speaking English

1. Review the key words to make sure you understand the unfamiliar ones Key vocabulary associated with antibiotics

antibiotic, characteristic, swelling, infection, prescription, allergic reaction, bacteria, medication, protein, viral infections, nausea, synthesis, resistant, vomiting, replicate, rash, tolerable

2. Try to answer the following conversation questions, speaking out loud to your partner or group: What are some of the different types of antibiotics? 1. 2. 3. 4.

B. Read the following two articles and, as best you can, discuss and explain the contents to your partner so that your partner will be able to answer the follow-up questions. Antibiotics

Antibiotics are strong medications that fight infections in the body. There are many classes of antibiotics and they have different effects on bacteria. Some antibiotics weaken cell walls. Some antibiotics block protein synthesis or DNA synthesis. Antibiotics can kill bacteria (bactericidal) or they can stop them from replicating or growing (bacteriostatic). Each antibiotic has specific characteristics and they don’t work against all types of bacteria.

It is important that patients know several things about antibiotics 1. Antibiotics don’t work against viral infections such as colds and the flu. 2. Antibiotics don’t work against sore throats and coughs*.

3. It is important to finish all of the medication even if you feel better.

If a patient doesn’t finish the prescription, it could be dangerous. Patients usually will feel better after 2-3 days. However, the bacteria might not be completely gone. If a patient stops taking their medication, the bacteria may grow, causing the patient to become sick again. Also, the bacteria might become resistant to the antibiotic making it more difficult to fight.

Problems can occur with antibiotics. If the patient notices a rash, swelling, or any other allergic reaction, they should stop taking the medication and contact their physician immediately. Also, if the patient has problems with nausea or vomiting, they should stop the medication and contact their physician. A more tolerable alternative might be available. * They are generally caused by viruses.

Antibiotics’ mechanism of action:

Aminoglycosides: Inhibit protein synthesis by binding to a portion of the bacterial ribosome. Most of them are bacteriocidal.

Beta-lactam antibiotics: A name for the group of antibiotics which contain a specific chemical structure. This includes penicillins, cephalosporins, carbapenems, and monobactams.

Cephalosporins: Similar to penicillins in their mode of action but they treat a broader range of bacterial infections. They have structural similarities to penicillins and many people with allergies to penicillins also have allergic reactions to cephalosporins.

1

Penicillins: Inhibit formation of the bacterial cell wall by blocking cross-linking of the cell wall structure. The cell wall is a needed protective casing for the bacterial cell.

Glycopeptides (e.g., vancomycin): Interferes with cell wall development by blocking the attachment of new cell wall subunits.

Macrolides (e.g., erythromycin) and Lincosamides (e.g., clindamycin): Inhibit protein synthesis by binding to a subunit of the bacterial ribosome.

Quinolones: Blocks DNA synthesis by inhibiting one of the enzymes (DNA gyrase) needed in this process。

Tetracyclines: Inhibit protein synthesis by binding to the subunit of the bacterial ribosome (30S subunit).

C. Medication directions.

Instruction: Write out the full English meaning of the following dir QD -- BID -- TID -- QID -- q4h --

D. Language useful for explaining medication: This is …

These are …

E. Antibiotics Discussion Questions

Instructions: Work with a partner or in a group, but do not work alone, and make sure you answer all of the questions

1. What do antibiotics do in the body? 2. What ways do antibiotics fight bacteria?

3. Antibiotics don’t work for many common problems. Give some examples. 4. Why is it important to finish your antibiotic prescription? 5. What do antibiotics do?

6. Do antibiotics help with colds and coughs? Explain. 7. What should your patient know about bacteria? 8. What should your patient know about antibiotics?

These are your antibiotics

supposed to…

You are supposed to take this three times a day.

He is supposed to take these

after meals.

This is your antibiotic.

This is a prescription for an antibiotic This is the antibiotic the doctor prescribed for you

Take …

Take this three times a day. Take this twice a day, after meals.

ac -- pc -- po -- pr -- prn --

hs – od – os – gt – x7d –

2

Asthma A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones Key vocabulary associated with Asthma asthma disease condition immune system case risk factors breathe

B. Diagram Labeling

Take a look at the diagram on this page. Label each of the five sections in English and Chinese.

symptoms tightness wheezing pressure infection treatment signs

features sensitivity inflammation obstruction exposure allergens breath

1. 2. 3. 4. 5.

