Unit 2

Describing Symptoms and Conditions

Workplace English for Nursing Assistants

Meet Mr. Osei

Watch the video about Mr. Osei. Watch what changes about him.

Case Study Video — Mr. Osei

Mr. Osei — A Sudden Change

Talk about it

  1. What might Mr. Osei be experiencing?
    Starter: "Mr. Osei may be having a ..."
  2. Which specific signs did you observe? List them.
    Starter: "I observed that his face ... , his arm ... , and his speech ..."
  3. Which letters of FAST match what you see?
  4. Why is it important to report these signs to the nurse right away?
  5. Write one sentence you would say to the nurse. Report what you saw — do not give a diagnosis.

First: Sign vs. Symptom

Chattybot · FlashcardsScan to drill these words out loud.
Four numbered steps joined by arrows reading notice, ask, say it back, and report.
Figure 2.1 — The Four Steps: Notice, Ask, Say It Back, Report: Your job has four steps: notice, ask, say it back, then report.
Two panels comparing a sign you can observe with a symptom the client reports.
Figure 2.2 — Sign or Symptom?: A sign you can see. A symptom the client tells you.

Two words you will use every day. A sign is something you can see, hear, feel, or measure (a rash, swelling, a blood pressure reading). A symptom is something the client feels and tells you (pain, nausea, dizziness). You report both.

Sign or symptom?
You noticeSign or symptom?Why
Swollen anklesSignYou can see and feel it.
"My chest hurts."SymptomOnly the client can feel it.
Heavy sweatingSignYou can see it.
"I feel dizzy."SymptomThe client tells you.

A symptom only reaches the nurse if you ask good questions and listen. One word — "pain" — is not enough. Where? What kind? Since when?

🗣 Speaking Toolbox: Getting the details of a symptom
🗣 Speaking Toolbox: Showing the client you are listening

The Decoder: prefixes and suffixes

Chattybot · FlashcardsScan to drill these words out loud.
Medical roots
Word partMeaningExample
dys-difficult / baddyspnea = difficult breathing
a- / an-withoutaphasia = without speech
-pneabreathingorthopnea = breathing (only) upright
-phagiaswallowingdysphagia = difficult swallowing
-uriaurinenocturia = urinating at night
hemi-halfhemiplegia = paralysis of half the body
-plegiaparalysisparaplegia = paralysis of the legs
See How It Works

dys- + -pnea = difficult breathing (dyspnea). dys- + -phagia = difficult swallowing (dysphagia).

A row showing word parts joined by plus and equals signs to build dyspnea and dysphagia.
Figure 2.3 — Building Words from Parts: Join two word parts to build a new medical word.

Practice 1 — The Decoder (Warm-Up)

Use the word part to guess the meaning. Write your guess on the line.

  1. dys- = "difficult." What does dysphagia (dys- + swallowing) mean?

    ______________________________________________________________

  2. -pnea = "breathing." What does dyspnea mean?

    ______________________________________________________________

  3. hemi- = "half." What does hemiplegia (hemi- + paralysis) mean?

    ______________________________________________________________

  4. -uria = "urine." What does nocturia (night + urine) mean?

    ______________________________________________________________

Everyday Symptom Words

Chattybot · FlashcardsScan to drill these words out loud.
Everyday symptom words
TermPlain meaning
DyspneaShortness of breath.
OrthopneaCannot breathe well lying flat; must sit up.
DysphagiaDifficulty swallowing.
DiaphoresisHeavy sweating.
NocturiaNeeding to urinate often at night.
EdemaSwelling from fluid (often in the legs and feet).
AspirationBreathing food, liquid, or saliva into the lungs.

