涉外护理英语Unit 2 Taking Medical SpecimensPPT文档.ppt

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1、Taking Medical Specimens,Explaining taking an MSU specimenChecking understanding and softening a requestContacting other staffExplaining urinary cathetersReading a Pathology ReportGiving an oral report of the case,Unit 2,医 学 标 本,解释留取中段尿标本确认是否理解并缓和请求联系其他工作人员解释导尿管的使用查看病理报告口头汇报病人病情,Description,Medical

2、specimens are samples taken from a patient,most frequently tissue,blood,urine,or stool,used for analysis and diagnosis.,翻译,单元描述,医学标本是取自于患者的标本，主要是人体组织、血液、尿液和大便，用于分析与诊断。,Description,Work Description,Blood specimen collection is performed primarily by nurses and phlebotomists.The physician orders the l

3、aboratory tests.The nurse is responsible for instructing the patient regarding the procedure and assessing the patients response.In addition,the nurse should be knowledgeable about the implications laboratory results may have on patient care.Prior to obtaining blood specimens,the nurse should assess

4、 the patient,noting factors that may affect test results,including medications,pregnancy,age,and sex.,翻译,Blood specimen collection,Work Description,Make sure the patient has followed any special instructions,which could include fasting for a number of hours or taking a medication at a certain time.P

5、atients should also be assessed for their knowledge level regarding the tests ordered.Instruct the patient as needed about the test and the procedure itself.Although most blood work does not require any special consent,some tests,like those for HIV,usually do.,翻译,Work Description,If needed,obtain co

6、nsent prior to collecting the specimen.There are four patient“rights”the nurse should consider when collecting blood specimens.These“rights”are:Right specimen.Make sure the specimen collected is the specimen ordered.Right time.Certain blood tests must be obtained at specific times.For example,when d

7、rawing antibiotic levels,trough specimens should be obtained immediately prior to the next dose.,翻译,Work Description,The time to draw peak levels may be dependent upon whether the antibiotic is given intravenously,orally,or intramuscularly.Right patient.Always verify the patients identification befo

8、re drawing a blood specimen.The person drawing the specimen should also label the container it is drawn into.Right method.Always follow universal precautions when performing a venipuncture.,翻译,Work Description,血液标本的采集首先由护士和采血师完成。医生开出实验室检查的医嘱，护士负责指导患者标本的采集以及评估患者的反应。另外，护士还应知道实验室检查结果对患者护理措施产生的影响。,血液标本的

9、采集,Work Description,在采集血液标本之前，护士必须评估患者，记录可能影响检查结果准确性的因素，如药物、妊娠、年龄和性别，确保患者遵从采血的每一项专门指导，包括空腹禁食若干小时和在规定时间里服药。同时还要评估患者对于所做检查的了解程度，必要时指导患者了解检查项目及其过程。虽然大部分的采血不需要专门同意，有些检验，如检测人类免疫缺陷病毒的，须征求患者同意。如有必要，在采血之前就要征求患者同意。,Work Description,护士采血时要考虑到患者的“四对”，它们是：正确的标本。确保采集的血样是医嘱开出的取样标本。正确的时间。某些血液检查必须在特定的时间里采集。比如，检测患者血

10、液中的抗生素水平，标本必须在下一剂用药前采集。采集血液抗生素最高水平的时间取决于抗生素的给药途径：静脉注射、口服和肌肉注射。正确的患者。通常在采血前要核对患者的身份，抽血者要在装血液的容器上贴上标签。正确的方法。做静脉穿刺要时刻全面预防。,Work Description,Stool specimen collection is performed primarily by nurses.The physician orders the laboratory tests.The nurse is responsible for instructing the patient regarding

11、 the procedure.In addition,the nurse should be knowledgeable about the implications laboratory results may have on patient care.To get started,collect the following equipment:a specimen container with lid,gloves,two tongue blades,a paper towel or paper bag,a bedpan or portable commode,two patient-ca

12、re reminders(for timed specimens),a lab request form and a lab biohazard transport bag.,Stool specimen collection,翻译,Work Description,And then,explain the procedure to the patient and his family,if possible,to ensure their cooperation and prevent inadvertent disposal of timed stool specimens.If a ra

13、ndom specimen is collected,tell the patient to notify you when he has the urge to defecate.Have him defecate into a clean,dry bedpan or commode.Instruct him not to contaminate the specimen with urine or toilet tissue.Put on gloves,using a tongue blade,transfer the most representative stool specimen

