In premodern times and even today in some developing countries, basic hygiene, clean water, and adequate nutrition have been the most important ways to promote health and reduce disease.
在未發(fā)達時代，甚至當今在一些發(fā)展中國家，基本衛(wèi)生條件、清潔飲用水和最低營養(yǎng)保障是促進健康的最重要方法。
In developed countries, the adoption of healthy lifestyles, including better diet and appropriate exercise, are cornorstones to reducing the epidemics of obesity, coronary disease, and diabetes.
adoption 采納、采用 epidemic 流行、傳染
在發(fā)達國家中，健康的生活方式包括良好飲食和適當鍛煉，是減少肥胖、冠心病和糖尿病的基礎(chǔ)。
Public health interventions to provide immunizations and to reduce injuries and the use of tobacco, illicit drugs, and excess alcohol collectively can produce more health benefit than nearly any other imaginable health intervention.
(illicit 非法的、違禁的 collectively 全體地、共同地 produce 生產(chǎn)、創(chuàng)造)
公共健康干預如進行疫苗接種、減少損傷、減少吸煙、減少吸毒、減少酗酒等措施共同產(chǎn)生的健康效果比幾乎可想象的任何其它健康干預措施都要好得多。
Vital signs Page 15
生命體征 第１５頁
A nurse or assistant often obtains the vital signs. 護士或護士助手經(jīng)�？傻玫缴w征
Traditionally the vital signs include pulse rate, blood pressure, respiratory rate, and body temperature. 傳統(tǒng)的生命體征包括脈搏（率)、血壓、呼吸（頻率)和體溫。
More recently, advocates of various causes have advocated for a “fifth vital sign”.
(advocate 提倡、主張) 最近，人們以多種理由提出 “第五生命體征”的建議。
The most cogent of these “new” vital signs is the patient’s quantitative assessment of pain.
(cogent 今人信服的，切實的，有力的)
這些“新”的生命體征中，最今人信服的是病人疼痛的定量評判。
The pulse should be recorded as not just the rate but also the rhythm.
脈搏不僅要記錄頻率，而且要記錄節(jié)律。
Physicians may prefer to initiate the examination by holding the patient’s hand while palpating the pulse.
(initiate 開始，創(chuàng)始) 醫(yī)生喜歡握住病人的手，觸摸脈搏，開始檢查。
This nonthreatening initial contact with the patient allows the physician to determine whether the patient has a regular or irregular rhythm.
這個對病人無威脅性的最初接觸讓醫(yī)生確定了脈搏是否具有節(jié)律性。
When the blood pressure is abnormal, many physicians repeat the measurement.
當測得的血壓不正常，許多醫(yī)生重復這個測量。
The instrument error that contributes to the greatest variability is the cuff size of the sphygmomanometer. (variability 變化，易變性 sphygmomanometer 血壓計)
變異性中占比例最大的設(shè)備誤差是血壓計袖套的大小。
Many adults require a large-size adult cuff; using a narrow cuff can alter systolic/diastolic blood pressure by -8 to +10/+2 to +8mmHg. (mmHg: millimeter of mercury)
許多成人需用大號的成人袖套，如果使用窄袖套能夠影響收縮壓-8~10mmHg ，舒張壓2~8mmHg。
The appearance of repetitive sounds (Korotkoff sounds, phase 1) constitutes the systolic pressure.
(constitute 構(gòu)成，設(shè)立，指定)重復脈搏音（Korotkoff 音，第１相)的出現(xiàn)定為收縮壓。
After the cuff is inflated about the palpated pressure, the Korotkoff sounds muffle and disappear as pressure is released (phase 5).(inflate 充氣、膨脹 muffle 含糊不清)
當袖套充氣壓力約在可觸摸脈搏壓力的20~30mmHg上方，Korotkoff音變鈍，當壓力釋放， Korotkoff音消失（第５相)。
The level at which the sounds disappear is the diastolic pressure.聲音消失的水平就是舒張壓
The American Heart Association recommends that each measure should be rounded upward to the nearest 2mmHg. (be round up to the nearest whole number取最近的整數(shù))
美國心臟病協(xié)會建議每次測量取最近的２mmHg整數(shù)。
The respiratory rate should be assessed at the same time the patient is observed to determine whether there is any respiratory discomfort (dyspnea). dyspnea 呼吸困難
測量呼吸頻率的同時要觀察病人以確定是否存在呼吸困難。
The subjective sensation of dyspnea is caused by an increased work of breathing.