Practice 2 — Everyday Symptom Words

2.1 Match the term to its meaning

  • 1. Dyspnea
  • 2. Orthopnea
  • 3. Dysphagia
  • 4. Diaphoresis
  • 5. Nocturia
  • 6. Edema
  • 7. Aspiration
  • A. Difficulty swallowing
  • B. Shortness of breath
  • C. Breathing food or liquid into the lungs
  • D. Swelling from fluid, often in the legs and feet
  • E. Cannot breathe well lying flat; must sit up
  • F. Needing to urinate often at night
  • G. Heavy sweating

2.2 Fill in the symptom word

  1. The client sits up all night because she cannot breathe lying down. This is ___________________.
  2. The client's ankles are swollen with fluid. This is _______________________________.
  3. The client coughs and chokes when drinking. He is at risk for ______________________________.

Skin, Bone & Muscle

Chattybot · FlashcardsScan to drill these words out loud.
Skin, bone, and muscle terms
TermPlain meaning
Pressure injuryA sore from constant pressure cutting off blood to the skin (also called a bed sore).
Stasis ulcerA leg sore from poor blood flow (not from pressure).
FomiteAn object that carries germs (a hairbrush, pillow, or bed linen).
AtrophyMuscle wasting — muscle shrinks from not being used.
ContractureA joint that shortens and stiffens so it cannot straighten.
KyphosisA forward-curved upper back (the "hunched" look of osteoporosis).
Two side profiles comparing a straight upper back with a forward-curved upper back.
Figure 2.4 Kyphosis: A Curved Upper Back
Two side profiles. On the left, labeled pressure injury from pressure, arrows point to circled spots at the tailbone and the back of the heel. On the right, labeled stasis ulcer from poor blood flow, a dashed line runs down the leg to a circled spot above the ankle.
Figure 2.5 Pressure and stasis injuries

Practice 3 — Skin, Bone & Muscle

3.1 Match the term to its meaning

  • 1. Pressure injury
  • 2. Stasis ulcer
  • 3. Fomite
  • 4. Atrophy
  • 5. Contracture
  • 6. Kyphosis
  • A. Muscle wasting from not being used
  • B. A sore from constant pressure cutting off blood (a bed sore)
  • C. A forward-curved upper back (the "hunched" look)
  • D. An object that carries germs (hairbrush, pillow, linens)
  • E. A leg sore caused by poor blood flow, not pressure
  • F. A joint that stiffens and cannot straighten

3.2 True or False

  1. A pressure injury is caused by constant pressure on the skin. __________
  2. A pillow can be a fomite. __________
  3. Atrophy means a muscle is getting stronger. __________

Heart & Brain

Chattybot · FlashcardsScan to drill these words out loud.
Heart and brain terms
TermPlain meaning
Arrhythmia (dysrhythmia)An irregular heartbeat. The two words mean the same thing.
AnginaChest pain, because the heart is not getting enough oxygen.
CVA (stroke)A "brain attack" — blood flow to the brain is blocked or bleeding.
HemiplegiaWeakness or paralysis on one side of the body (often after a stroke).
AphasiaLoss of the ability to speak or to understand speech.

Practice 4 — Heart & Brain

4.1 Match the term to its meaning

  • 1. Arrhythmia
  • 2. Angina
  • 3. CVA (stroke)
  • 4. Hemiplegia
  • 5. Aphasia
  • A. Weakness or paralysis on one side of the body
  • B. An irregular heartbeat
  • C. Loss of the ability to speak or understand speech
  • D. Chest pain because the heart is not getting enough oxygen
  • E. A "brain attack" — blocked or bleeding blood flow to the brain

4.2 Word building

  1. "a-" means "without." "-phasia" means "speech." So aphasia means _______________________.
  2. "hemi-" means "half." So hemiplegia affects ________________________ of the body.

Mind & Confusion

Chattybot · FlashcardsScan to drill these words out loud.

These are easy to mix up. The key difference: delirium comes on fast and can be reversed; dementia comes on slowly and does not.

Mind and confusion terms
TermPlain meaning
HallucinationSensing something that is not there (seeing, hearing, smelling it).
DelusionFirmly believing something that is not true.
DeliriumSudden, temporary confusion — often from infection, medication, or dehydration.
DementiaSlow, permanent loss of memory and thinking (for example, Alzheimer's).
Mental illnessA condition affecting mood, thinking, or behavior; may be brief or long-term.
Why the Difference Matters at Work

If a client suddenly becomes confused, that is a sign — report it now. In older adults, sudden confusion (delirium) is often caused by a urinary tract infection, dehydration, or a medication problem, which can be treated.