14、from the bedpan to the container,and cap the container.If the patient passes blood,mucus,or pus with the stool,include this with the specimen.Wrap the tongue blade in a paper towel and discard it.Remove and discard your gloves,and wash your hands thoroughly to prevent cross-contamination.,翻译,Work De

15、scription,If a timed specimen is collected,place a patient-care reminder stating SAVE ALL STOOL SAMPLES over the patients bed and in his bathroom.After putting on gloves,collect the first specimen,and include this in the total specimen.Obtain the timed specimen as you would a random specimen,but rem

16、ember to transfer all stool to the specimen container.As ordered,send each specimen to the lab immediately with a lab request form or,if permitted,refrigerate the specimens collected during the test period and send them when collection is complete.All specimens must be stored and transported in an a

17、pproved lab biohazard container.Remove and discard gloves.Make sure the patient is comfortable after the procedure and he has the opportunity to thoroughly clean his hands and perinea area.,翻译,Work Description,It may be necessary for you to assist the patient with perinea care.Document the date and

18、time of the specimen collection in the patients medical record along with instructions that the patient can resume his normal diet and medication regime unless otherwise specified.If stool must be obtained with an enema,use only tap water or normal saline solution.Never place a stool specimen in a r

19、efrigerator that contains food or medication to prevent contamination.Notify the healthcare provider if the stool specimen looks unusual.,翻译,Work Description,粪便标本的采集主要由护士完成。医生开出实验室检查的医嘱。护士负责指导患者完成标本采集，除此之外，护士还应知道检验结果可能对患者护理上的影响。首先，准备以下用物：带盖的检便盒、手套、两个检便匙、纸巾或纸袋、便盆或便携式马桶、两张患者护理提醒便条（对于特定时间的标本采集）、检验申请单和实

20、验室生物安全运输袋。,粪便标本的采集,Work Description,然后，向患者及家属解释采集过程。如果可能，要确保患者合作并避免对定时采集的粪便标本的处理。若收集随机粪便标本，告知患者当有排便冲动时通知你，让他排便于清洁、干燥的便盆或便携式马桶内，指导患者不要将尿液或者卫生纸污染了标本。戴上手套，用检便匙将便盆内具有代表性的粪便取出放于检便盒里，并盖上盖子。如果粪便上带有血液、粘液或者脓水，将它们同标本一起取出，用卫生纸将检便匙包住后丢弃，脱掉并丢掉手套，彻底清洁双手防止交叉污染。,Work Description,若收集24小时粪便标本，在患者的床头和洗手间放一张写有“保留所有大便标本

21、”的患者护理提醒便条。戴上手套后，采集第一次粪便标本，将其放入总标本里，就像采集随机粪便标本那样采集24小时粪便标本，但是要记住将所有的粪便放入检便盒内。遵医嘱，立即带上检验申请将标本送去实验室检验。,Work Description,如果条件允许，检验期间要将采集的标本冷藏直至采集完成再送去实验室。所有标本的存放和运输必须在一个被认可的实验室生物安全容器内。脱掉并扔掉手套。采集完后要确保患者舒适，让患者彻底清洁手及肛门周围。必要时要协助患者清洁肛门周围。在患者的医疗记录上记录采集标本的日期、时间并说明。如果没其他规定，患者可以恢复正常饮食和服药。如果粪便标本必须通过灌肠来获得，使用自来水或生

22、理盐水。不要将粪便标本放于装有食品、药物的冰箱里以防交叉污染。如果粪便异常就通知管床医生。,Work Description,When collecting a urine specimen,give the patient a urine container with a lid.Prepare a label that has the patients information on it,including the medical record number,name,and birth date.Avoid incorrect labeling by labeling the speci

23、men in front of the patient.Fill out the lab request form and attach it to the specimen according to the facilitys policy.Perform hand hygiene and wear gloves when handling the specimen.Explain to the patient that a urine specimen is needed for the lab,and provide him with the container.If the patie

24、nt is a child,instruct the parent and ask him/her to collect the specimen.If the patient is unable to hold the container over the toilet and urinate into it,give him/her a clean urinal or bedpan to use on the toilet or in bed.,MSU specimen collection,翻译,Work Description,When collecting a clean-catch

25、 midstream specimen,proper patient instruction in cleaning the urinary meatus and surrounding tissue before collection is the secret to collecting an uncontaminated specimen.Tell your patient to start the stream and begin the collection in the middle of the stream.Instruct the male patient to clean