2. Try to answer the following conversation questions, speaking out loud to your partner or group:

a. What is asthma?

b. What causes an asthma attack?

c. What happens in the body during an asthma attack? d. What else do you know about asthma?

3

C. Read the following article and, as best you can, discuss and explain the contents to your partner so that your partner will be able to answer the follow-up questions. Article 1: Overview of Asthma

Asthma is a disease of the lungs that is that is characterized by tightening of the air pathways. Common symptoms of asthma are wheezing, shortness of breath, coughing, chest pain, tightness or pressure. Many of these conditions are reversible with medication but not 100% reversible in all patients. Some common features of asthma are inflammation, airway obstruction and airway sensitivity. Some risk factors for asthma are a family history of asthma, regular lung infections, presence of allergies, exposure to tobacco smoke, low birth weight, and being male.

The current rise in asthma cases among children is alarming. Asthma may occur at any age but is very common in children. Approximately 10% of children have asthma and that rate may rise in the future. Experts don't agree why the rate is increasing but here are some ideas:

a. Children are being exposed to more triggers (things that bring on asthma attacks; dust, tobacco b. Children don't have strong immune systems (they aren't exposed to many childhood diseases.) c. Decreases in the rates of breast feeding may also play a role. smoke, pollution)

Asthma is a disease that causes many problems for the patient. However, it can be controlled. With the right information and medical attention medical professionals can prevent many deaths.

Article 2: Information for the Patient

Asthma is a disease of the lungs that causes wheezing, coughing, chest tightness and difficulty breathing. It can be very scary for the patient. Luckily, asthma and its effects are reversible with medication. There are a few options for asthma treatment:

a. Breathing machines (or nebulizers) are machines that turn liquid medication into mist. A mask is used and treatment takes about 10-15 minutes and is given several times per day.

b. Inhalers are common for older patients and medication is breathed in using a spacer.

c. Syrups and other oral medications are available, but aren't useful for asthma attacks because their effects take time.

Asthma attacks are the periods when symptoms suddenly become worse. Some common triggers for these attacks are exercise, infections, dust, tobacco smoke, allergens, cold air and nervousness. Limiting exposure to these triggers may help improve quality of life. When an asthma attack occurs, take your medication according to your asthma action plan, wait 10 to 15 minutes if symptoms worsen or don't improve immediate medical attention may be necessary. Some danger signs are severe wheezing or coughing, trouble walking, and blue lips or fingernails. If any of these danger signs occur go to the emergency room or call 911.

Asthma is a lifelong disease. Some people have fewer attacks as they grow older, but most patients see a return of symptoms in their 30s and 40s. The effects of asthma attacks on the lungs can cause serious problems later in life. Proper management of asthma is very important.

D. Asthma Discussion Questions

Instructions: Work with a partner or in a group, but do not work alone, and make sure you answer all of the questions 1. 2.

What are the main features of asthma?

What are some of the common symptoms of asthma?

4

3. 4. 5. 6. 7. 8. 9. 10. 11. What are some triggers for asthma attacks? What are asthma attacks?

What are some risk factors for asthma?

How can you reverse the effect of an asthma attack? What are some danger signs associated with asthma attacks? What happens in the body during an asthma attack? What should a patient do if any danger signs occur? What population is seeing a rise in asthma cases?

What are two theories why the rate is increasing in this population? 12.

What information is important to tell the patient?

5

Next Class Arthritis A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones Key vocabulary associated with arthritis

anti-inflammatory, immune system, prevalent, synovial fluid, arthritis, inflammation, rheumatoid arthritis, synovial lining, brace, inflammatory response, risk factors, tenderness, cartilage, joint, splint, tissue, crystallize, osteoarthritis, stiffness, treatment, diagnose, overweight, strenuous activity, uric acid, gender, pain relievers, swelling, gout, permanently, symptoms

B. Diagram Labeling

Take a look at the diagram below. Label each of the six parts of the joint in English and Chinese.