Two panels comparing delirium with fast reversible onset and dementia with slow permanent onset.
Figure 2.6 — Delirium vs. Dementia: Delirium starts fast and can be treated. Dementia starts slowly.

Practice 5 — Mind & Confusion

5.1 Match the term to its meaning

  • 1. Hallucination
  • 2. Delusion
  • 3. Delirium
  • 4. Dementia
  • 5. Mental illness
  • A. Slow, permanent loss of memory and thinking
  • B. Firmly believing something that is not true
  • C. Sensing something that is not there
  • D. A condition affecting mood, thinking, or behavior
  • E. Sudden, temporary confusion (often reversible)

5.2 Delirium or dementia?

  1. Comes on suddenly and can often be reversed: ______________________________
  2. Comes on slowly and is permanent: ______________________________

HIV & Cancer

Chattybot · FlashcardsScan to drill these words out loud.
HIV and cancer terms
TermPlain meaning
HIVA virus that attacks the immune system (the T cells that fight infection).
AIDSThe late stage of HIV, when the immune system is severely damaged.
CancerA disease where abnormal cells grow out of control and can invade other tissue.
MetastasisWhen cancer spreads from where it started to another part of the body.
Benign tumorA growth that is not cancer and does not spread.
Malignant tumorA growth that is cancer and can spread.
Professional Facts About HIV

HIV is carried in blood and certain body fluids. It is not spread by everyday social contact — shaking hands, sharing dishes, a closed-mouth kiss, or insect bites do not transmit it.

A healthcare worker treats every client with the same respect and standard precautions, without judgment about how anyone became infected.

Practice 6 — HIV & Cancer

6.1 Match the term to its meaning

  • 1. HIV
  • 2. AIDS
  • 3. Cancer
  • 4. Metastasis
  • 5. Benign tumor
  • 6. Malignant tumor
  • A. A growth that is cancer and can spread
  • B. A virus that attacks the immune system
  • C. When cancer spreads to another part of the body
  • D. The late stage of HIV, when the immune system is severely damaged
  • E. A growth that is not cancer and does not spread
  • F. Abnormal cells that grow out of control and can invade other tissue

6.2 True or False

  1. HIV can be spread by shaking hands or sharing dishes. __________
  2. A benign tumor can spread to other parts of the body. __________
  3. A healthcare worker cares for every client with respect and standard precautions. __________

Recognize and Report NOW — 3 Emergencies

Chattybot · FlashcardsScan to drill these words out loud.
Stroke — use FAST

Face drooping • Arm weakness • Speech slurred • Time to call for help.

Four rows showing the letters F, A, S, and T with icons for face, arm, speech, and time.
Figure 2.7 — FAST: The Stroke Signs: FAST helps you remember the four stroke warning signs.
Dangerous blood sugar (diabetes)

Low (hypoglycemia): shaky, sweating, confused, cool clammy skin.

High (hyperglycemia): very thirsty, frequent urination, fruity breath, confusion.

Two panels comparing the warning signs of low blood sugar and high blood sugar.
Figure 2.8 — Low vs. High Blood Sugar: Report both right away.
Heart attack (myocardial infarction)

Crushing chest pain, heavy sweating, shortness of breath, grey skin. In women, signs can be vague: arm or back pain, nausea, a feeling of dread.

When you see these signs, you reach a conclusion — but be careful what kind of conclusion you say out loud.

A do-and-don't pair contrasting an action report with a diagnosis statement.
Figure 2.9 — Report the Action, Not the Diagnosis: Say what you saw and get the nurse. Never name the disease.

