3. Exercise

Translate the following sentences.

1. When that happens, part of the brain can’t get the blood (and oxygen) it needs, so it starts to die.

2. When part of the brain dies from lack of the blood flow, the part of the body it controls is affected.

3. TIAs occurs when a blood clot temporarily clogs an artery, and part of the brain doesn’t get the blood it needs.

4. Here are the risk factors that people can modify by their personal choices they make each day.

3. Grammar note Слово likely может выступать как наречие (Adverb) со значением «вероятно», как прилагательное (Adjective) со значением «вероят­ный, возможный; правдоподобный».

НАПРИМЕР:

• You will very likely see your attending doctor again (Adverb).

Вы, скорее всего, еще увидитесь со своим лечащим врачом.

• In molecular biology much is likely to become clear within the next decade (Adjective).

Весьма вероятно, что многое в молекулярной биологии станет ясным в сле­дующем десятилетии.

Слово unlike может выступать как прилагательное (Adjective) со значением «непохожий», как предлог (Preposition) со значением «в отличие от».

НАПРИМЕР:

• These diseases have unlike signs and symptoms (Adjective).

Эти заболевания имеют разные (несхожие) признаки и симптомы.

• For centuries, unlike other sciences, medicine and pharmacy were not inde­pendant (Preposition).

Веками, в отличие от других наук, медицина и фармация были взаимосвя­заны.

Exercise

Translate the following sentences. Analyze the function and mean­ing of the words like, likely, unlike. (Review: Grammar Note 5, Text A, Unit 14.)

1. Like stroke, TIA symptoms occur rapidly, but they last a relatively short time.

2. Compared with people who haven’t had a TIA, people who’ve had a TIA are 9 times more likely to have a stroke.

3. Unlike stroke, when a TIA ends, the blood clot resolves itself and the symptoms disappear, leaving no permanent effects.

III. Text Exercises

1. Make a list of questions (6-8 questions) to ask a neurologist about stroke risk factors.

2. Translate Text A in written form*. (Use: Active vocabulary to Text A, Text Notes, Vocabulary Exercises, Grammar Notes and Exercises, Text Exercises.)

TEXT

Active Vocabulary to Text В

impact ['impaskt] — влияние, воздействие

(cerebrovascular) accident ['sksident] — инсульт

profound [pra'faund] — основательный, глубокий

recovery [ri 'кдуэп] — выздоровление, восстановление

improvement [im'pruivmsnt] — улучшение

initially [I'mfsh] — вначале; на ранней стадии

disability [diss'biliti] — нетрудоспособность

current [ 'клг(э)т] — текущий

perceptual [рэ 'septjual] — воспринимающий, ощущающий

cognitive [ 'kognitiv] — познавательный

strength [streijG] — сила

pillow [ 'pilau] — подушка

blanket roll [ 'bleeqkrt reul] — свернутое (скатанное) одеяло

joint [ 'd30int] — сустав

contracture [кэп'trsektfa] — сведение, контрактура

decubiti [di 'kju.’bitai] — мн.ч. пролежни

to tolerate [ "tolsreit] — переносить, быть устойчивым

awareness [з' weanis] — зд.: ощущение

environment [in'vaiarsnmant] — окружение, окружающая среда

item [ 'aitam] — отдельный предмет

to reintegrate [' ri:' intigreit] — восстанавливать

BEFORE READING THE TEXT AND DOING EXERCISES

Look through Text В and say

1. which is the term for the condition when a patient is unable to feel one side of his body and, as a result, is unable to maintain proper body position;

2. how visitors can help the patient to develop an awareness of the right side of the body.

NURSING NEEDS OF STROKE PATIENT:

FOCUS ON MOBILITY

The impact of a stroke, or cerebrovascular accident on a person’s ability to communicate and on their mobility can be profound. Since recovery can take up to a year, the nurse in the hospital may not see much improvement initially. However, early interventions can set the tone for ongoing progress. Once the patient has stabilized, usually after the first 72 hours, the emphasis of care is rehabilitation and sup­port for the patient’s adaptation to the current disability.