1. 2. 3. 4. 5. 6.

2. Try to answer the following conversation questions, speaking out loud to your partner or group:

a. What is arthritis?

b. What are some of the major types of arthritis and their characteristics? c. What types of treatment are available for arthritis patients?

B. Read the following two articles and, as best you can, discuss and explain the contents to your partner so that your partner will be able to answer the follow-up questions. Article 1: Overview of Arthritis

Arthritis is a general term that refers to over a hundred different types of joint inflammation. This joint inflammation causes swelling, pain and stiffness. If the disease lasts long or occurs repeatedly, it can lead to tissue damage. The typical signs of arthritis are swelling of the joint that is warm to the touch, pain, tenderness, stiffness, redness and loss of function. Arthritis is not always limited to the joints of the body and can affect soft tissues and internal organs.

6

In the joint, inflammation causes damage to the cartilage and synovial lining. When the cartilage is warn down, the space in the joint becomes smaller and the bones may rub together. Damage to the synovial lining cause synovial fluid to leak and produce fluid in the joint lining. This adds to the swelling along with the inflammatory response of the body. If the joint lining continues to grow, it can permanently damage the bone. All of this causes pain, swelling and distress for the patient. The three most common types of arthritis are:

a. Osteoarthritis. This is the most prevalent. In osteoarthritis, the cartilage of the bone slowly wears away with age and the bones rub together.

b. Rheumatoid arthritis (RA.) In rheumatoid arthritis, the body•fs immune system begins to attack the joints of the body causing the joint lining to swell.

c. Gout. Gout is a condition where the body cannot effectively remove uric acid and the uric acid crystallizes in the joints like needles. These crystals cause swelling and severe pain.

Article 2: Arthritis Information for the Patient

Arthritis is caused by inflammation inside the joints of the body. Arthritis is very common and affects almost a third of the American population. There are many types of arthritis and in general the causes are still unknown. However, there are some risk factors for arthritis. These may include age, gender, lifestyle factors, and being overweight. With age, the cartilage in the joints wears down causing the most common type of arthritis, osteoarthritis. Arthritis also occurs more often in women than men. Work conditions that require heavy lifting and being overweight cause heavy stress on the joints of the body.

Some common symptoms of arthritis are redness, joint pain, swelling, warmth around the joint, and stiffness. To diagnose arthritis a variety of blood tests and x-rays may be necessary. There are more than 100 different types of arthritis and treatment may vary depending on the type of arthritis the patient has. Treatment for arthritis generally involves pain management, exercise and relaxation. The goals of arthritis treatment are to avoid pain and further destruction of the joint. One way is to avoid activities that cause pain. When the joint becomes painful, pain relievers and anti-inflammatory medication should be taken to relieve the pain and swelling. A physical therapist can advise exercise routines that help maintain joint mobility. Lastly, the patient should use braces, splints and supporters to help support the joints especially during strenuous activities. Surgery to correct the joint damage may also be an option. Treatment will vary with the type of arthritis and the patient. Factors to take under consideration are age, current medications, overall health and medical history.

D. Arthritis Discussion Questions

Instructions: Work with a partner or in a group, but do not work alone, and make sure you answer all of the questions

1. What type of disease is arthritis?

2. What are some common signs of arthritis? 3. What are the symptoms of arthritis? 4. How is arthritis diagnosed?

5. What causes the swelling in arthritis?

6. What are the three most common types of arthritis? 7. What are the goals of treatment with arthritis? 8. What are some risk factors for developing arthritis?

9. What are some ways patients can help manage their condition?

7

10. What is the difference between osteoarthritis and rheumatoid arthritis?

8

Type 1 Diabetes A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones Key vocabulary associated with the Type 1 Diabetes： abnormality detection ketone bodies toxin complication immune system

2. Try to answer the following conversation questions, speaking out loud to your partner or group:

B. Read the following two articles and, as best you can, discuss and explain the contents to your partner so that your partner will be able to answer the follow-up questions. Type 1 Diabetes: An Overview

Type 1 Diabetes is an autoimmune disease. It is thought to be caused by an environmental trigger (possibly a virus or toxin, but doctors aren’t sure). This trigger causes the immune system to attack beta cells in the pancreas. Beta cells produce insulin, and after the immune system damages enough beta cells, the body cannot produce sufficient insulin supplies.

