35˚ C= ˚F
6. 41 ˚ C= ˚F
USEFUL EXPRESSIONS

Starting intervention
I need to take your temperature.
to weigh you.
to count your pulse.
to measure your height.

Please weigh yourself on the scale.

How much do I Asking about measurements

weigh? What is my temperature?
blood pressure?
pulse?
height?

How much do I weigh?

Is it normal?

Telling about measurements

 It’s 37˚C.
 You are running a temperature (higher than normal).
 You have a temperature (means the temperature is higher than normal
because of an illness).
 You weigh 67 kilograms.
 You are 170 cm tall.
 It is . . . over. . . . (telling blood pressure)
 It is within normal limits.
Activity 2
Translate these sentences into communicative English.
1. Silahkan berdiri di atas timbangan.
2. Saya perlu tahu berapa berat badan anda.
3. Saya sedang menghitung denyut nadi anda.
4. Berapa berat badan saya?
5. Badan anda panas.
6. Tekanan darah anda 110/80.
7. Tekanan darah anda sedikit di atas normal.
8. Apakah berat badan saya normal?
9. Berapa tinggi badan saya?
10. Saya perlu mengukur tinggi badan anda.
1. Please stand on the scales.
2. I need to know how much you weigh.
3. I'm counting your pulse.
4. How much do I weigh?
5. Your body is hot.
6. Your blood pressure is 110/80.
7. Your blood pressure is slightly above normal.
8. Is my weight normal?
9. How tall am I?
10. I need to measure your height.

Dialog

In Dr. Clark’s Clinic.

Patient : Good afternoon.
Nurse : Good afternoon. Have a nice seat.
Patient : Thank you.
Nurse : So, how can I help you?
Patient : Yes . . . . I need to visit Dr. Clark. Is he available now?
Nurse : Sure. He is available now. (asking personal data, complete name, address, etc).
So, what is your problem?
Patient : I feel hot.
Nurse : Have you taken your temperature with a thermometer?
Patient : Not yet.
Nurse : OK. Now, I need to take your temperature, just insert this into your right armpit..
(inserting the thermometer into the armpit. It takes 5 to 10 minutes).
 Activity 3. Role Play

Task 1.
Make and practice a conversation when measuring the height of
the patient.

Task 2.
Make and practice a conversation when measuring the
weight of the patient.

Task 1
Task 3.
Make and practice a conversation when measuring the
temperature of the patient.
Nurse; good morning Miss
Patient: good morning nurse"
Nurse : " I need to to measure your height "
Patient:" Yess nurse"
Nurse:" You are 160 cm tall"
Patient " Thank you nurse"
Nurse :" you're welcome

Task 2
Nurse:"excuse me".
Patient:"please nurse".
Nurse: "I need to know your weight as a reference for the next therapy".
"are you ready?"
Patient: "yes nurse, I'm ready"
Nurse:"Please stand on the scales!"
Patient: "How much do I weigh?"
Nurse:"Your weight is 50kg".
Patient:"Is my weight normal?"
Nurse: "yes if your height is 160cm, your weight is normal".
I'm done, excuse me
Patient:"please,thank you"
Task 3
Nurse :" excuse me miss'
Patient:' yes ,nurse please"
Nurse:" I need to check your body temperature"
Patient :" Ok"
Nurse :" Please raise your hand , and I Will put the termometer under your arm "
Patient :" what is my temperatur e?"
Nurse:" you're temperature is 38 C
Patient:" is it normal?
Nurse:" No.its higher than normal.but don't worry, you just take a rest, drink much of water, and
take your medicine.
Patient:" Ok nurse, thank you.
Nurse : "you are welcome"
Task 4:
Nurse:" excuse me, i need to take your blood pressure"
Patient:" Yess nurse, please"
Nurse :" your blood pressure is 120/75 mmHg.
Patient:' ia it normal?"
Nurse:" yes.it is.don't worry
Patient:" ok nurse, thanks
 UNIT 3
WALKING AID

Language function : Giving instructions

Language focus : Command/Imperatives

USEFUL EXPRESSION

Explaining the procedures

 It’s time to practice crutch walking.
 I will assist you have to use these crutches.
give you instructions how to use the crutches.
Give you an example on how to walk with these crutches.
Others:
This will take time. You to put on your . . .
Follow/listen to my instructions.
Let me help you to put on your . . . shoe/shoes.
Do you feel . . . . . dizzy?
Fine, that’s it . . . .

Measuring a client for a correct crutch fit.

Would you . . . .
lie flat on the bed.
I need to fit these crutches with your body.

Basic Instructions to crutch-walking

Move your . . . . . . . . . . . forward.
right foot/leg
left foot/leg
both legs

left crutch
right crutch
both crutches
Walking Procedures
1. Four-point gait
Procedures:
Advance right crutch, then left foot, then left
crutch, then right foot.

Clues:
Right crutch – left foot – left crutch – right foot.

2. Three-point gait
Procedures:
Advance both crutches and affected extremity
at the same time, advance unaffected
extremity.

Clues:
Both crutches and affected foot (right or left
foot)

Unaffected foot (right or left foot)

3. Two-point gait
Procedures:
Advance right crutch and left foot together, then left
crutch and right foot together.

Clues:
Right crutch + left foot left crutch + right foot

4. Walking downstairs with crutches

Walking downstairs:
1. Place both crutches on the same lavel as feet.
2. Shift weight to the stronger leg.
3. Lower affected leg and crutches to the next step
while bearing down crutch handles.
4. Advance unaffected leg last.
5. Walking with a cane.
Walking with a cane:
1. Patient stands in a normal position for walking.
2. Cane is held in ahead of unaffected side.
3. Cane is placed slightly ahead (10 to 15 cms or 5
to 6 inches) of unaffected leg.
4. Cane is moved ahead.
5. Affected leg is moved ahead even with a cane.
6. Unaffected leg is moved ahead.

Activity 1. Write the correct instruction

1. Have your client lie flat on the bed with proper shoes on.
2. Assist your client into shoes that are comfortable, nonskid, hard soled, and low heeled.
3. Slowly help your client move into a sitting position; assess for dizziness, faintness, or decreases in
orientation.

Activity 2. Translate these sentences communicative English.

