Activity 4: TAKING A BLOOD PRESSURE Time clauses

Transcription

1 Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 1 of 8 Activity 4: TAKING A BLOOD PRESSURE Time clauses Learning Goal(s) Identify and explain the steps in taking a blood pressure Communicate effectively with the resident while taking a blood pressure Utilize time clauses to communicate the correct sequence of steps Construct English sentences with dependent and independent clauses which correctly convey a time sequence Materials (handouts provided below) Realia (teaching aids): blood pressure cuffs and stethoscopes for each student, alcohol wipes, (double-listener stethoscope for instructor), pillow Blood Pressure PowerPoint Handout A: Taking A Blood Pressure Procedure Handout B: Taking A Blood Pressure - What To Say Handout C: Future Time Clause Grammar Guide Handout D: Future Time Clause Exercises Handout E: Kinesthetic Clause Word Cards Envelopes (one envelope each for word cards that make up each complete sentence) Handout F: Quiz Procedure 1. Pass out stethoscope, blood pressure cuff, and alcohol wipes. 2. Using PowerPoint, demonstrate and have students following along as indicated. 3. At directions slide have students pair off and practice as indicated. 4. Read Handout A: Taking A Blood Pressure - Procedure. 5. Discuss and review grammar using Handout C: Future Time Clause Grammar Guide. 6. Using Handout E: Kinesthetic Clause Word Cards students take sentence word cards and physically form sentences with independent clauses and dependent time clauses, manipulating the order to gain insight (see exercise instructions on Handout D: Future Time Clause Exercises). 7. Students consult Handout A: Taking A Blood Pressure Procedure to make time clause sentences responding to these prompts. Next, change the order of the clauses. a. What are you going to do before the procedure? b. What are you going to do after the procedure? c. What are some actions you will do at the same time? d. Use while and as e. What are you going to do if you hear the heartbeat immediately? f. What are you going to do if the resident has pain or has had surgery in one arm? 8. Students read Handout B: Taking A Blood Pressure - What To Say and practice speaking 9. Students perform procedure including communication with resident 10. Practice grammar exercises in both written and spoken forms. 11. Students complete Handout F: Quiz. Review quiz answers and discuss questions.

2 Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 2 of 8 Assessment: Instructor will be able to observe student progress during activities. Students will receive feedback form peers. An informal assessment of oral skills as students perform exercises and utilize quiz results to evaluate progress or for a grade if desired.

3 Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 3 of 8 Handout A: Taking A Blood Pressure - Procedure Getting Ready 1. Wash your hands 2. Knock on the door, introduce yourself, verify client identity 3. Explain what you are going to do and ask if it is a good time 4. Ask if client has any pain, IV s, wounds in their arms. Ask about surgeries, especially mastectomies 5. Collect and clean supplies 6. Elevate the bed to working position and elevate the arm to heart level with a pillow 7. Ask if client knows their usual BP 8. Find the brachial pulse and wrap the blood pressure cuff snugly but not tightly 9. Put stethoscope in ears and place large diaphragm on carotid pulse 10. Make sure the gauge (dial) is visible Perform the Procedure 11. Tighten valve 12. Pump up the cuff until the dial is 30 above usual BP or 180 if unknown 13. Slowly release the valve as you watch the gauge (dial) 14. Note the point at which you can begin to hear the pulse beating 15. Slowly release the valve to zero and note point of the last pulse beat you can hear When Finished 16. Wipe off equipment with alcohol 17. Check to make sure the bed is down with brakes on, the side rails are up, call light is in reach, client is comfortable and safe 18. Tell the client you are going to wash your hands, record and report.

4 Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 4 of 8 Handout B: Taking A Blood Pressure What to Say What to Say (Knock on door) Hi, May I come in? Hi there, I m Penny Mortier, I m your Nursing Assistant. I ve washed my hands. Can you tell me your name and birthdate? (If in facility check name band) The nurse has asked me to take your blood pressure. Is now a good time? Which arm would you like me to use? Do you have pain, sores; anything in or on your arm? Have you had any surgeries? Mastectomy? I m going to raise your bed. Notes Respect privacy and ask permission-this is the resident s s room Identify self to put client at ease; client may be confused or not remember you Handwashing #1 way to prevent spread of infection; resident will feel safer Check to make sure you are doing procedure on correct resident; can assess client mental status Resident right to know what you will do Resident more cooperative if asked permission May not be a good time because resident has to use restroom, etc. Promote resident safety and comfort Check for IV s or patches, wounds that may be under gown Put bed to working level for good body mechanics Let me put this pillow under your arm. Can you uncross your legs? I m going to put this cuff around you. Tell me if it is too tight. Do you know your usual blood pressure? All right, here we go. This is going to feel a little tight. All finished. Let me put your bed down. Arm at heart level, legs uncrossed to ensure accuracy Resident comfort Won t have to over-tighten the arm by pumping too high Resident knows what to expect Safety I m going to wash my hands, record and report. Do you need anything before I leave? Here is your call bell. Be sure to call if you need me. Lunch will be ready soon. Check for safety and comfort Side rails up, bed down and secure, call bell and water within reach, light on or off as desired Supplies out Wash hands, record and report