Some of the more common symptoms of Type 1 Diabetes are frequent urination, unexplainable weight loss, hunger after meals, fatigue, blurred vision, and dehydration complications. Filtering of glucose by the kidneys results in large amounts of water loss, causing dehydration. Dehydration associated with hyperglycemia (high blood sugar) causes increased thirst and dry mouth, as well as increased skin, urinary tract, and vaginal infections.

Diagnosis is usually made by detection of abnormalities in blood glucose levels and by glucose or ketone bodies in the urine. Because of the high risks associated with hyperglycemia and the difficulties associated with therapy, it is suggested patients visit a diabetes counselor for regular monitoring, counseling, and follow-up.

Type 1 Diabetes: Information for the Patient

Type 1 Diabetes is a disease that destroys the insulin-producing cells in the pancreas. It is an autoimmune disease, which means the body’s immune system is attacking itself. The insulin-producing cells are damaged and cannot produce enough insulin to supply the body.

In the body, insulin helps move sugar and other nutrients from the bloodstream into the cells of the body. Cells use sugar as energy for all their functions. When the body destroys the beta cells, nutrients, especially sugar, are not transported into the cells. The cells of the body starve and the blood sugar level rises. High blood sugar can cause dehydration, weight loss, and irreversible damage to small blood vessels in the kidney, eyes, and heart.

a. What are the main features of Type 1 diabetes? b. What role does insulin play in the body?

c. What are some of the problems with uncontrolled blood sugar? d. What information is important to tell the patient?

dehydration insulin symptom circulatory hyperglycemia

infection starve subtle cells glucose nutrients

retinopathy diabetes blood vessels function nerve damage

kidney urine pancreas amputation diagnosis

autoimmune disease insurance

9

When blood sugar is not controlled, patients are in danger of developing serious diseases and complications such as: a. b. c.

retinopathy—a disease that affects the eyes and vision

kidney damage—this can lead to kidney failure and heart disease

circulatory problems—this can possibly lead to nerve damage, infection, and amputation

Patients’ quality of life can be maintained by keeping blood sugar levels in target ranges. Management of diabetes requires exercise, meal planning, and insulin therapy (insulin injections). Careful monitoring of blood sugar levels, both fasting and after meals, is important. There are diabetes counselors who can help patients take control of their disease. These services are often covered by insurance plans and can be a great benefit to patients.

C. Type 1 Diabetes Discussion Questions

Instructions: Work with a partner or in a group, but do not work alone, and make sure you answer all of the questions

1. What is Type 1 Diabetes?

2. What kind of disease is Type 1 Diabetes?

2. What organ systems are most affected by diabetes? 3. What does insulin do in the body?

4. Why can’t the body produce insulin in Type 1 Diabetes? 5. What are common symptoms of Type 1 Diabetes? 6. What are the problems associated with dehydration? 7. How is diabetes usually diagnosed?

8. What effects does high blood sugar have in the body? 9. What serious disease result from uncontrolled blood sugar? 10. What are some ways to manage diabetes?

10

The Nurse A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones

nurse, duties, complex, prescribe, responsibilities, specialties, treatment, medication, maintenance, direct care, symptoms, response, progress, healthcare professional, supervising, diagnose, medical procedures

B. Read the following article and, as best you can, discuss and explain the contents to your partner so that your partner will be able to answer the follow-up questions. Article 1: The Nurse

Nurses are healthcare professionals with a very wide range of duties, responsibilities, and specialties. Nurses are responsible for the treatment, care and safety of patients. They are also responsible for maintenance of health and education for the patient. Nurses provide direct care and monitor symptoms, response, and progress in patient care.

Three main types of nurses are: a. b. c.

LPNs RNs APNs.

An LPN (licensed practical nurse) usually has less than 2 years of training. They perform simple and some complex medical procedures. They work under other health care professionals to provide patient care.