1. Ayunkan kaki kanan ke depan.
2. Gerakkan kedua kruk ke depan.
3. Saya mau mengukur kruk ini ke tubuh anda.
4. Ikuti petunjuk saya.
5. Saya akan memberi contoh bagaimana menggunakan kruk ini.
6. Boleh saya bantu anda memakai sepatu?
7. Apakah anda merasa pusing?
8. Saya akan menemani anda selama latihan.
9. Ayunkan tubuh anda di antara kruk.
10. Bagus, anda melakukan dengan baik.

Activity 3. Make a conversation in the assessment step (before doing the implementation of
the crutch walking procedure.
 Assessment
 Explaining the procedure
 UNIT 4
STARTING AN INTERVENTION
Language Function : Explaining an Intervention
Language Focus : It is time for me . . . .
Now, I am going . . . .
I would like . . . .
I need . . . .
I just want . . . + to infinitive
I’ll help you . . . .
Let me + bare infinitive

USEFUL EXPRESSIONS

 It is time for me to . . . .
 Now, I am going to . . . .
 I would like to . . . .
 I need to . . . .
 I just want to . . . . .
 OK. Now I’ll help you . . . .
 Let me . . . . .

List of some nursing interventions:

 change your position
 check your blood pressure
 take your blood sample
 check your respiratory
 replace the rubber sheet
 replace this bed sheet
 change this blanket
 make up your bed
 check your temperature
 or other expressions . . . .

Activity 1. Translate these sentences communicative English.

1. Maaf Pak, saya perlu mengganti alas tidur bapak.
2. Maaf Bu, saya akan memeriksa temperature anda. Suhu badan anda Nampak meningkat.
3. Maaf, saya mau memeriksa tekanan darah anda.
4. Maaf Bu, sekarang waktunya untuk mengganti sprei ini.
5. Baik Pak, saya sekarang mau membantu merapikan tempat tidur anda.
Activity 2. Give the right expressions
Discuss with your partner what expressions each medical staff may say according to the illustration
below.
Picture 1 Picture 2 Picture 3

Picture 4 Picture 5 Picture 6

Activity 3. Choose one picture only then make a conversation.

Example : It is based on Picture 1.

Nurse : Good morning Mrs. Angela.

Patient : Good morning, nurse.
Nurse : How is your leg? Is it still painful?
Patient : Not really.
Nurse : Now, try to lift up your leg. OK. Fine. Is it OK?
Patient : Yes. No problem I think.
Nurse : OK. Let me help you go around this hospital with this wheel chair.
Patient : Sure. Thank you.
Nurse : I’ll help you sit on this wheel chair.
Patient : Thank you nurse.
Nurse :No problem.
 UNIT 5
ASKING THE DIMENSIONS OF SYMPTOM

Language function : Asking about dimensions of symptom

Language focus : Question Word Question, Yes-No Question

Yes – No Question

Yes – No Question that may be answered by “yes” or “no”

How to arrange Yes – No Question

 Do you apply infusion to Mr. Junaidi?

 Did the nurse accompany Mrs. Ryan to go around with the
wheelchair this morning?
Auxiliary Verb  Has Hasan been hospitalized in public hospital?
 Does the nurse check the patient’s blood pressure every
morning?

 Is Manometer used to measure blood pressure?

 Is your back really hurting you today?
Be
 Were three people killed and injured in the crash?

 Will you give injection to Mrs. Prita?

 Can you help me move the patient to the wheelchair ?
Modals
 Could you tell me the name of the ward?

Question Words Question

Question Words Question is a question that asks for information by using question words: who,
when, why, what, which, whose, how.
How to arrange Information Question

Others
Question Words Auxiliary/be/modals Subject
What time is dr. Dandy available?
How are you feeling?
Why do you feel that?
Who is your physician?
When will the doctor visit the patient?
When can I start the meal?
How many times does the patient take the medicine in a
day?
VOCABULARY
dull :
stabbing :
sharp :
aching :
aggravating factors :
alleviating factors :

USEFUL EXPRESSION
ASKING THE DIMENSIONS OF SYMPTOM

LOCATION
 Where do you feel it?
 Does it move around?
 Show me where.

QUALITY OR CHARACTER
 What is it like? Is it sharp, dull, stabbing, aching?
 Do you feel . . . . ?

SEVERITY
 On a scale of 0 to 10, with ten the worst, how
would you rate what you feel right now?
 What is the worst it has been?
 Does this interfere your usual activities? In what
ways?

TIMING
 When did you first notice it?
 How long does it last?
 How often does it happen?

SETTING
 Does it occur in a particular place or under certain circumstances?

TIMING
 What makes it better?
 What makes it worse?
 When does it charge?
 Have you noticed other changes associated with this?

Activity 1. Translate these into communicative English.

1. Apakah anda pernah memperhatikan ada perubahan lain sehubungan dengan rasa sakit ini?
2. Bagaimana rasa sakit ini mempengaruhi kegiatan anda sehari-hari?
3. Apakah rasa sakit itu terjadi di tempat tertentu atau dalam kondisi tertentu?
4. Apa yang menjadikan rasa sakit makin buruk?
5. Apakah sakitnya menyebar?
6. Kapan rasa sakit itu berubah?
7. Berapakah skala yang terburuk yang pernah anda rasakan?
8. Berapa sering rasa sakit itu terjadi?
9. Berapa lama rasa sakit itu berlangsung?
10. Dalam skala 1 sampai 10, dengan 10 yang terburuk, bagaimana tingkat rasa sakit anda
sekarang?

Activity 2. For each number, arrange these jumbled words into a sentence about patient’s
complaints.
1. vomiting – have – I – been
2. short – lost – have – a lot of – I – weight – in – time
3. 3 days – more – pain – my – than – persists
4. pain – the – mainly – back – lower – in – is – part – the – my – of
5. pain – the – back – legs – shoots – the – my – down – of

Activity 3. Complete the dialog below with the sentences are available.

- What is it like?
- What makes it worse?
- Does it move around?
- What do you feel right now?
- When did you first notice it?

Case : A patient with Angina Pectoris.

Patient : Nurse, I have a pain in my chest.
Nurse : (1) . . . . . . . . . . . . . . . . . . . . . . . . .?
Patient : It started a week ago, after having exercising.
Nurse : (2) . . . . . . . . . . . . . . . . . . . . . . . . .?
Patient : Yes. It moves to the throat and upper jaw.
Nurse : (3) . . . . . . . . . . . . . . . . . . . . . . . . .? Sharp, dull, stabbing, aching?
Patient : I feel dull pain.
Nurse : On a scale of 0 to 10, with 10 as the worst, how would you rate
(4) . . . . . . . . . . . . . . . . . . . . . . . . .?
Patient : I think it is 6.
Nurse : What is the worst it has been?
Patient : It has been 8.
Nurse : Does it occur in a particular place or under certain circumstances?
Patient : Yes. It occurs in a cold weather or after heavy meals.
Nurse : (5) . . . . . . . . . . . . . . . . . . . . . . . . .?
Patient : When I exercise heavily. What health problem do I have, nurse?
Nurse : You may have angina, but let me consult your doctor.