To plan care, the nurse must carefully assess sensory, perceptual, cognitive and motor deficits and strengths of the patient. Also essen­tial is to assess the emotional state following this crisis and family or social supports. We will focus on one aspect of the care plan.

Immobility. Hemiparesis is common in certain types of strokes. The patient is unable to feel one side of his body and, as a result, will need help with positioning in order to maintain proper body position. Proper body position will require pillows or blanket rolls to support the affected limbs and to protect and minimize joint strain. One risk of immobility is contractures. A nursing intervention to prevent this from occurring is passive and active range of motion exercises. Putting the joints on the affected side through gentle exercises will maintain the range through which the joint can move. Teach and encourage the patient to initiate similar exercises on the unaffected side. This will get him involved in self-care activities from the beginning of his recovery^A. These exercises should be done four to five times a day.

Since the patient with hemiparesis cannot safely move himself, it is essential to turn the patient every two hours. This helps prevent decubiti, contractures and pulmonary complications. Getting the patient up to a chair® as soon as possible will also help to decrease the risk of these complications. Most patients are able to tolerate sitting in a chair for short periods three days after the stroke occurs.

Since the patients with left sided hemiparesis cannot feel their left side and often lacks awareness of his left side in general, he is at risk for injury. The patient will also not notice heat applied to the injured side or any other injury. Should he try to move on his own^c, he may fall. How can the nurse help with this hemiparesis? Encourage the patient to scan the left side of his environment, to turn his head and look at that side of the room or his meal tray. Often, the patient will only eat that food on the tray on his unaffected side. Place items such as his toothbrush on the right side of his bed table to encourage him to reach in that direction with his left hand. Suggest to the patient’s visitors that they sit on his left side so that he will develop an aware­ness of that side of his body, even if he cannot feel it. These interven­tions will help the patient to reintegrate his right side back into his body awareness.

Notes:

^A this will get him involved in self-care activities from the beginning of his re­covery — это будет способствовать тому, что он с самого начала восстанови­тельного периода будет учиться самостоятельно ухаживать за собой

⁸ getting the patient up to a chair — зд. \ усаживать больного на стул

^с should he try to move on his own — если он попытается сделать какое-либо дви­жение самостоятельно...

I. Vocabulary Exercises

1. Practice the pronunciation of the following words:

impact

contracture

recovery

joint

profound

perceptual

accident

environment

improvement

decubiti

initially

cognitive

awareness

disability

pillow

item

current

reintegrate

2. Pronounce the following words and give their Russian equiva­lents. Consult the dictionary to check your answers.

Cerebrovascular [,seribro'vaeskju:l9], mobility [mau'bihti], tone [taun], progress [ "'prsugrss], to stabilize [ 'steibilaiz], rehabilitation ['ribbiirteijbn], adaptation [,asdaep'tei/эп], sensory ['sensari], motor ['mauts], immobility [jmau'bihti], hemiparesis [^hemipg'riisis], position [pa'zifn], pulmonary ['рл1тэпэп], scan [skasn], visitor ['vizita].

3. Find in the Text English equivalents of the following Russian words and expressions.

Воздействие инсульта; на ранней стадии; раннее вмешательство; задавать тон; адаптация пациента к нарушение познавательной способности пациента; нарушение восприятия (окружающей действительности); нарушение двигательной способности; неподвижность; поражение конечности; поврежденная сторона; самостоятельная деятельность (активность); страдать отсутствием чувствительности.

II. Grammar Exercises

1. Exercise

Find in the Text sentences with verbs in the Imperative Mood and translate them. (Review: Grammar Note 4, Text B, Unit 12.)

1. Exercise

Find in the Text sentences with the conjunction «since» and translate them. (Review: Grammar Note 3, Text B, Unit 11.)

3. Exercise

Fill in the appropriate modal verbs (can, must, should), comment on your choice. (Review: Grammar Note 1, Text A, Unit 6.)

1. The impact of a stroke, or cerebrovascular accident on a person’s ability to communicate and on their mobility ... be profound.