(subjective 主觀的) 呼吸困難的主觀感覺是由于呼吸功增加起的。
The examiner should decide whether patients have tachypnea (a rapid rate of breathing) or hypopnea (a slow or shallow rate of breathing).(tachypnea 呼吸急促 hypopnea 呼吸減弱)
檢查者要確定病人是否存在呼吸急促（呼吸頻率快)或呼吸減弱（呼吸頻率慢或淺)
Tachpnea is not always associated with hyperventilation, which is defined by increased alvealar ventilation resulting in a lower arterial carbon dioxide level.
hyperventilation 換氣過度 resulting in 導致、引起
呼吸急促不是都伴有過度換氣，過度換氣的定義是肺泡通氣量增高引起動脈血二氧化碳水平降低。
In the evaluation of patients suspected of having pneumonia, examiners agree on the presence of tachypnea only 63% of the time. (agree on 對……取得一致意見)
對一組疑為肺炎患者的評估中，檢查者認為當時呼吸急促的出現(xiàn)率僅為63%。
The body temperature of adults usually is measured with an oral electric thermometer.
成人體溫通常用口腔電子體溫計測定。
These thermometers correlate well with the traditional mercury thermometer and are safer to use.
(mercury 汞) 這種體溫計與傳統(tǒng)的汞體溫計高度相關(guān)，使用安全。
Rectal thermometers reliably record temperatures 0.4℃ higher than oral thermometers.
直腸體溫計可靠地記錄了高于口表0.4℃的溫度。
By comparison, newer tympanic thermometers may vary too much compared with oral thermometers (-1.2℃ to +1.6℃ versus the oral temperature) to be reliable among hospitalized patients. (tympanic 鼓膜的、鼓室的 too much ……to be 太……以致于不)
相比較，新型的鼓式體溫計相對口表可能誤差太大（與口表相差-1.2~1.6度)，不宜用于住院病人。
Why Geriatric Patients Are Different
老年病人的特殊性 第20頁
Older patients differ from young or middle-aged adults with the same disease in many ways, one of which is the frequent occurrence of comorbidities and of subclinical disease.
(comorbidities 并存病 subclinical 亞臨床的)
同樣的疾病，年齡大的病人在許多方面與青中年病人是有區(qū)別的，其中之一是并存病多和亞臨床疾病多。
As a function of the high prevalence of disease, comorbidity (or the co-occurrence of two or more diseases in the same individual) is also common.
(prevalence 流行、普遍 co-occurrence 同時發(fā)生)
作為高發(fā)疾病的結(jié)果，并存�。▋蓚�或更多的疾病在同一個體同時發(fā)生)也是多見的。
Of people age 65 and older, 50% have two or more chronic disease, and these diseases can confer additive risk of adverse outcomes, such as mortality.
(confer 授予、給予 additive 附加的、附屬物)
65歲以上的老年中，50%患有兩種以上的慢性疾病，這些疾病能夠增加不利預后的風險，如死亡率。
In some patients, cognitive impairment may mask the symptoms of important conditions.
(cognitive 認知的、認識的 impairment 損害 mask 口罩、假面具、掩飾)
在一些病人中，認知損害可以掩蓋重要病情的癥狀。
Treatment for one disease may affect another adversely, as in the use of aspirin to prevent stroke in individuals with a history of peptic ulcer disease. (stroke 中風 peptic ulcer 消化性潰瘍)
對一種疾病的治療可能加重另一種疾病，例如，對有消化性潰瘍病史的病人使用阿斯匹林預防中風。
The risk for becoming disabled or dependent also increases with the number of diseases present.
disabled 殘廢的、有缺陷的 dependent 依靠的、依賴的
病殘或生活不能自理發(fā)生的風險也隨著并存的疾病數(shù)而增高。