Task.
1. Make a complete conversation to explore the dimensions of symptom.
2. Take one case only.

Case 1. A patient with Anorexia Nervosa expresses.

 I don’t want to have a lot of meal.
 I don’t want to be plump.
 My arms and legs are getting fat.
 I have difficulty in bowel motion.
 I feel nausea.
 I want to vomit.
 Food makes my stomach upset.
 I am afraid of being fat.
 I start feeling this when I was in the midst of teens.
 It became worse a week ago.

Case 2. A patient suspected with Appendicitis expresses.

 I feel pain around my navel.
 I feel pain around here (in lower right spot of my abdomen)
 I feel a sharp pain.
 Don’t touch my stomach, it increases my pain.
 I feel feverish.
 I feel nausea.
 I vomit.
 I lost my appetite.
 I have recurrent pain in my lower part of my stomach.
 It becomes more painful if I do the squatting bowel motion.
 UNIT 6
PATIENT ASSESSMENT 2
(NOSE, SINUSES, MOUTH AND PHARYNX)

Language function : Giving Instruction

Language focus : Do you have + health problem
Have you + V3
Do you + V1
Vocabulary
extremities :
epistaxis :
nares :
uvula :
mucous :
pharynx :
bilateral :
buccal :
denture :

USEFUL EXPRESSIONS
1. ASSESSMENT

Questions to ask:
 Do you . . . . . . . . . . . . . . . . . . . . .?
snore at night
smoke
use any nasal sprays or drops
drink alcohol
use dentures
feel any pain when you brush your teeth
feel any tenderness?
brush your teeth everyday. (How much time a day?)

Questions to ask:
 Do you . . . . . . . . . . . . . . . . . . . . .?
difficulty breathing through the nose
nasal discharge
any problem with your appetite recently
any problem with your dentures

 Have you . . . . . . . . . . . . . . . . . . . . .?
 experienced any injury to your nose or mouth?
ever had bleeding from your nose

2. Implementation Steps
Explaining what you are going to do immediately.
 It is time for me to . . . . . . . . .
 I just want to . . . . . . . . . . . . . .
 I would like to . . . . . . . . . . . . .
 I am going to . . . . . . . . . . . . . .
 I need to . . . . . . . . . . . . . . . . .
examine your nose/mouth
press you on his spot. (frontal sinus)
close one of your nostrils.

Instructions
 Will you . . . . . . . . . . . . . . . . . . . . .?
 Would you . . . . . . . . . . . . . . . . . . .?
 Please, . . . . . . . . . . . . . . . . . . . . . .
 Now, I want you to . . . . . . . . . . . .
open your mouth
tip your head back slightly
say “ah”
breath with your other nostril, I will press the other one.
do the same with the opposite part

Activity 1. Translate these into communicative English.

1. Maaf Pak, sekarang saya mau memeriksa mulut anda.
2. Apakah anda pernah mengalami luka hidung atau di mulut?
3. Sekarang saya akan menutup salah satu lubang hidung anda.
4. Apakah gigi palsu anda pas dengan gusi anda.?
5. Sekarang, angkat kepala anda ke belakang sedikit.

Activity 2. Arrange these jumbled words into good sentence.

1. In – the nostril – my nose – the blockage – and – are – worsens – stuffed.
2. very – speaking – my throat – when – painful – is
3. this – nasal – voice – my speech – runny nose – becomes – because of
4. and – look – tonsils – red – inflamed – my

Activity 3. See the illustration below. Make a short conversation when you need to use the
tongue depressor.
Activity 4.
 Make a complete conversation on assessing the nose, sinuses, mouth and pharynx.
 Use expressions given above.
 UNIT 7
PATIENT ASSESSMENT 3
(EYES AND EARS)

Language function : Giving Instruction

Language focus : Have you ever had . . . + health problem.

Part 1. Assessing Eyes

Vocabulary
diplopia :
blur :
discharge :
spotter :
floater :
acuity :
bridge :
regurgitate :
glasses :
spectacles :

USEFUL EXPRESSIONS
1. Eye Assessment

Questions to ask:
 Have you ever had . . . . . . . . . . . . . . . . . . . . .?
eye disease
eye trauma
eye itching
eye discharge
blurred vision
double vision (diplopia)
spotters in your eyes
floaters
flashes of light
hallow around light

 Do you use . . . . . . . . . . . . . . . . . . . . .?
glasses
contact lens

Questions to ask:
  Do you have diabetes?
 Do you take any medication recently, for instance antibiotics or large dosage of
aspirin?

2. Implementation Step
Explaining what you are going to do immediately.
It is time for me to . . . . . . .
I just want to . . . . . . . . . . . .
I would like to . . . . . . . . . . . examine your eyes
I am going to . . . . . . . . . . . .
I need to . . . . . . . . . . . . . . . .

Instructions
 Just, follow my instructions.
 Please . . . . . . . . . . . . . . . .
 Now, I want you to . . . . . + (one of the expressions below)

Visual Acuity:
read this newspapers while wearing glasses
read this letter (written on the snellen eye chart)

 Can you . . . . . . . . . . . .
mention what letter it is?
see the print clearly?
Visual fields:
sit in front of me
look at my eye
close one eye with your palm hand
look at movement of my finger/this object
state when you first notice it
Extra ocular movement test
look straight toward me
keep your head motionless/keep your head steady
follow movement of my finger with your eyes, keep your head
still
Accommodation test
Just stay here, look at the wall in this distance.
 (I want to move my finger toward your nose) look at my finger.
 (I want to move my finger toward your nasal bridge) look at my finger.

External eye assessment

 (I need to check your lid position) . . . . . Now close both eyes.
 (I need to check your upper eye lid) . . . . Now, raise your eyebrows.
 (I need to press here gently) . . . . .
 (I need to check your cornea) . . . . . . . . . Now, look up (I’m going to shine your eye with this
light)
Activity 1. Translate these sentences into communicative English
1. Maaf Pak, sekarang saya mau memeriksa mata anda.
2. Apakah anda pernah mengalami masalah dengan mata anda, misalnya gatal atau luka.
3. Sekarang saya meminta anda membaca huruf ini.
4. Saya akan menggerakkan telunjuk jari saya ke tengah hidung anda. Coba ikuti gerakan
telunjuk saya.
5. Saya mau mengecek kornea anda. Sekarang silahkan lihat ke atas, saya mau menyinari
mata anda.

