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  • Учебное пособие НАР.ШАМ. 2008. Учебное пособие НАР.ШАМ. Kursk state medical university V. I. Narolina, I. F. Shamara


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    НазваниеKursk state medical university V. I. Narolina, I. F. Shamara
    АнкорУчебное пособие НАР.ШАМ. 2008.doc
    Дата10.03.2018
    Размер1.35 Mb.
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    Имя файлаУчебное пособие НАР.ШАМ. 2008.doc
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    Doctor-Patient Interaction




    Asking the Patient about the Present Illness


    What do you complain of? What is wrong with you? What's the matter with you?
    Patient's emotions whileDoctor's showing interest, describing his conditionasking for additional

    information, consolation

    Oh, Doctor, nothing serious. Really! Oh, indeed! Is that so?

    Just a trifle. I see. That's clear.

    You see, Doctor… I know what you mean.

    The matter is that... Anything else? What else?

    In short... Tell me more about it

    To be honest. Now, now. Calm down.

    Unfortunately... Take it easy. Please, don't worry.

    My... troubles me. Thing's do happen. Never mind.

    My... gives some causes for concern. Don't be nervous. Cheer up!

    I am worried about... There is nothing to worry about.

    I am scared. Don't let it upset/distress you

    I am very anxious about... /get you down.

    I feel awful. Don't take it so much to heart.

    1 suspect... Let’ s hope for the better.

    It's horrible! You'll be well again soon.

    It's too awful for words! Everything will be fine, I am sure.
    - When did you fall ill? Hew long have you been ill? Since when do you feel ill? When did the first symptoms appear?

    - 1 fell ill about a week ago. -1 have been ill for 2 years. The pains are troubling me for 2-3 months. The pains got worse in the past 2 weeks.

    - What was the onset of your disease? What began to trouble you first? What was the first symptom?

    - There was a bad cough at first (pains in my wrist, fever, vomiting).

    - How is the disease developing? Did your condition get worse (better)? Did the character of the pains change?

    - Pains (cough, attacks, shortness of breath) intensified lately (subsided).

    - Did you take drugs?

    - Yes I take tranquilizers. - No, I don't take any drugs. My doctor prescribed me the medicine for my headache, but I don't take it regularly.

    - Does the drug relieve pains? - Yes, it does. It relieves the pain but for a short period. - Yes, when taking the drug I feel the pain subsides. - No I don't say the drug helps me.
    Physical Examination of a Patient

    (Giving commands)
    Please, come over here. I'll examine you. Roll your sleeve up. Ваге уоuг arm to the elbow. Get undressed, please. Take your clothes off. Remove your clothes. Take everything off.

    Undress, please. Don't get undressed.

    Strip to the waist, Don't strip naked. Take off the shirt.

    Bare your abdomen.

    Dress up, please. Put your clothes on.

    You may put your clothes on. You may get dressed now, thank you.

    Let me feel your pulse. Give me your hand/wrist. Give me your arm, I want to check your blood pressure, Let me put my blood pressure machine cuff. Let me put the cuff around your arm; and, please, relax.

    Please, open your mouth wide. Stick out/show me your tongue. Say "Ah!" I want to check your throat. Let me see your tonsils. Thank you. Close your mouth. Put your chin up; let me palpate your tonsils. Swallow, please, is it hard to swallow? Does it hurt here? Cough a little. That will do. I want to listen to your heart and lungs. Please, take a deep breath and hold it. Breathe in and keep it. Take a deep breath and keep it. Now, blow your air out and hold it. Don't breathe now. Breathe in and out through your mouth. Breathe deeply. Breathe normally. Turn your head and breathe. Continue. Enough.

    Stand/keep still. Don't move. Sit down. Sit still. Sit quiet, please. Move nearer.

    Lean slightly forward. Lie down on the couch/on the examination table. Lie down on your back/right side/left side/abdomen. Lie quietly. Take/remove your hands off/from the abdomen. Put/hold your hands along the trunk/body.

    I'm going to examine your abdomen. I must palpate your liver. Does it hurt when I press? Does it hurt when I withdraw my fingers? Did it hurt anywhere that I touched you? Where does it hurt? Show where the pain is the most acute Strain/relax the abdominal muscles. Inflate your belly. Deflate your abdomen. Pull in your belly. Draw your abdomen in. That will do. Sit up, please. Relax, please. Try to relax.

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