5 Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 5 of 8 Handout C: Future Time Clause Grammar Guide Complex Sentences combine independent and dependent clauses A clause is a phrase within a sentence that has a subject and verb (Clause 1) Before I finish the shift, (Clause 2) I m going to record my vital signs. An independent clause can stand alone as a complete sentence: The nurse talked to the patient after the doctor left. A dependent clause cannot stand alone as a complete sentence and relies on the independent clause to provide a complete thought. After the doctor left (incomplete thought) The nurse talked to the patient after the doctor left (complete thought) Future Time Clauses The nurse will change the bandage after she comes back from lunch. (Independent clause) (dependent time clause) After the nurse comes back from lunch, she will change the dressing. (dependent time clause) (independent clause) A time clause is a dependent clause that begins with a time adverb such as before, after, while as soon as, when and if. In a future time clause, the verb in the independent clause is future with will or going to The verb in the dependent time clause (the clause following the time adverb) is in present. A time clause can be at the beginning or end of the sentence without changing the meaning. The nurse will change the bandage after she comes back from lunch. After she comes back from lunch, the nurse will change the bandage. If the sentence begins with the adverb, place a comma after the dependent phrase. If the sentence begins with the dependent phrase, a comma is not necessary After the nurse comes back from lunch, she will change the dressing. The nurse will change the dressing after she comes back from lunch When and as soon as convey the same meaning: the action occurs after an event happens: As soon as (when) the family leaves, she ll take his blood pressure. While conveys that different actions happen at the same time If indicates that a condition must be met first (also categorized as a conditional) If you feel any pain, ask the nurse for your medicine.

6 Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 6 of 8 Handout D: Future Time Kinesthetic Clause Exercises Adopted from Expansion Activities Understanding and Using English Grammar 3rd Edition Pearson Education 2007 Chapter 7, Adverb clauses (Azargrammer.com) DESCRIPTION Students physically become moveable parts of a complex sentence including subject-verb, dependent/independent clauses, connecting words, and punctuation. Students identify the parts, learn about correct punctuation and investigate what happens as the clauses are moved around. PREPARATION AND SUPPLIES Strips of paper about 3 x 8 long, one for every word in each sentence. You can write a number on the back to designate order or let the students organize themselves. Example sentences (unpunctuated): 1. Before he leaves, he s going to sign out. 2. She ll take vital signs after she answers the call lights. 3. After you leave the room, you ll wash your hands. 4. While I check her ID, I m going to ask her name. 5. While the patient dangles, he is going to put on her shoes. 6. When you are finished, record the vital signs. 7. If you can t hear the beat, you can ask for help. PROCEDURE 1. Students stand in order from left to right showing their sentence words. Students read their words aloud. 2. Ask each subject and verb in the sentence to move forward. 3. Identify the two clauses by having the two groups of students separate leaving the time word in the middle 4. Ask if each set of subjects and verbs has its own complete idea. Identify the dependent clause. Have the dependent clause kneel to illustrate its dependency. 5. Have the clauses switch positions. Ask if the sentence still retains the original meaning. 6. Have the sequence word student move to the head of one clause and then the other. Ask the class if the sentence still retains the original meaning. 7. Hand out another paper strip with a comma on it and give to a seated student, asking the student to fit into the sentence. 8. Have the subordinate clause students move to the end and ask if the comma should go in. Note: For a more advanced exercise, add other types of adverbial connectors that show cause and effect, contradiction, similarity, etc. Students can experiment with which connectors fit different clause pairs

7 Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 7 of 8 Handout E: Kinesthetic Clause Word Cards Instructions: Match the time clauses on the left to the future clause on the right that makes the most sense. Use each phrase only once. 1. When the surgery is over, a. we will do the fasting blood test 2. After you finish eating, b. he s going to visit you. 3. Before you eat, c. I ll take your tray away 4. If you press the signal light, d. someone will come right in. 5. As soon as you are finished with the bedpan, e. you will go to the recovery room. 6. When your husband finishes work, f. I ll empty it. Change the position of the clauses without changing the meaning. 1. The doctor will call you at home after she looks at the test results. 2. Before you eat, you ll have to take this medicine. 3. When dinner is ready I ll take you to the dining room. 4. You are going to feel some discomfort when he gives you the enema. 5. If the doctor writes the discharge order, you re going to go home tomorrow. 6. After you finish lunch, I ll help you walk around the floor. 7. The nurse is going to ask you some questions after you get settled in the room. 8. After we complete the range of motion exercises, your family will come back into the room. 9. The nurse will check your glucose before you have anything to eat. 10. The occupational therapist is going to work with you after he is finished with the other patient.

8 Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 8 of 8 Handout F: Quiz A. Change the position of the clauses without changing the meaning: 1. If the doctor writes the discharge order, you re going to go home tomorrow. 2. After you finish lunch, I ll help you walk around the floor. 3. The nurse is going to ask you some questions when you get settled in the room. 4. After we complete the range of motion exercises, your family will come back into the room. 5. The nurse will check your glucose before you have anything to eat. B. Fill in these sentences use the appropriate time word: 6. I m going to feel for the brachial pulse I place the stethoscope. 7. I ll record and report I wash my hands. 8. You are going to feel a little pain the blood pressure cuff compresses. 9. she releases the valve, she is going to watch the dial. 10. The students will need to ask if the resident has had any arm or breast surgery they decide which arm to use. 11. your first hear the heartbeat, you are going to note the number the hand is pointing to on the dial. C. Complete these statements: 1. After I walk into the room. 2. before I chose an arm. 3. When I finish using the stethoscope 4. I will check the valve. 5. I m going to put a pillow under your arm. D. Correct these sentences: 1. She going to collects her supplies after she introduce herself. 2. The nursing assistants is going to wash their hands before and after the procedure. 3. He won t to reuse the alcohol wipes, after he will finish. 4. If the blood pressure cuff don t fit he going to gets a larger one. 5. You are going to feel for the brachial pulse before you place the stethoscope? 6. The resident will to feel any pain as you pump up the cuff?