Unit 7 – Key Assessing patient elimination 1 Suggested answers The patient is most likely suffering from constipation. Causes include undernourishment, poor diet and patient’s current psychological state. 2 1 bathroom 2 wee 3 Urine, urinate 4 waterworks, incontinent 5 bowel 6 pooh, defecate 7 diarrhoea, constipation 8 runs 3 Toni: problem with urinating Leah: constipation Dave: diarrhoea 4 1 with my waterworks again 2 do a poo 3 wee wee 4 the runs 5 Suggested answers 1 I’ve had problems urinating. 2 Leah, did you have a bowel movement this morning? 3 I urinated. 4 Well, basically, I’ve had diarrhoea ever since I came back from holiday. 7 1 been 2 passed 3 noticed 4 been 5 had 6 had 8 a 3, Leah b 4, Leah c 6, Dave d 2, Toni e 5, Dave f 1, Toni Describing bodily functions 1 1 Does it hurt to do a pooh / go to the toilet? 2 Do you often have to get up in the night to wee/go to the toilet? 3 Have you noticed any blood when you wee? 4 How many times a day do you pooh/go to the toilet? 5 She’s been having problems with her waterworks/going to the toilet. 6 Do you have hard poohs? / Is it hard when you go to the toilet? 2 Verbal techniques: take your time, could you explain what you mean? (open question), pain (repetition), can you describe your bowel movements (open question), I understand it isn’t an easy thing to talk about (empathy) Non-verbal techniques: smiles warmly, pausing, nodding 4 1 regular 2 he’s not been active since his operation 3 since his operation/for one week 5 1 have, felt 2 Have, opened 3 did, open 4 have, been 6 1 I’ve felt/been bloated/like this for a couple of days. 2 No, I haven’t opened my bowels today. 3 I last opened my bowels before my operation. 4 I’ve been in hospital since 5th May, for a week. 7 1 has been 2 hasn’t been 3 has felt 4 had 5 didn’t eat 6 hasn’t eaten 8 Christophe has not eaten anything since yesterday and has only drunk juice for breakfast. His stools have been small and hard and he needs to push to defecate. He has not experienced pain going to the toilet and has not suffered abdominal pain this morning/he suffered bloating this morning. 9 Suggested answer Christophe was in a motorbike accident and had an operation to repair a broken femur/leg. He’s been in hospital since 5th May, and it is a week since his operation. He has not opened his bowels since before the operation. For the last two days he has felt bloated. He hasn’t eaten anything for the last three days except a glass of orange juice. His stools have been small and hard. He needs to push to defecate but has not experienced any pain when going to the toilet or any abdominal pain. Diarrhoea 1 Suggested answer Diarrhoea is an infection of the intestine caused by bacteria, a virus or a parasite. It can be dangerous because it can cause dehydration which means loss of water and electrolytes (essential chemicals – sodium, chloride, potassium, bicarbonate). Diarrhoea can be treated with antibiotics if it is a fairly mild form and all patients should try to replace fluids. 2 1 result 2 cause 3 causes 4 result 3 Table: 1 diarrhoeal 2 dehydration 3 intestine 4 to replace 5 to lose Sentences: 1 dehydration 2 loss 3 intestine 4 replacement 5 Diarrhoeal 4 1 a refugee camp in North East Africa, lack of clean drinking water that leads to sickness and diarrhoea 2 moderate dehydration 5 1 rehydrate 2 fluids 3 drip 4 sugar 5 cheap 6 dehydration 7 replaces 8 faeces Presenting a patient case 1 1 presented 2 became 3 hasn’t cooked 4 has been 5 was 6 hasn’t taken 7 has suffered 2 1 On admission, Eileen complained of abdominal pain. 2 Dr Insulza saw her at 16.00 and she rated the pain seven out of ten on the pain scale. 3 She had her last bowl movement four days ago. 4 She has opened her bowels every three or four days since the beginning of May. 5 She described her stools as hard lumps, which is Type 1 on the Bristol Stool Chart. 6 Eileen has experienced some pain but no blood or mucus. 3 1 stomach ache, frequent bowel movement 2 embarrassed 3 diarrhoea 4 Suggested answers How long have you suffered from diarrhoea? / When did the symptoms begin? How often do you visit the toilet on a typical day? How many times a day do you need to go to the toilet? Can you describe your stools for me? Do you suffer from any other symptoms? 5 1 allergies 2 spicy 3 weight 4 kilos 5 overweight 6 angry 7 laxatives 8 embarrassed 7 Suggested answers The patient abuses laxatives that she uses to try and lose weight. The patient is suffering from constipation but experiences bouts of diarrhoea and cramping as a result of taking laxatives. Treatment means working with a team of health professionals with expertise in eating disorders (GP, psychiatrist or psychologist, dietician). Support from close friends and family is also crucial.