自发性气胸的双语护理教学查房

自发性气胸的双语护理教学查房2380自发性气胸的双语护理教学查房陈佩娟徐恒贾海娜护士长为提高同学们英语水平,规范护理查房,今天对一名自发性气胸病人进行双语教学查房下面请教学组长组织CHARGENURSEINORDERTOIMPROVETHELEVELOFENGLISHANDSTANDARDIZESEMINAR,TODAYWEWILLCARRYOUTBILINGUALCOURSEOFSEMINARONAPATIENTAFTERSPONTANEOUSPNEUMOTHORAXSOLETSASKTEACHINGGROUPLEADERTOHOLDTHEFOLLOWINGPROCEDURE教学组长今天我们对3床病人进行护理教学查房,先请林晓萍同学简单介绍一下患者的病情TEACHINGGROUPLEADERTODAYWEWILLHAVESEMINARONTHEPATIENTONTHETHIRDSICKEDNOWLETXIAOPINGLIINTRODUCETHEPATIENTSCONDITION林同学病人,原某,男,26岁,因胸痛胸闷,呼吸困难于2007年3月27日送人我科患者人院后急诊拍X线示左侧液气胸,左侧肺部被压缩7O,经低流量吸氧,胸腔闭式引流后,胸痛胸闷皮下气肿缓解3月28日予急诊住院处理,医嘱予二级护理,半卧位,停吸氧,持续胸腔闭式引流以及消炎,3月28日X线示左侧液气胸,左侧肺部被压缩6O,29日X线示左侧液气胸,左侧肺部被压缩5O,患者自述有肺大泡病史作者单位南方医科大学南方医院急诊科广州邮编510515收稿日期2007一O827JOURNALOFQIQIHARMEDICALCOLLEGE,2007,VO128,NO19MISSLINPATIENTYUANZHENHUA,MALE,26YEARSOLDTHEPATIENTWHOHADDIFFICULTYINBREATHING,CHESTPAINANDCHESTDISTRESSWASSENDEDTOEMERGENCYROOMONMARCH27,2007THEPATIENTTOOKTHERAYXWHICHSHOWTHEHYDROPNEUMOTHORAXANDTHELEFTLUNGISPRESSEDPLEASED70AFTERHEENTERTHEEMERGENCYMEDICALTREATMENT,HEWASGIVENDRAINAGEOFPLEURALCAVITYANDLOWFLOWOXYGEN,HISCHESTPAIN,CHESTDISTRESSANDTHEPNEUMODERMAWEREALLEVIATEDINMARCH28GIVENTHEEMERGENCYMEDICALTREATMENTTOBEHOSPITALIZEDPROCESSING,THEDOCTORSADVICEGAVETWOLEVELSTONURSE,SEMIRECLININGPOSITION,STOPEDATTRACTSTHEOXYGEN,CONTINUESDRAINAGEOFPLEURALCAVITY,ANDCANSTERILIZEINMARCHTHE28RAYXSHOWEDTHEHYDROPNEUMOTHORAX,THELEFTLUNGISPRESSEDPLEASED60,ON29THRAYXSHOWEDTHEHYDROPNEUMOTHORAX,THELEFTLUNGWASPRESSEDPLEASED50THEPATIENTSAIDHEHADBULLAEOFLUNGINTHEMEDICALHISTORY教学组长自发性气胸是我们急诊科常见病,林同学已经介绍了病情,现在由陈艺嫒同学来介绍其护理问题,以及采取了哪些针对性措施TEACHINGGROUPLEADERSPONTANEOUSPNEUMOTHORAXISANORDINARYILLNESSINEMERGENCYMISSLI语用学和语用语言学两方面结合起来,在语言形式,语用功能,社交环境和文化意义之间找到了联系,获得了发展自身语用能力所需的相关信息,提高了语用意识4结论学习者的文化差异敏感性越强,其语用能力也就越强在实际英语教学中要积极地引导学生,利用现代化的教学手段去培养和提高学生学习英语的语用意识,将社交语用学和语用语言学结合起来,全方位多角度的综合发展,加强语言形式和功能的教学,加强语境中语言的得体性的教学,加强学生对文化差异的敏感性教学从而不断发展学生语用能力,提高改进英语教学效果参考文献1洪岗英语语用能力调查及对外语教学的启示J外语教学与研究,199142胡文仲跨文化非语言交际RM外语教学与研究出版杜,34567891OL999LL64HANVEY,RGCROSSCULTURALAWARENESSAELISECSLIDECSMITHLOURSEFIBERLUSETOWARDSINTERNATIONALISMTREADINGINCROSSCULTURALCOMMUNICATIONCNEWBURYHOUSEPUBLISHERSINS,197953司联合文化教学与语用能力J宁波大学,19983戴炜栋,杨仙菊第二语言语用习得的课堂教学模式J外语界,20052KASPER,ROSEPRAGMATICDEVELOPMENTINASEC0NDLANGUAGERMMALDEN,MABLACKWELL,200296BLUMKULKA,HOUSEANDKASPER,EDCROSSCULTURALPRAGMATICSMNORWOOD,NJABLEX,198918何自然语用学与英语学习M上海上海外语教育出版社,1997THOMAS,JCROSS2CULTURALPRAGMATICFAILUREJAPPLIEDLINGUISTICS,1983MEANINGININTERACTIONANINTRODUCTIONTOPRAGMATICSMLONGMAN,1995齐齐哈尔医学院2007年第28卷第19期HASINTRODUCEDTHEPATMNTSCONDITION,LETYWUANCHENINTRODUCETHENURSINGDIAGNOSISANDNURSINGMEASURESOFTHEPATIENT陈同学主要存在四个方面的问题1气体交换功能受损与胸腔积气积液有关采取的措施有3密切观察病人的体温呼吸,脉搏,血压变化,呼吸困难有无改善,有无口唇青紫和面色改变B观察胸起伏情况,呼吸运动度,听诊呼吸音C保持闭式引流装置固定,密闭,通畅,防止脱出及打折D观察水柱波动及引流液的颜色,性质,量E保持闭式引流装置无菌,定时更换,防止逆行感染2活动无耐力与胸腔积气积液有关采取的措施有3绝对卧床休息,取半坐卧位,减轻腹部压力,以利于膈肌下降,改善呼吸B避免闭气与剧烈咳嗽C给予低流量吸氧3营养失调给予机体需要量采取的措施有给予高蛋白,高维生素,清淡,易消化饮食,以增加机体抵抗力,多食新鲜蔬菜和水果,保持大便通畅防止排便用力引起胸痛或伤口疼痛4知识缺乏与文化程度有关采取的措施有A应避免气压骤变,剧烈咳嗽,喷嚏,屏气,高喊大笑,举手欢呼,抬举重物,剧烈运动等诱发因素B注意保暖,防止感冒,预防呼吸道感染C保持大便通畅,防止便秘及用力排便MISSCHENASFAR38IKNEW,THEPATIENTHADFOURMAIN1IMPAIREDGASEXCHANGECAREPLANSINCLUDED30BSERVEPATIENTTEMPERATURE,PULSE,BLOODPRESSURE,DOSETHEPATIENTDYSPNENHAVEIMPROVEBOBSERVEPATIENTSBONYTHORAXMOVEMENTANDTHERANGEOFTHERESPIRATORYNOTION,ANDAUSCULTATIONPATIENTSBREATHINGSOUNDCKEEPTHETHORACICCLOSEDDRAINAGESYSTEMFIXED,BECLOSEDTIGHTLYANDBEUNOBSTRUCTEDPREVENTTHETUBEPROLAPSEDANDFOLDD0BSERVETHEFLUCTUATIONOFTHEWATERCOLUMN,OBSERVETHECOLOR,THEQUALITYANDTHECAPACITYOFTHEDRAINAGELIQUIDEKEEPTHETHORACICCLOSEDDRAINAGESYSTEMASEPTIC,TOCHANGEITREGULARITY,ANDPREVENTRETROGRADEINFECTION2ACTIVITYINTOLERANCE,CAREPLANSINCLUDEDACOMPLETEBEDREST,TAKEHALFCLINOSTATISM,ITCANLIGHTENTHEPRESSUREOFABDOMENANDIMPROVEBREATHINGBASKTHEPATIENTTOAVOIDTOHOLDHISBREATHANDTOCOUGHINTENSITYCGIVINGLOWFLOWOXYGEN3NUTRITIONALTEREDLESSTHANBODYREQUIREMENT,CAREPLANSINCLUDEDGIVINGHIGHPROTEINJ,HIGHVITAMINFOOD,ANDMILD,EASYTODIGESTDIETTOLDTHEPATIENTTOEATMOREFRESHVEGETABLESANDFRUIT,KEEPBOWELSOPEN4KNOWLEDGEDEFICIT,CAREPLANSINCLUDED3TOAVOIDHOLDHISBREATH,2381COUGHANDLAUGHINTENSITYDONTTAKEVIOLENTEXERCISEANDRAISEHEAVYTHINGSBTOKEEPBODYWARM,PREVENTTOCATCHCOLDANDHAVERESPIRATORYTRACTINFECTIONCKEEPBOWELSOPEN,PREVENTCONSTIPATION教学组长陈同学对该病人提出了4个护理问题,也针对性采取了护理措施,在这里我再补充一点陈同学提出的第三个护理诊断是不必要的,就目前病人的情况来看,并不存在营养失调的症状,所以该护理诊断可以省略其他的诊断都提的非常好TEACHINGGROUPLEADERMISSCHENHASRAISEDFOURNURSINGPROBLEMSANDCOUNTERMEASURESOFTHEPATIENTHEREIN,1WOULDLIKETOADDANOTHERPOINTTHETHIRDNURSINGDIAGNOSISWHICHMISSCHENHASSHOWEDUSWASUNNECESSARYBEAIMEDATTHEPATIENTSCONDITIONDOESNTOCCURINHISBODYATPRESENTSOWECANLEAVEOUTTHETHIRDNURSINGDIAGNOSISMISSCHENHAD3PERFECTJOBWITHTHERESTOFTHEDIAGNOSIS护士长今天的查房大家讲得都挺好,在英语方面,我发现大家都做了充分的准备,表达比较清楚,语言比较流利希望通过这次双语护理查房,能进一步调动同学们学习英语的积极性随着我国加入WTO,各类外资医院将不断增加,对外交流的机会亦增多,我们的护理工作也要逐步与国际接轨,因此对我们护士的英语水平有了一个更高的要求希望大家在今后的工作中理论联系实际,在业务上精益求精,在英语学习上积极主动,提高我们自身素质,去迎接新时代的机遇与挑战_1CHARGENURSEWEHAE3GREATSEMINARTODAYASFARASENGLISHISCONCERNED,EVERYONEMAKES3GOODPREPARATIONWITHCLEARANDFLUENTEXPRESSIONIHOPETHATTHISBILINGUALCOURSEOFSEMINARWILLFURTHERINCREASEOURINTERESTINENGLISHSTUDYWITHOURCOUNTRYENTRYWTO,ALLKINDOFFOREIGNHOSPITALWILLCOMEINTOCHINA,SOWESHOULDIMPROVEOURLEVELOFNURSINGTOACCORDWITHTHEINTERNATIONALPRACTI