Activity 2. Complete the following text with the appropriate words in the box.

The retina The pupil rays The lens The light rays

HOW YOUR EYES FUNCTION

You are able to see as a result of the ability of your eyes to take in . . . . (1) that have been
reflected or bounced off objects. The rays of the light that are reflected off an object area
bent as they enter the eye through the cornea. . . . . . (2) then pass through . . . . (3) and
onto . . . . (4), which brings them into focus on . . . . (5). Light-sensitive cells in retina
produce an upside-down image of the object. This image creates a pattern of nerve impulses
that are sent along the optic nerve to your brain. Your brain interprets and reverses the
upside-down image, allowing you to see.

Activity 3.
 Make a complete conversation on assessing eyes using an ophthalmoscope.
 Use expressions listed above.

Part 2. Assessing Ears

USEFUL EXPRESSIONS
1. Ear Assessment

Questions to ask:
 Have you ever had . . . . . . . . . . . . . . . . . . . . .?
ear disease
ear itching
ear discharge
ringing of the ears (tinnitus)

 Do you use . . . . . . . . . . . . . . . . . . . . .?
hearing aids
 What do you say when you are going to insert the tip of an otoscope into the ear canal.

2. Implementation Step

Explaining what you are going to do immediately.

It is time for me to . . . . . . .
I just want to . . . . . . . . . . . .
I would like to . . . . . . . . . . . + check your ears
I am going to . . . . . . . . . . . .
I need to . . . . . . . . . . . . . . . .
Now, let me

Instructions
 Just, follow my instructions.
 Please . . . . . . . . . . . . . . . .
 Now, I want you to . . . . . + (the expressions below)
 Would you . . . . . . . . . . . .

Hearing Acuity Test:

put off your hearing aids
close your eyes

 (Now I want to whisper “nine four”) repeat what I mentioned

If you suspect a loss of hearing, perform a tuning fork test Webber’s test:
(Now I put this in the middle of your forehead)
 Can you . . . . . . . . . . . . . . . . ?
 Do you . . . . . . . . . . . . . . . . ?
listen the sound equally in both ears?
listen the sound better in one ear?

Rinne test (listening to the length of the vibration of the tuning fork)
Listen to this . . . . Tell me when sound is no longer heard.
Activity 1. Translate these sentences into communicative English
1. Sekarang saya mau memeriksa telinga anda.
 2. Apakah anda pernah mengalami masalah dengan telinga anda, misalnya suara
berdengung?
3. Dapatkah anda mendengar dengan baik kedua telinga anda?
4. Coba dengarkan suara dari alat ini.
5. Katakana kapan suaranya tidak terdengar lagi.

Activity 2.
 Make a complete conversation on assessing ears using an otoscope.
 Use expressions listed above.
 UNIT 8
PROMOTING HYGIENE 2
(ORAL HYGIENE AND DENTURE CARE)

Objectives : Perform communication when assisting oral hygiene and denture care.
Give instructions when assisting oral hygiene and denture care.
Language function : Giving Instruction
Language focus : Yes/No Question, Let me . . . , May I . . . , Here it is/Here you are + noun

PART 1. ORAL HYGIENE

Vocabulary
rinse the mouth :
gargle :
spit :
intact :

USEFUL EXPRESSION
Assessment
A nurse has to identify the presence of natural problems.
 Questions to ask :
Do you . . . . . . . . . . . . . . . . . . . . .?
need my assistance for tooth brushing?
have any problem with your gum or tooth?

 Let me . . . .
 May I . . . . .
 Now I want to . . . .
check your mouth.
Others :
 Is there.
Any of your family (next of kin) who want to help you brush your teeth?

Implementation Step
Patient brushes the teeth.
 Here it is . . . . . . . . . . . . .
 Here you are . . . . . . . . . . . .
your brush
your tooth paste
the water
the basin
equipment for tooth brushing.
 Do you need to rinse your mouth now?
 Spit the mouth rinse in this basin.
Activity 1. Match the English word with its translation.

No. Equipment Translation

1. Soft-bristled toothbrush a. Alat dari busa untuk menyerap cairan di
sekitar mulut.
2. Anti-infective solution or b. Sikat gigi dengan bulu sikat yang lembut dan
normal saline to loosen crusts tegak.
3. Sponge toothette c. Bilah yang berlapis kasa untuk membersihkan
lidah.
4. Padded tongue blade d. Sarung tangan sekali pakai.
5. Emesis basin e. Cairan anti infeksi atau cairan garam untuk
melembutkan lapisan yang kering.
6. Face towel f. Handuk muka
7. Suction equipment g. Alat untuk menghisap cairan dari mulut (bila
perlu untuk pasien yang tidak sadar)
8. Disposable gloves h. Pelumas yang dapat larut dalam air
9. Water soluble lubricant i. Wadah untuk membuang cairan kumur.

Activity 2. Match the oral problem with its description

No. Oral Problem Description

1. Dental caries a. Receding gum lines, inflammation, gaps
between teeth, rough or jagged teeth.
2. Gingivitis b. Pain when you bite on the area and
unpleasant taste
3. Periodontitis c. Inflammation of gum
4. Halitosis d. Discoloration of tooth enamel
5. Pericoronitis e. Bad breath

Activity 3. Translate into communicative English.

1. Apakah anda mempunyai masalah dengan kesehatan mulut anda.
2. Apakah gusi anda terasa sakit ketika menggosok gigi?
3. Ini perlu perlengkapan anda untuk menggosok gigi.
4. Anda mau berkumur sekarang?
5. Muntahkan air sisa kumur ke dalam wadah ini.

PART 2. Providing Denture Care

Vocabulary
denture :
fit :
remove :
sink :

USEFUL EXPRESSION
Assessment
(Yes-No questions)
Do your dentures fit to you?
Do you have any problem with your gum? Let me check your gum.
Do you use a special product to wash your gum?

Implementation :
(Would you . . . . )
 remove your denture?
 put your denture in here?
 rinse your mouth thoroughly?
Do you need my assistance to insert your denture?

Activity 1. Write appropriate expression according to the nursing procedures.