An RN (registered nurse) has a university degree in nursing and often is responsible for supervising the tasks of LPNs. RNs provide direct care, patient education and make decisions about proper patient care.

An APN (advanced practice nurse) has a masters or doctoral degree. They provide direct care, diagnose disease, prescribe medication, work in research and educate patients and other healthcare professionals. There are many specialties for APNs.

Nurses play a very important part of direct patient care and maintaining health in the community. The art of nursing makes dramatic differences in patient outcomes and disease treatment.

C. Try to answer the following conversation questions, speaking out loud to your partner or group:

a. What are some different types of nurses? b. Where do nurses work?

c. What are the main roles of a registered nurse? d. What are some responsibilities of nurses?

e. What are some types of patient education nurses provide? f. What does an RN do? g. What does an APN do?

h. What are some main features of a nurse’s role that this article didn’t mention? i. What are some other nursing specialties not listed in the article?

j. How does the information differ from the roles of nurses in your country?

k. If you were going to rewrite this article, what information would you add or remove?

l. Explain verbally, without the article, what a nurse is, what a nurse does, and any other useful information you think your partner or group should hear.

11

The Pharmacist A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones

Pharmacist, healthcare professional, deal with, dispense, medication, regimen, prescription, counsel, side effects, medication profiles, drug interactions, drug, prescribe, accessible, pharmaceutical

B. Read the following article and, as best you can, discuss and explain the contents to your partner so that your partner will be able to answer the follow-up questions. Article 1: The Pharmacist

Pharmacists are healthcare professionals that deal primarily with dispensing medications and managing patient medication regimens.

The pharmacist has many responsibilities.

a. The pharmacist fills prescriptions from doctors.

b. The pharmacist also counsels the patient about medication, side effects, and how to use the

medication correctly.

c. Another responsibility of the pharmacist is to manage and monitor patient medication

profiles. Pharmacists must check for drug interactions, proper prescribing and drug safety.

The pharmacist works closely with patients, physicians, and other healthcare professionals to provide medication to the patient.

The roles of the pharmacist are quite varied. They include:

a. Reviewing and monitoring patient medication regimens b. General health advice

c. Counseling patients about disease states and medication d. Dispensing medication by prescription

e. Counseling patients about the best use of medication

Pharmacists work in a variety of places with many different specialties. Pharmacists are often the first person patients ask for medical advice. With their position in the community and because they are very accessible, pharmacists play a major role in patient care.

Pharmacists work in community pharmacies hospitals clinics pharmaceutical companies government offices

2. Try to answer the following conversation questions, speaking out loud to your partner or group:

a. What is a pharmacist? b. Where do pharmacists work?

c. What are the main roles of a pharmacist? c. What are the responsibilities of the pharmacist?

d. What does a pharmacist check when reviewing medication profiles? e. What information does the pharmacist counsel the patient about? f. What are some different types of pharmacists?

12

Pharmacist specialties include community pharmacists hospital pharmacists nuclear pharmacists clinical research pharmacists consultant pharmacist g. What are some features of a pharmacist’s role that this article didn’t mention? h. What are some ways pharmacists improve patient care?

i. How does the information differ from the roles of pharmacists in your country? j. If you were going to rewrite this article, what information would you add or remove?

k. Verbally explain, without the article, what a pharmacist is, does, and any other useful information you think your partner or group should hear.

13

Physical Therapy A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones

assessment, diagnosis, physical therapist, technique, asthma, disability, physical therapy, therapeutic, cardio-pulmonary, disease, physiotherapist, treatment, conditions, integumentary, physiotherapy, wounds, COPD, motor function, reduction, cystic fibrosis, musculoskeletal, rehabilitation, devices, neurological, scar

B. Read the following article and, as best you can, discuss and explain the contents to your partner so that your partner will be able to answer the follow-up questions. Article 1: Physical Therapy

The physical therapy department is much broader than just rehabilitation. Physical therapy treatment is provided under the care of a physical therapist, also known as a physiotherapist. The physical therapist is responsible for diagnosis, assessment and treatment of disease or disability.