26、the tip of his penis with soap and water,then with disposable wipes or with cotton balls soaked in povidone-iodine solution or Chloroprep.Tell him to start the urine stream and,without stopping,begin the specimen collection by moving the container into the urine stream.For an uncircumcised male,remi

27、nd him to retract the foreskin to clean the urinary meatus more effectively and to keep it retracted during voiding.,翻译,Work Description,Instruct the female patient to clean her genital area with soap and water and then to sit far back on the toilet or to sit backward on the toilet.It may be easier

28、for her to strip from the waist down in order to spread her legs far enough apart.With disposable wipes or cotton balls soaked in povidone-iodine solution or Chloroprep,instruct her to wipe first down one side,and then down the other side,and finally down the middle of the labial folds,vulva,and uri

29、nary meatus.Stress the importance of wiping from front to back to avoid fecal contamination.Instruct the patient to begin voiding into the toilet and to keep the labial folds separated during the specimen collection.Tell her to start the stream and,without stopping,begin collecting the specimen in t

30、he middle of the stream by moving the specimen container into the stream.,翻译,Work Description,Wear gloves to collect the container and put on the lid without touching the inside of the lid.If the outside of the container is soiled,clean it and wipe it dry.Wash your hands and instruct the patient to

31、do the same.When collecting a specimen from an in-dwelling catheter,clamp the catheter at least 30 minutes before collecting the specimen to allow urine to collect in the bladder.Never take a specimen from the collection bag because its considered contaminated.Clamp the tube just below the point whe

32、re the specimen will be collected.If the drainage tube has a built-in sampling port,put on gloves and wipe the sampling port with alcohol.,翻译,Work Description,At a 90-degree angle,insert a needle with a large syringe,depending on how much urine is required for the specific test.Collect the specimen

33、and unclamp the tubing.Place the specimen in the appropriate container,label it,and send it to the lab immediately.Regardless of the type of urine specimen,record the time of collection,when it is sent to the lab,the method of collection,and the test ordered.The odor,color,and any unusual characteri

34、stics are also documented.,翻译,Work Description,当采集尿标本时，给患者一个带盖的标本容器，准备一张写有患者信息的标签，包括医疗记录号、姓名和出生日期。为避免贴错，当着患者的面贴。根据医院规定填写检验申请单，将其贴于标本盒上。处理标本时要清洁双手并戴上手套。向患者解释需要尿标本检验，并给患者提供容器。如果患者是小孩，指导家长采集尿标本。如果患者不能在马桶上拿住容器将尿排于容器中，给他提供清洁尿壶或便盆放于马桶或是床上使用。,中段尿标本的采集,Work Description,当采集清洁中段尿标本时，正确指导患者在采集前清洁尿道外口和周围组织，这是采集

35、无污染标本的秘诀。告诉患者开始排尿，然后采集尿的中段部分。指导男性患者先用肥皂和水，再用蘸有碘伏或消毒剂的一次性湿巾或棉球清洁阴茎头。告诉他开始排尿，持续排尿，然后指导患者将尿排于容器中。对于未割包皮的男性，提醒他缩回包皮以有效清洁尿道外口，并且排尿时要一直保持缩回。,Work Description,指导女性患者用肥皂和水清洁生殖器区，蹲于远离马桶的上方，患者最好把衣物从腰部尽量往下脱以便双腿能够足够分开，指导患者用浸有碘伏或消毒剂的一次性湿巾或棉球，首先从上至下擦外阴和尿道外口的一边，接着另一边，最后中间。强调必须由前往后擦拭的重要性以避免粪便污染。指导患者到马桶排尿，保持阴唇分开。告诉患

36、者开始排尿，直至采集中段尿于容器中。,Work Description,收集容器时要戴手套，盖上盖子时不要碰到盖子的内面。如果容器的外面被污染，洗后擦干净。护士洗手，也指导患者洗手。从留置导尿管中采集标本时，采集标本前必须夹闭导尿管至少30分钟使尿液保留在膀胱内。不要从尿袋内采集标本，因为其中的尿液被认定为污染了。如果尿管有内置采样端口，戴上手套并用酒精消毒端口处。,Work Description,在90度角的地方，插入针头。注射器的大小取决于用于检验的量。收集标本，开放导尿管，将标本置于适当的容器内，做好标记，然后立即送实验室检验。不管采集何种尿标本，要记录采集的时间、送检的时间、采集的方