1. Ask patient if dentures fit and if there is any gum or mucous membrane tenderness or
irritation.
2. Ask patient to remove dentures.
3. Ask patient to place the dentures in basin or denture cup.
4. Inspect oral cavity and denture surface after dentures are removed.
5. Ask patient whether she/he can remove the dentures himself/herself.
6. Ask patient about preferences for denture care and products used and remove gloves.

PART 3. Assisting with Flossing The Teeth

Vocabulary
Dental floss :
Scrap up and down :
Glide the floss between the teeth :

USEFUL EXPRESSION
Assessment
(Yes-No questions)
Do your to floss your teeth?

Implementation
 Glide the floss between each tooth.
 Scrap up and down.
 Do you need to rinse your mouth?

Activity 1. Write appropriate expression according to the nursing procedures.

 1. Ask patient if he/she needs to floss teeth.
2. Using a 1-inch piece of floss, ask the patient to gently glide the floss between each tooth.
3. Ask the patient to gently scrap up and down between the teeth.
4. Ask patient to rewrap the floss around the fingers.
5. Ask if the patient will probably want to rinse after flossing.

Assignment. Choose one topic.

1. Make a conversation focusing on assisting the patient with flossing teeth. Use the
expressions listed above.
2. Make a conversation focusing on assisting the patient with tooth brushing. Use the
expressions listed above.
3. Make a conversation focusing on assisting the patient with washing the dentures. Use the
expressions listed above.
 UNIT 9
PROMOTING HYGIENE 3
(ASSISSTING WITH ELIMINATION)

Objectives : Communicate in English when assisting with elimination

Language function : Giving Instruction
Language focus : Yes/No Question.
Do you need/use/have.
Will/would you + bare Infinitive

Elimination equipment
Bedpan :
Regular bedpan :
Fracture bedpan :
Urinal (male and female) :
Under pad :
Disposable gloves :

Vocabulary
elimination :
defecate :
do bowel movement :
do waterworks :
laxative :
flatus :
break the wind=pass wind :
buttock :
thigh :
micturate :
micturition :

USEFUL EXPRESSION
Assessment

Questions to ask :
 Do you . . . . . . . . . . . . . . . . . . . . . . . . . ?
need my assistance for your bowel movement?
need my assistance for your waterworks?
use laxatives or stool softener for your bowel movement?
do your bowel movement in the morning?
have any problem with your bowel movement? Waterworks?
have any pain when doing bowel movement?
  Others: (for urination or defecation)
Can you move yourself easily?
Are you fit enough to go to toilet?
Are you able to . . . . . . . . . . . . . . . . ?
Do you feel comfortable lying in bed when doing waterworks?
Do you feel comfortable sitting with head of the bed elevated, or standing
when doing waterworks?

Implementation

State what you are going to do immediately.

 I just want to . . . . . . . . . .
 I would like to . . . . . . . . . .
 I am going to . . . . . . . . . . .
 I need to . . . . . . . . . . . . . . .
 Let me . . . . . . . . . . . . . . . . .
lower head of this bed.
raise head of this bed
put this bedpan under your buttocks
put this urinal between your thighs
take this bedpan
help you clean this area
Instructions
 Will you . . . . . . . . . . . . . . . . . ?
 Would you . . . . . . . . . . . . . . . ?
 Please . . . . . . . . . . . . . . . . . . . .
 Now, I want you to . . . . . . . . .
roll yourself into side-lying position
roll back onto the pan.
lift up your buttock
Expressions After elimination:
 Let me help you wash your hand.
 Is this position comfortable for you?
 Did you break the win during elimination?

Activity 1. Translate these into communicative English.

1. Saya mau menurunkan bagian atas bed anda.
2. Apakah anda cukup kuat untuk pergi ke toilet sendiri?
3. Apakah anda perlu bantuan saya untuk b.a.b?
4. Kapan biasanya anda buang air besar?
5. Apakah anda punya masalah pada waktu b.a.b atau b.a.k?
6. Angkat pantat anda. Saya mau meletakkan ini di bawah pantat anda.
7. Saya mau meletakkan ini di antara paha anda?
Activity 2. Write the appropriate expressions according to the nursing procedures.
1. Discuss patient’s elimination needs?
2. Assess elimination pattern focused on timing.
3. Ask patient about the use of laxatives or stool softeners.
4. Assess the length and extent of immobility.
5. Assess extent and location of pain that may influence the ability to void, defecate, or
position on a bedpan.
6. Ask patient if flatus is being passed.

Activity 3. Write the appropriate expressions according to the nursing procedures.

1. Position patient on side, back, or sitting with head of the bed elevated, or assist to
standing position.
Ask the patient for the most comfortable position when voiding.

2. If lying in bed, patient should hold urinal with base flat on the bed between the thighs,
and if possible, patient places penis into neck of the urinal. Assist as needed and discard
gloves.
Tell the patient that you need to place the urinal between the thighs.

Activity 4.
 Make a complete conversation focusing on assessing patient’s need for elimination.
 Use expressions available above.
Questions :
 When do you usually do your bowel movement?
 Have you ever got a problem with your bowel movement?
 How many times do you usually do your bowel movement?
 How do you usually do your bowel movement?

UNIT 10
GIVING INJECTION
Objectives : Explain about the procedure in giving injection
Give instructions when giving injection.
Language function : Giving Instruction
Language focus : Would you . . . , Please?
Please . . . . .
Now, I want you . . . . + to infinitive.
This will give . . . .
You will/may feel . . . .

Vocabulary
syringe :
couch :
roll :
sleeve :
buttock :
vein :
clench :
fist :
jab :

USEFUL EXPRESSION
Expression 1 : Explaining the procedures

 It is time for me . . . . . . .
 I just want . . . . . . . . . . . .
 I am going . . . . . . . . . . . .
 I would like . . . . . . . . . . .
 I need . . . . . . . . . . . . . . . .
to give injection
to give injection onto your buttocks
to inject your buttock
to give injection onto your (upper) arm

Expression 2 : Giving instruction and expression during implementation

 Would you . . . . . . . . . , please?

 Please . . . . . . . . . . . . . . . . . . .
  Now, I want you to . . . . . . . .
sit down
lie down on your face
lie onto your tummy
lie with face downwards
roll up your sleeve
give your right/left hand
lower your pant down

Expression 3 : Cautionary expressions

 a little pain
 This will give . . . .  a bit hurt
 You may feel . . . .  a bit uncomfortable
 You’ll feel . . . . . . .  a little bit uncomfortable
 a jab

Activity 1. Translate these into communicative English

1. Pak, sekarang saya mau menyuntik bapak.
2. Terlungkup di tempat tidur itu.
3. Buka sedikit celananya.
4. Sedikit sakit pak.
5. Bagus, sudah selesai.