The conditions physical therapists manage are musculoskeletal, cardio-pulmonary, integumentary and neurological conditions. Rehabilitation spans all four of these categories. Treatment may involve patient education, physiotherapeutic techniques, and assisting devices.

a. Musculoskeletal physiotherapy uses a variety of techniques to treat heart and lung diseases such as asthma, cystic fibrosis and chronic obstructive pulmonary disease (COPD.)

b. Integumentary physiotherapy deals primarily with treatment of the skin. This may include care of wounds, bandages, and scar reduction

c. Neurological physiotherapy use exercise to help improve motor function.

Outside of the hospital, physical therapists work in home daycare centers, schools, clinics, nursing care centers, rehabilitation centers and for athletic clubs.

C. Try to answer the following conversation questions, speaking out loud to your partner or group:

a. Who works in the physical therapy department?

b. What conditions are treated by the physical therapy department?

c. What are the primary roles and responsibilities of the physical therapy department?

d. What are some types of therapies used?

e. What types of medical devices do physical therapists prescribe? f. What role does physical therapy play outside of the hospital? g. What is another word for physical therapist? h. What is the physical therapist responsible for?

i. What conditions does integumentary physiotherapy care for? j. What are 5 places a physical therapist might work?

k. How does this description differ from the physical therapy department in your country/hospital? l. Can you think of other treatment methods used by the physical therapy department. m. If you were going to rewrite this article, what information would you add or remove?

n. Verbally explain, without the article, what a physical therapist is, what conditions physical

therapists treat, and any other useful information your partner or group should hear.

14

Radiology A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones

bony structures, imaging, radiology, CT scans, interventional, soft tissue, department, MRI scans, specialty, diagnose, physicians, therapy, diagnostic, procedures, treat, disease, radiation, ultrasound, fields, radiologists, x-rays

B. Read the following article and, as best you can, discuss and explain the contents to your partner so that your partner will be able to answer the follow-up questions. Article 1: Radiology

Radiology is a medical specialty that uses images to diagnose disease. In the hospital the radiology department is often one of the first places physicians turn to for diagnosis.

Physicians that specialize in radiology are called radiologists. Radiology is divided up into several fields:

a. Diagnostic radiology uses imaging to diagnose disease. b. Interventional radiology uses imaging to guide procedures. c. Radiation therapy uses radiation to treat diseases.

The radiology department provides many services in the hospital. Some include the following: a. X-rays, which are used to evaluate bony structures and soft tissue.

b. CT scans, which use x-rays and computers to make 3-D images of soft tissues.

c. Ultrasounds, which are used to see soft tissue structures in real time, without dangerous radiation. d. MRI scans, which give the best images of soft tissue structures, but patients must stay still for very long periods.

C. Try to answer the following conversation questions, speaking out loud to your partner or group:

a. What tests are performed in the radiology department? b. Who works in the radiology department?

c. What role does the radiology department play in patient care? d. What are the responsibilities of the radiology department? e. What role does radiology play outside of the hospital? f. What do radiologists use to diagnose diseases? g. What are some radiology fields?

h. What are 3 tests the radiology department provides? i. What are the differences between a CT scan and an MRI? j. What is an advantage of ultrasounds?

k. What are the advantages and disadvantages of MRI scans?

l. How does the description of the radiology department in this article differ from that in your country/hospital?

m. Can you think of any other services provided by the radiology department?

n. If you were going to rewrite this article, what information would you add or remove?

o. Verbally explain, without the article, what the radiology department provides, what some of the tests are, and any other useful information you think your partner or group should hear.

15

Type 2 Diabetes A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones

amputation, fatigue, life expectancy, resistant, arteries, function, metabolic syndrome, retina, blurred, glucose, nephrons, retinopathy, cells, hyperglycemia, neuropathy, symptoms, condition, hypertension, numbness, therapy, destruction, infection, obesity, ulcers, diabetes, injections, overweight, failure, insulin, pancreas

B. Read the following two articles and, as best you can, discuss and explain the contents to your partner so that your partner will be able to answer the follow-up questions. Article 1: Overview of Type 2 Diabetes

Type 2 diabetes is the most common of the two forms of diabetes, affecting 90% or greater of the people with diabetes. In type 2 diabetes, the pancreas produces insulin but the cells of the body become resistant or the amount of insulin produced is not enough. Glucose builds up in the blood stream (hyperglycemia,) and the cells of the body are unable to function properly.