37、法及检验医嘱。气味、颜色，以及任何异常的特征也得记录下来。,Task 1 Explaining taking an MSU specimen,Taking an MSU specimen is to get a specimen(sample)of urine from the middle of ones bladder.Urine is normally sterile(no bacteria present).If bacteria are found in the sample,it means that the urine is infected.,Description,翻译,任务

38、一 解释留取中段尿标本,采集中段尿标本指采集从膀胱排出的中段尿标本。尿液通常是无菌的（无微生物寄存）。如果标本中有细菌，表明尿被感染。,任务描述,Related Information,The mid-stream urine specimen(MSU)is taken for analysis at the pathology lab when urinary tract infection(UTI)is suspected.The result of testing the microbiology of MSU is awaited before antibiotic therapy i

39、s started so as to target the infection with the correct antibiotic.Test results are received in the ward via the hospital intranet and later as a paper copy which is filed in the Patient Record.Nurses may have to contact the patients doctor to pass on the test results so that antibiotic therapy can

40、 be started as soon as possible.,The reasons for taking an MSU specimen,翻译,相关信息,当怀疑有尿道感染时，采集中段尿标本作病理学实验室分析。在进行抗生素治疗前须等待中段尿标本的微生物学检测结果，以便使用正确的抗生素来治疗感染。病房里查看医院内部联网可收到化验结果，打印出后可贴在患者的记录单上。护士需联系医生告诉他检测结果以便医生能够尽可能快地进行抗生素治疗。,采集中段尿标本的原因,UTI,A urinary tract infection(UTI)is a bacterial infection that affects

41、 any part of the urinary tract.Symptoms include frequent feeling and/or need to urinate,pain during urination,and cloudy urine.The main causal agent is Escherichia coli.Although urine contains a variety of fluids,salts,and waste products,it does not usually have bacteria in it,but when bacteria get

42、into the bladder or kidney and multiply in the urine,they may cause a UTI.,翻译,The most common type of UTI is acute cystitis often referred to as a bladder infection.An infection of the upper urinary tract or kidney is known as pyelonephritis.Although they cause discomfort,urinary tract infections ca

43、n usually be easily treated with a short course of antibiotics with no significant difference between the classes of antibiotics commonly used.,翻译,泌尿道感染,泌尿道感染是细菌感染，可以发生在泌尿道的任何部位。症状包括尿频感、尿痛和尿浑浊。主要病原菌是大肠杆菌。虽然尿液含有水分、无机盐和代谢废物，但通常是无菌的，但当细菌侵入膀胱或肾脏，在尿道繁殖，就会导致泌尿道感染。最常见的泌尿道感染类型是急性膀胱炎，常称为膀胱炎。上泌尿道或肾脏的感染称作肾盂肾炎。

44、泌尿道感染引起的不适，通常用短程抗生素易于治疗，疗效和其他等级的常用抗生素没有显著区别。,Asking for clarification,Asking for clarification when unsure that an instruction has been received correctly is an important feature of active listening skills to avoid misunderstandings,which is vital in the healthcare setting.There are several clarific

45、ation strategies as follows:1.Ask the speaker to clarify what he/she has said.,翻译,Medical specimens are samples taken from a patient,most frequently tissue,blood,urine,or stool,used for analysis and diagnosis.,2.Paraphrase what has been said.3.Use a questioning intonation pattern.4.Repeat the inform

46、ation back to the speaker.,MSU is short for the mid-stream urine,which is taken for analysis at the pathology lab when urinary tract infection(UTI)is suspected.,Privacy must be respected especially when patients are in a multi-bed room;cultural sensitivities can also be an issue.,To monitor the prog

47、ress of their patients,to check for toxicity of a drug before administration,to monitor infection and decide on changing patient precaution code(standard precaution to special precaution).,Discussion of the nursing topic,1.What kinds of specimen are taken and why?2.What is an MSU and its purposes?,M

48、edical specimens are samples taken from a patient,most frequently tissue,blood,urine,or stool,used for analysis and diagnosis.,MSU is short for the mid-stream urine,which is taken for analysis at the pathology lab when urinary tract infection(UTI)is suspected.,3.What special considerations are neede

49、d when taking urine specimens?4.Why is it important for nurses to understand the results of the pathology tests?,Privacy must be respected especially when patients are in a multi-bed room;cultural sensitivities can also be an issue.,To monitor the progress of their patients,to check for toxicity of

50、a drug before administration,to monitor infection and decide on changing patient precaution code(standard precaution to special precaution).,Common patterns and questions found in a dialogue when taking an MSU,1.Do you mean?2.Tell me what happens when 3.So what youre saying is that 4.It sounds as if