Activity 2. For each number, arrange these jumbled words into good sentences.
1. injection – nurse – this – scares – me!
2. arm – have – I – injection – my – got – never – in – before
3. to – allergic – I’m – nurse – penicillin
4. feel – getting – in – score – injection – my – I – buttock – after
5. it – be – to get – this – will – nurse – painful – injection?

UNIT 11
APPLYING AN INFUSION
Objectives : Explain the procedure in applying an infusion
Give instructions when applying infusion
Language function : Giving Instruction
Language focus : It’s time/I need + to infinitive (to apply . . . .)
Would you . . . . , please?
Please . . .
Now, I want you . . . + to infinitive

Vocabulary
tourniquet :
apply :
infusion :
intravenous :
roll round :
rationale :

USEFUL EXPRESSION
Expression 1: Explaining the procedures

 It’s time for me . . . . . . .

 I just want . . . . . . . . . . .
 I am going . . . . . . . . . . .
 I would like . . . . . . . . . . .
 I need . . . . . . . . . . . . . . .
to apply this infusion
to give injection into your vein
to apply this tourniquet round your arm

Expression 2: Rationale (if asked by the patient)

 What for is it?

 What is it used for?
Response:
To make medication easier
To increase solution in your body
And other rationales . . . . . .

Expression 3: Giving instruction and expression during implementation.

 Would you . . . . , please?

 Please . . . . . . . . .
 Now, I want you to . . . . . . . . .
in flat on your back
roll up your sleeve
 give your right/left hand

Expression 4: Reassurance (if patient looks afraid of the injection)

 Don’t worry. It’s OK.

 It won’t take long.
 I’ll do this as quick as I can
 Have you ever had/got an infusion before?
 Everything will be OK.
 It shouldn’t be painful.

Activity 1. Translate these into communicative English.

1. Ibu, sekarang saya mau memasang infus.
2. Silahkan berbaring di tempat tidur itu.
3. Saya mau mengikat alat ini (tourniquet) di dengan ibu.
4. Ibu akan merasa sedikit sakit, tapi saya akan melakukan secepatnya.
5. Jangan banyak bergerak ya bu.
6. Bagus, sudah selesai.

Activity 2.
 Make your own conversation focused on applying infusion
 Practice in pairs
 Act out the conversation before the class using a real syringe and infusion as models.

Case : A doctor orders you to give infusion to a newly hospitalized patient suspected with
dengue fever.
Nurse gives:
 Short explanation to apply infusion
 Instruction to lie flat on back
 Instruction during implementation
 Cautionary advice when ready
 Reassurance to patient if afraid of the injection
 UNIT 12
TAKING THE LAB SAMPLE 1
(Taking Blood Sample)

Objectives : Explain the procedure in taking blood sample

Give instructions when taking blood sample
Language function : Giving Instruction
Language focus : Can I have your . . . .
Give me your . . . + a part of body.
I just want/ I would like . . . .
I am going . . . . + to infinitive
Vocabulary
Find the meanings of the words below:
white count :
HB count :
CBC :
lab findings/lab result :
within normal limit :
container :
blood group :
blood chemistry :
blood serum :
blood sugar :
blood sedimentation rate :
fasting blood glucose :
oxalate tube :
a letter of referral :
below normal :
abnormally high/above normal :

USEFUL EXPRESSION
Expression 1. Explaining the Procedures

 I just want . . . . . to take your blood sample.

 I would like . . . . to roll this (tourniquet) round your upper arm.
 I am going . . . . . to apply this tourniquet round your upper arm.

Expression 2. Giving instructions during implementation.

roll your sleeve up?
 Would you . . . . . . . . . . . . , please? clench your fist
open your fist
 Would you mind . . . . . . ?
hold on
 Please . . . . . . . . . . . . . . . . .
fold your arm
 Now, I want you to . . . . . . .
bend your arm, like this
 Can I have your . . . . . . . . . . . . , please?
Give me your . . . . . . . . . . . . . . ,
please?
right hand

Expression 3. Cautionary Expression

 a little pain
 This will give . . . .  a bit hurt
 You may feel . . . .  a bit uncomfortable
 You’ll feel . . . . . . .  a little bit uncomfortable
 a jab

Expression 4. Reassurance
 Don’t worry. It’s OK.
 It won’t take long.
 I’ll do this as quick as I can
 Have you ever had/got an infusion before?
 Everything will be OK.
 It shouldn’t be painful.

Activity 1. Write sentences using the words in parenthesis.

1. (blood sample)
2. (a bit above normal)
3. (Complete Blood Count)
4. (within normal limit)
5. (tourniquet)

Activity 2. Give communication response to patient’s expression and condition below.

1. Nurse, I am afraid of this injection.
2. When can I take the result?
3. Patient’s arms are stiff. He is afraid of the injection.
4. Patient wears shirt with long sleeves. You need to apply tourniquet round the upper arm.
5. Patient’s is afraid of seeing the needle. He cannot do this in sitting position.
Activity 3. Complete this conversation, then practice with a partner.

Nurse : Good morning (Sir/Madam)

Patient :........................
Nurse : . . . . . . . . . . . . . . . . . . . . a sample of your blood. Now, I am going . . . . . . . . . . . . your
sleeves, please? Now, . . . . . . . . . . . . . . . . this tourniquet round your upper arm.
Patient : Nurse, I am afraid of . . . . . . . . . . . . . . . . . . . .
Nurse : Don’t worry . . . . . . . . . . . . . . . . . . . . painful. I will do this . . . . . . .
OK, . . . . . . . . . . . . . . . . your fist. You’ll feel . . . . . . . . . . Now open your . . . . . . .
Fine, that’s it.

Activity 4. Make your own conversation based on the case below.