Type 2 diabetes can affect anyone at any age but is more common in overweight populations, people with a family history of type 2 diabetes, the elderly, and people with metabolic syndrome (problems with hypertension and cholesterol issues.) The origin is still unknown but it is probably a combination of factors.

Many life-threatening problems can occur with uncontrolled blood glucose levels. The three most notable are retinopathy, kidney damage, and circulatory problems.

Retinopathy is caused by damage to the small blood vessels of the retina. These blood vessels begin to leak fluid into the retina which leads to blurred vision.

Kidney damage is cause by destruction of the small vessels in the nephrons allowing protein to flow into the urine. As this neuropathy continues, the function of the kidney declines and leads to kidney failure and end-stage kidney disease.

Circulatory problems and nerve damage are cause by a hardening of the arteries. This causes loss of sensation, risk of ulcers, infection and can lead to amputation.

The effects of type 2 diabetes on the body are often irreversible and compounding. Quick diagnosis and immediate strict control of blood glucose levels is crucial.

Type 2 Diabetes: Information for the Patient

Type 2 diabetes is caused by a lack of insulin or the body doesn't recognize the insulin, called insulin-resistance. Insulin moves nutrients into the cells of the body. When insulin resistance occurs, the cells of the body starve and many problems occur. The initial damage to the body can go unnoticed but the damage is severe. Uncontrolled blood sugar can lead to kidney failure, heart disease and even amputation.

Some common symptoms of uncontrolled blood sugar are frequent urination, increased thirst, dry mouth, vision problems, fatigue, and numbness in the hands and feet, among others.

Treatment of type 2 diabetes is usually managed with oral medication. There are medications that help increase insulin production and medications that increase the cells' sensitivity to insulin. Combination therapy may also be required. If oral therapy fails, insulin replacement therapy may be necessary. This uses insulin injections. Constant monitoring of blood sugar levels several times per day is very important. This can be done with blood sugar monitors.

16

Exercise, weight loss and diet management can be very effective means of managing type 2 diabetes initially. Obesity (the condition of being overweight) is a major factor in causing type 2 diabetes. In type 2 diabetes, exercise and weight loss can make dramatic changes for the better.

The damages and problems in the body caused by diabetes can often go unnoticed until they are serious. Proper management of blood sugar levels isn't easy, but aggressive therapy and control can greatly improve quality of life and lengthen life expectancy.

C. Try to answer the following conversation questions, speaking out loud to your partner or group:

a. What are the main features of type 2 diabetes?

b. What are some ways to manage type 2 diabetes without medication c. What are some of the complications associated with type 2 diabetes? d. What information is important to tell the patient?

17

Patient’s Information A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones

medication, form, substance use, medical, information, alcohol, condition, sex, tobacco, allergy, reason, occupation, fill out

2. Try to answer the following conversation questions, speaking out loud to your partner or group:

Taking a patient's blood pressure, temperature and pulse A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones

blood pressure, diastolic, pulse, breath, systolic, temperature, Fahrenheit, stethoscope, Celsius, thermometer, blood pressure monitor, sphygmomanometer

2. Try to answer the following conversation questions, speaking out loud to your partner or group:

Giving a shot A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones

injection, hurt, dizzy, shot, administer, syringe, needle, tingling, medication, swab, numbness, injection site, disinfect, immunization

2. Try to answer the following conversation questions, speaking out loud to your partner or group:

Taking a blood sample from a patient A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones

blood, blood sample, tourniquet, thumb, fist, injection site, disinfect, squeeze, relax, press, rub, bend, hurt, queasy, nauseous, faint, sting, tight

2. Try to answer the following conversation questions, speaking out loud to your partner or group:

Giving medication to a patient and explaining a prescription A. Warm-up

1. Review the key words to make sure you understand the unfamiliar ones various diseases, symptoms, prescription shorthand directions.

2. Try to answer the following conversation questions, speaking out loud to your partner or group:

18