2. Early interventions ... set the tone for ongoing progress.

3. To plan patient’s care, the nurse ... carefully assess sensory, perceptual, cognitive, and motor deficits and strengths.

4. Putting the joints on the affected side through gentle exercises will maintain the range through which the joint... move.

5. Since the patient ... not feel his left side and often lacks awareness of his left side in general, he is at risk for injury.

6. ... he try to move on his own, he may fall.

NURSING CARE OF PATIENTS WITH NEUROLOGICAL DISEASES (II)

TEXT

Active Vocabulary to Text A

sign [sain] — признак

right [rait] — правый, правосторонний

left [left] — левый, левосторонний

trouble [ trAbl] — проблема

considerable [кэгГsidarabl] — значительный

cautious [ 'ko:j9S] — осторожный

anxious [ 'asqkjas] — беспокоящийся, тревожащийся

reinforcement [,ri:in 'foismant] — усиление, укрепление

success [sak'ses] — успех

failure ['fejljs] — неудача; недостаточность

to adjust [a'd^st] — приспосабливать(ся)

spatial ['speijal] — пространственный

to judge ['d;yui3] — судить, определять

rate [reit] — зд.: скорость

to overlook — игнорировать, не обращать внимания

to assume [э 'sju:m] — признавать, допускать

cue [kju:] — намек, verbal cues — зд.: словесный метод

BEFORE READING THE TEXT AND DOING EXERCISES

Look through Text A and point out major problems of patients with а) right-side paralysis;

2. left paralysis.

RIGHT-SIDE AND LEFT SIDE PARALYSISES

The most visible sign of the stroke is usually paralysis on one side of the body. Right-side paralysis (right hemiplegia) is caused by an injury to the left side of the brain whereas left-side paralysis (left hemiplegia) is caused by an injury to the right side of the brain. People with right- side hemiplegia who are right-handed often have problems with speech and language. This is called aphasia. Sometimes they can understand more than they can speak or write. Typically, though, people who have aphasia have some trouble both speaking and understanding. Although this is true, it does not mean that they cannot communicate. Nor does it mean^A that they can understand a considerable amount of vocabulary. Some people will be able to communicate better by writing; while for others spoken communication works better. If someone can’t talk, try another form of communication.

Right-side paralysis also causes people to be cautious, anxious, and disorganized when attempting new tasks®. These people need constant positive reinforcement for their behavior and need to be told about their success more than their failure. Families may have difficulty adjusting to this new behavior and may need tasks to be broken down small steps, allowing them to succeed.

People with left-side paralysis often have trouble with spatial-per­ceptual tasks leading to

difficulty in their ability to judge distance, size, position, rate of movement, form, and how parts relate to wholes. Spatial-perceptual deficits are often overlooked and attention is placed on speech and communication. If a person can talk and communicate it is assumed that they are unimpaired. It is important to assess for any deficits in this area by having them demonstrate they can do something safely rather than taking their word for it^c. It is important to use ver­bal cues when working with these people since they often cannot learn by demonstration due to their spatial — perceptual deficits.

People with left-side paralysis and spatial-perceptual deficits are poor judges of their ability and often do not realize their limitations. They tend to overestimate their abilities, act impulsively and move too fast. This carefree behavior can lead to injury. It is important to keep the environment around them safe.

Notes:

^A nor does it mean... — не означает это также и ...

^в when attempting new tasks — при попытке выполнить новое действие ^с rather than taking their word for it... — зд.: вместо того, чтобы полагаться на их утверждения

Loss of spatial perceptual ability to judge distance and size

Left brain damage can cause:

Right side paralysis and loss of sensation

Right brain damage can cause:

Left side paralysis and loss of sensation

Problems with speech,

language, and swallowing

Tendency to be disorganized, slow, and cautious

Tendency to be impulsive and a poor judge of own abilities

Brain stem

Loss of vision in right side of both eyes

Loss of vision in left side of both eyes

Damage to the cerebellum

can result in poor balance or coordination, or dizziness

Damage to the brain stem

can result in irregular breathing or

heartbeat, or coma