A patient is suspected with diabetes mellitus. He has performed a urinal test. Still the result
is uncertain. His doctor suggested him to take a glucose tolerance test. A series of blood
sample has to be taken before and after swallowing a glucose drink and then the glucose
levels are measured.
 UNIT 13
TAKING THE LAB SAMPLE 2
(Sputum, Feces, Urine, Phelgm-Sample)

Objectives : Explain the procedure in taking some lab sample

Give instructions when taking a certain lab sample
Language function : Giving Instruction and Suggestions
Language focus : You have to . . . .
You’d better . . . . .
Would you . . . . . + bare infinitive

Vocabulary
phlegm :
sputum :
spit :
saliva :
piss :
urinate :

USEFUL EXPRESSION
Expression 1. Explaining the Procedures
sputum
 We need some tests of your . . . . . . .
feces
 We need a sample of your . . . . . . . urine
 phlegm

Expression 2. Giving Instruction

put your . . . . . . . . . .into this container

 Would you . . . . . sputum
feces
 Please . . . . . . . . . urine
 phlegm

 take the fist sputum early in the

You’d better . . . . . . morning, soon after getting up.
 Send a sample of new feces, at least
an hour after bowel motion.
  The urine
. . . . should be passed first thing in the morning
 The sputum
You have to . . . . . . . . .
 do this procedure in empty stomach.
 be back after (an hour/two hours).
 empty your stomach for . . . . hours before the procedure.
Don’t . . . . . . . . . . . . . .
 take anything to eat for at least . . . . . hours.

Activity 1. Write sentences using the words in parenthesis.

1. (spit)
2. (sputum)
3. (phlegm)
4. (piss)
5. (toilet)

Activity 2. Arrange each of these jumbled words into a good sentence.

1. (have – water – can – fasting – a sip of – I – during)
2. (waterworks – well – can – I – do – not) (dribbled – is – it)
3. (put – should –where – the – feces – I – sample)
4. (time – done – What – the – will – procedure – be?)
5. (can – my – get – I – when – of – the urinal – result – test?)

Activity 3. Give a communicative response to patient’s expressions and condition below.

1. Nurse, how much urine sample should I provide?
2. A hospitalized patient asks you: When are you going to take the sample?

Activity 4. What do you say to your patient?

1. The doctor orders the nurse to check the feces sample. As a nurse you have to explain it to
your patient.
2. The patient has to empty his stomach for 12 hours before the procedure of endoscopy.
3. Instruct the patient to put the sputum sample into the container provided by the hospital.
4. Ask the patient to provide a new sample of feces.
5. Ask your patient to take the urine sample in the toilet next to your laboratory.

Activity 5. Complete this conversation below.

A doctor orders a nurse to check patient’s urine suspected with urinal infection.
Nurse : Good morning. Mr/Mrs . . . . . . . . How . . . . . . . . . .
Patient : Not . . . . . . . . . . . . I’m afraid. I still get temperature.
Nurse : OK. Mr. . . . . . . . . . s urine sample. Are you . . . . . . . . to toilet?
Patient : Yes. I think.
Nurse : Just . . . . . . . . into this container.
Patient : How much nurse?
Nurse : . . . .. . . . . . . . is enough. . . . . . OK. Let me help you stand up.
Patient : Thank you.

Activity 6. Make a complete conversation according to the case described below. Choose
one of them.
CASE 1:
A mother with absence of periods for two weeks wants to confirm about her
pregnancy. She has to undergo a set of urinal test.

CASE 2:
A patient is suspected with coronary heart disease. A doctor advised him to have a
cholesterol test.

CASE 3:
A patient complains about having a pain in the center of the chest. The pain spreads
to the throat, the back and arms (mainly the left one). Doctor suspects that he has an
angina. To confirm the diagnosis, doctor had him undergo a series of laboratory test.
The doctor orders to check the level of his fat and the urinal test to determine whether
he has diabetes or not.
 UNIT 14
DISCHARGE INSTRUCTIONS

Objectives : Give instructions and suggestions according to the patient’s health

problem
Deliver a therapeutic communication
Language function : Giving Instruction
Language focus : It’s . . . . . (required, important, essential) You should avoid . . . . . .
You need . . . . . . . .

Vocabulary
avoid :
contraindicated :
indicated :
suggest :
pus :
suture :
sponge :
bouillon :
popsicle :
foul :
splint :
swollen :
numb :
paralysis :
convulsion :
patch :
hazardous equipment :
rub :
greasy . . . . . :
rash :
tightness in the . . . . :

USEFUL EXPRESSION
Pattern 1: Recommendation

Pattern Meaning Example

should Harus dilakukan  You should take the complete (entire)
must dose prescribed.
be + required  These tablets contain antibiotic. It is
essential required you take the complete dose
important prescribed.
indicated
 have to . . .
had better + bare infinitive Sangat dianjurkan  You’d better take your medicine
regularly.
advice Menyarankan  I advise you to see a doctor soon.
suggest  I suggest you drink a lot of water.

Pattern 2: Prohibition

Pattern Meaning Example

should not + V1 dilarang  You should not drink this antibiotic
must not + V1 tidak boleh with milk.
may not + V1
should + avoid + Ving menghindari  You should avoid drinking alcohol.
have to + avoid + Ving sebaiknya tidak
had better not + bare
infinitive

INSTRUCTION CHART 1

WOUND CARE (CUTS, ABRASIONS, BURNS)

1. Keep the area clean and dry. INSTRUCTION CHART 2
2. Keep wound covered with clean dressing, change the
FEVER
dressing daily.
1. Take your
3. Keep temperature
the injured part atwith
rest aand
thermometer.
elevate for 12 hours.
2. Drink plenty of liquid.
4. Watch for redness, pus, or increased soreness. Contact your
3. doctor
Take Tylenol according to directions. Avoid giving aspirin to
if this occurs.
children.
5. Have your wound checked and your sutures removed as
4. advised
Sponge bybaththeasemergency
with lukewarm
physicianwater
in . .for temperature over
. Days.
102 for 15 – 20 minutes.
5. Do not use alcohol or ice for sponging.
6. If your fever is not down in 48 hours, return to your family
doctor or the emergency department.
 INSTRUCTION CHART 3

VOMITING AND DIARRHEA

INSTRUCTION CHART 4
1. Do not give a person with nausea or vomiting anything by mouth
until 2 hours after the last vomiting.
2. If no nausea or vomiting give clear liquid you can see through
(water, tea, soft drinks, bouillon, jelly, Popsicles) in small
amounts.
3. Do not give dairy products (milk, butter, eggs, cheese) or citrus
fruit.
4. If vomiting occurs shortly after eating, wait two hours before
attempting to eat again.
If your child has:
a. high fever
b. decreased urination
c. more than 8 – 10 stools in a 24 hour period
d. stools that are very foul smelling or bloody

CAST/SPLINT CARE
1. Do not apply any weight or pressure on a new cast or splint
for the first 24 – 48 hours.
2. Keep the cast/splint clean and dry.
3. Elevate the injured part for 48 hours on pillows above your
heart.
4. Do not put foreign objects inside the cast.
5. Wiggle your fingers or toes inside the cast every hour.
 INSTRUCTION CHART 5

SPRAINS, SEVERE BRUISES, MINOR FRACTURE

1. Elevate the injured part for 24 – 48 hours or until the swelling
decreases.
2. Apply ice for the 24 – 48 hours.
3. Limit activity to the use of crutches for ambulation.
 Non – weight bearing
 Partial weight bearing
4. Wear the splint or bandage as ordered. Rewrap if too tight or
too loose.
5. If the injured part becomes extremely swollen, cold, blue or
numb, or the pain increases markedly, call your doctor
immediately.

