Third Chapter : CRITICAL THINKING

Checking Vital Signs :

Vocabulary :
• Pulse Rate : Jumlah denyutan
• Rhythm or regularity : Irama denyutan / cepat –lambat
• Tension or compressibility : ketegangan
• Beats per minute : denyutan per menit
• Patient’s Chart : Lembar Penilaian pasien
• Normal Pulse Rhythm : irama denyutan normal
• Bradycardia : denyut nadi dewasa di bawah 60 beats / min
• Tachyardia : denyut nadi dewasa di atas 100 beats / min
• Bounding : lompatan denyut nadi yg kuat
• Thready / weak : denyut nadi yang semakin menurun

NOTE : It is common practice for nurses to communicate with patients as much as possible when
they are doing routine nursing tasks. If nurses talk & ask , the patients become involved
in their treatment. As a nurse takes the patients vital signs, it will be better a nurse says
what she is going to do, explains why she is doing it and gives the patient feed back.
1. Why should a nurse talk when doing practice ?
2. What things should nurse communicate with the patients ?
 WORDS ASSOCIATED WITH BREATHING
Medical Words Colloquial Expressions
Dyspnoea Breathlessness, out of breath, puffed, short of
breath, fighting for breath
Expectorate To bring up / cough up phlegm / spit
Expiration Breathing out
Inhaler for drugs Puffer
Inspiration Breathing in
Respiration Breathing
Sputum Phlegm

Pronunciation Drill : Temperature

Inspiration Weak
Blood Respiratory Breath
Rhythm Anus Armpit
Pulse Breathe Mouth
Pressure Thermometer Unbutton
Tension Rate Expectorate
 USEFUL EXPRESSION / Explaining the Procedures
• It is time for me………. I just want …………………
• I would like…………. I am going……………..
» To measure your blood pressure
» To count your pulse
» To check your respiration
» To measure your temperature
» To put this cuff (around your upper arm)
» To insert this (thermometer) into your armpit
» To insert this (thermometer)into your arms
» To put this (thermometer) into your mouth

Would you.………… Lie down on the couch

Lie flat on the bed
Roll your sleeve up
Give me your right / left hand
Slip off your top things
Unbutton your shirt
Raise your arm
Roll yourself into a bedside lying position
Take a deep breath
Breathe in…………… breathe out.
 Complete the Blanks (In a short conversation exchange)

Nurse : Good Morning Mr. Rowlan.

Patient : Good Morning, Nurse.
Nurse : How about you ?
Patient : I am not really feeling good.
Nurse : Did you sleep well last night ?
Patient : Not really, I feel feverish.
Nurse : (Touching his head) Let me check your temperature. It looks like you’ve
got a temperature. Now, I am going (1)…for…using this thermometer.
I need to place this under your armpit.
Patient : Sure.
Nurse : Just keep it there for about 5 minutes.
After 5 minutes…go by / left….., taking out the thermometer.
Patient : What is my temperature, Nurse ?
Nurse : (2)……May……………I will report this to your doctor.
Patient : Thank you, Nurse.
Nurse : No problem.
Complete the Blanks (In a short conversation exchange)
Nurse : Good Morning, Mr / Mrs……………(name’s patient)
Patient : Good Morning, Nurse………………….(nurse’s name)
Nurse : How are you ?
Patient : I am fine, nurse.
Nurse : ……May ….I…check your blood pressure , please?
Patient : Sure.
Nurse : Did you sleep well last night ?
Patient : Not really, cause I still got a problem with my headache.
Nurse : You got a problem with your headache ? OK, I will report this to your
doctor. Now, can you roll…your sleeve up.
Patient : Sure.
Nurse : (checking the blood pressure)
Now, can I have…the data. …? I need to check your pulse.
Patient : What is my blood pressure ?
Nurse : Oh, it is in the normal range .
 Definition of Symptom
The Definitions of Symptom :
1. An outward sign of inner change, new feelings, etc.
A change in body or mind which shows disease or disorder.