INSTRUCTION CHART 6

BACKAND NECK INJURY

1. Use heat or cold on the injury areas whichever feels
better. INSTRUCTION CHART 7
2. Rest as much as possible until you are improved.
HEAD
3. Avoid INJURY
positions and movement that make the pain
The worse.
first 24 hours after a head injury are the most important, although after effects may
appear
4. Avoidmuch later.
lifting It is important
anything heavy andthat a responsible
automobile person awakens the patient every 2
travel.
hours for the
5. Relax first 24 hours
emotionally, if youand
arewatches forproblem
tense the the following
will symptoms. If any of these
occurs,
onlycall
be your
worse.doctor or return to the emergency department.
1.
6. Persistent
Sleep on headache, nauseaororplace
a firm matters vomiting more
boards than your
under twice.
2. Weakness, numbness or paralysis of the arms or legs.
3. Blood or clear fluid from the ears or nose.
4. Blurred vision; unequal pupils (one larger than the other).
5. Convulsions
No alcohol beverage.
Take nothing stronger than aspirin or Tylenol for pain.
Instruction: Write Questions for number 1, 2, 3, 4 to check the patient condition.
 INSTRUCTION CHART 8

EYE INJURIES
1. If your eye has been patched it is difficult to judge distance. Do not drive a vehicle or
use hazardous equipment.
2. Do not rub your eyes.
3. Avoid bright lights and glaring sunshine. Wear sunglasses.
4. If your eye is patched it must be rechecked within 24 hours by your family doctor or an
ophthalmologist. If you are unable to obtain an appointment in 24 hours, return to the
emergency department.

INSTRUCTION CHART 9

X – RAY
The X – Ray report, which you have received, is only a preliminary interpretation of the
films. The radiologist will give your physician a complete report following his
interpretation. You will be contacted by the Emergency Department if this differs from the
preliminary report. You should contact your family doctor or the orthopedist to whom you
have been referred within 3 days if you are still having symptoms so that he/she may review
the final report.

INSTRUCTION CHART 10

ABDOMINAL PAIN
1. Eat a bland diet for 24 hours. Avoid caffeine containing beverages such as coffee, tea,
cola sodas, cocoa, chocolate and alcohol; fatty, greasy, spicy, highly seasoned foods,
strongly flavored vegetables.
2. You should be rechecked by your doctor in 24 – 48 hours.
3. If the pain becomes worse, a fever or vomiting occurs, return to the emergency
department.
 INSTRUCTION CHART 11

NOSE BLEED
After you leave the Emergency department
1. Keep your nose and head above the level of your heart. Sleep on your back with your
upper body elevated on pillows.
2. Do not blow your nose.
3. Do not sneeze or cough.
4. Do not drink hot liquid.
5. Do not apply hot packs to your face.
6. Do not take any medication with aspirin in it.
7. Do not drink alcohol.
8. If bleeding stops
a. Sit up.
b. Pinch the lower one-half of the nose (not just the tip) between the thumb and
index fingers.
c. Pinch for 10 minutes continuously.
9. If bleeding does not stop, call your doctor or return to the Emergency.

INSTRUCTION CHART 12

ALLERGIC REACTION
1. Rest. Stay cool. Do not engage in activities which may cause your body to become
overheated.
2. Apply ice to swollen areas.
3. If the rash gets progressively worse, call your doctor or return to the Emergency
Department.
4. If you become SHORT OF BREATH or develop TIGHTNESS IN THE THROAT OR
CHEST PAIN, go to Emergency Department immediately. If symptoms are severe call

Activity 1. Write sentences using the word in parenthesis.

1. (pus)
…………………………………………………………………………………………….
2. (convulsion)
…………………………………………………………………………………….
3. (bouillon)
………………………………………………………………………………………..
4. (avoid)
…………………………………………………………………………………………..
5. (contraindicated)
………………………………………………………………………………...

Activity 2. Write sentences related to giving discharge instructions using the word in
parenthesis.
1. (important) ……………………………………………………………………………………..
2. (‘d better)
……………………………………………………………………………………….
3. (should not) …………………………………………………………………………………….
4. (suggest) ………………………………………………………………………………………..
5. (need) …………………………………………………………………………………………..

Activity 3. Translate these expressions into communicative English.

1. Lukanya harus dijaga supaya tetap kering and bersih.
2. Anda harus minum banyak air.
3. Anda jangan makan apapun 2 jam setelah muntah.
4. Kalau anak anda panasnya tinggi, anda harus segera menelpon IGD.
5. Anda sebaiknya meninggalkan posisi kaki yang terluka selama satu atau dua hari sampai
bengkaknya mengempis.
6. Anda harus menghindari gerakan-gerakan yang menimbulkan rasa sakit.
7. Anda tidak boleh mengucek mata anda.
8. Anda perlu menghindari kontak langsung dengan sinar terang atau sinar matahari.
9. Kalau anda merasa semakin sakit atau muntah, anda harus segera kembali ke IGD.
10. Selama hidung anda masih berdarah, anda tidak boleh minum air panas.

Activity 4. Give your suggestion or response based on the situation below.

1. Give suggestion to the patient to take the temperature if he/she gets fever.
2. Give suggestion to the patient not to take anything to eat after vomiting.
3. Give recommendation for the patient not to consume dairy products.
4. Tell the patient if the condition worsens, he/she should contact the ER or doctor.
5. Ask the patient if he/she feels blurred vision, he should call the doctor.

Activity 5. Make conversation in giving appropriate suggestion and advice.

Make a conversation between a nurse and a patient or an intermediary.
Situation: A patient has just got a medical treatment in outpatient clinic. Now you have to give
discharge instruction to your patient.