2. Subjective evidence of disease or physical disturbance ; broadly

something that indicates the presence of bodily disorder.
3. Something that indicates the existence of something else.
4. Any feeling of illness or physical or mental change that is caused
by a particular disease.
5. Any single problem that is caused by and shows a more serious
and general problem.
6. Any indication of greatest significance to the health care provider,
establishing the identity of the illness.
7. The symptoms shown in the temperature, pulse, and respiration.
 Explanation more about Symptom and Sign
• Symptom can also be defined as what the patient reports, but which cannot
be verified. Feeling tired, feeling dizzy and having pain are some of the
symptoms, which can not verified.
• But signs on the other hand can be verified. Signs can be measured in a clinic
setting. High or low blood pressure, rapid heart rate or fever, can be
measured.
• It is only when the patient experiences certain symptoms that he or she
approval the physician. Symptoms help the physician diagnose the problem.
As symptom and visible outwards, it is most important that the patient be as
descriptive so that the doctor or the physician may be able to asses and
evaluate the symptoms.
• While signs are the physical manifestation of injury, illness or disease,
symptoms can be described as what a patient experiences about the injury,
illness. When the patient notices symptoms, it is the others, especially the
physician or doctor who notices signs.
The characteristics of Symptom : Subjective
data / experience, not see, what feeling by the
patients, depends on the patients opinion, invisible

There are some kinds of Symptoms :

1. Dissociation Symptom : anesthesia to pain and to head and cold.
2. Objective Symptom : one perceptible to others than the patients, such as
pallor, rapid pulse, rapid respiration.
3. Presenting Symptom : the symptoms or group of symptoms about which
the patient complaints or from which he seeks relief.
4. Signal Symptom : a sensation, aura, or other subjective experience
indicative of an impending epileptic or other.
5. Subjective Symptom : one perceptible only to the patient, such as pain,
pruritus, or vertigo.
 Definition of Sign :
The Definitions of Sign :
1. A movement of the body intended to express a meaning, signal.
2. A standard mark, something is seen and represents a knowing
meaning.
3. Something that shows a quality or the presence or coming of
something else.
4. A motion or gesture by which a thought is expressed or a command or
which made known.
5. One of gestures used to represent language.
6. A mark having a conventional meaning and used in place of words or
to represent a complex notion.
7. Any objective evidence of disease or dysfunction.
8. An objective physical so frequently associated with a given condition
as to be considered indicative of its presence.
9. An observable physical phenomenon so frequently associated with a
given condition as to be considered indicative of its presence.
The characteristics of Sign :
• We can see, objective data, observable, can be measured by the tools or
medical equipment, to measure by numbers, touching, related with the
numbers, fact, and more accurate, visible
• Depend on our vision look likes, not depend of the patients feelings.
• Vital signs : the signs of life, namely pulse, respiration, and temperature.
Nursing Process : 1. Assessing
2. Diagnosing
3. Planning
4. Implementing
5. Evaluation
5R : Right time (waktu yang tepat)
Right does / treatment (pengobatan yang tepat)
Right ages (sesuai dgn usia pasien)
Right dosage (dosis / takaran yang akurat / tepat)
Right patient (pasien yg tepat, bagi siapa).
`
 THE DIFFERENCES OF SYMPTOM & SIGN :
Examples of Symptom VS Sign :
A doctor can usually diagnose a medical condition more easily if they have observable signs
and a subjective description of a patient’s symptom

Medical Issue Sign (Objective) Symptom

(Subjective)
Common cold Runny Nose Sinus pain from congestion
Chickenpox Spot and blisters Fatigue
Type 2 Diabetes Poor wound healing Thirst
Coronary heart disease Fast heart rate Chest pain
Covid 19 Fever Loss of taste or smell
Depression Withdrawing from Feeling of misery friends