The Language of Reporting

Report what you observed
Instead of guessing...Report what you observed
"I think he had a stroke.""His face is drooping on the left and his speech is slurred."
"She can't breathe.""She is short of breath and cannot lie flat."
"He seems off today.""He is suddenly confused and did not know the date."
Language Focus: Reporting Sentence Frames

A good report is short. You do not repeat everything the client said — you summarize it. Summarizing also works with the client: say back what you heard, so they can correct you before you report it.

Check Your Knowledge Chattybot · Check Your KnowledgeScan to answer these questions out loud.
  1. A client says "I feel sick to my stomach." Sign or symptom?
  2. You see a new red rash. Sign or symptom?
  3. A client says only "It hurts." What two questions you would ask?
  4. What does "dysphagia" mean? Which two parts build it?
  5. "Hemi-" + "-plegia" = ? Which side of the body?
  6. Which sore comes from pressure? Which comes from poor blood flow?
  7. Name two fomites in a client's room.
  8. Mrs. L was clear yesterday and confused today. Delirium or dementia?
  9. A client believes she is in a hotel. Hallucination or delusion?
  10. Which two FAST letters match a drooping face and a weak arm?
  11. Rewrite "It's clear she's having a heart attack" as an action conclusion.

Dialogue Practice

Read these dialogues out loud with a partner.

Two people having a scripted workplace dialogue.

Dialogue 1 —"I just don't feel right today."

Chattybot · DialogueScan to read this script out loud.

Mr. Petrov, 79, is usually cheerful. This morning he is quiet and stays in his chair.

Mr. Petrov: I don't know. I just don't feel right today.

You: I'm sorry to hear that. Could you tell me more about how you feel?

Mr. Petrov: Tired. And my legs feel heavy.

You: Go on. What kind of heavy — sore, or swollen?

Mr. Petrov: Swollen, I think. My shoes were tight yesterday too.

You: Can you explain when it started?

Mr. Petrov: Two days now. And I'm up all night to the bathroom.

You: Mm-hmm. Thank you for telling me. I will let the nurse know.



Two people having a scripted workplace dialogue.

Dialogue 2 —A long story, a short report

Chattybot · DialogueScan to read this script out loud.

Mrs. Achebe, 84, talks for two minutes about her night. You must find the facts inside the story.

Mrs. Achebe: It was a terrible night. I couldn't lie down at all. Every time I put my head down I felt like I was drowning, so I sat up in the chair with the light on, and then my grandson called...

You: Uh-huh. That sounds hard.

Mrs. Achebe: — and I was up and down to the bathroom, maybe five times. My chest felt tight when I walked back.

You: It sounds like you could not lie flat all night, and you were up about five times. Is that right?

Mrs. Achebe: Yes. Five or six.

You: And you had tightness in your chest when you walked. What kind of tightness — pain, or pressure?

Mrs. Achebe: Pressure. Like a weight.

You: So what you're saying is, you could not lie flat, you were up five or six times, and you had chest pressure when walking. In summary, three new things since yesterday. I'm going to get the nurse.

Roleplays

Work with a partner (or the practice bot).

An older woman resident sitting up, looking unwell.

Roleplay 1 —"I don't feel good"

Chattybot · RoleplayScan to rehearse this roleplay out loud.

Situation

Mrs. Halloran, 81, says only "I don't feel good." She will not give details unless you ask. Find out enough to report something useful to the nurse.

Your Goals:

  1. Use at least THREE Soliciting Information questions (what kind / where / since when).
  2. Use at least TWO Verbal Cues to keep her talking.
  3. Find out at least THREE facts (what, where, how long).
  4. Do not tell her what you think the illness is.
An older man resident talking, mid-story.

Roleplay 2 —The long story

Chattybot · RoleplayScan to rehearse this roleplay out loud.

Situation

Mr. Bianchi, 77, tells you a long, mixed-up story about his weekend. Inside it are three reportable facts. Listen, summarize, and check with him before you report.

Your Goals:

  1. Use at least TWO Summarizing phrases ("It sounds like..." / "So what you're saying is...").
  2. Ask ONE Soliciting Information question about an unclear detail.
  3. End with a one-sentence summary containing only facts he actually said.

Cumulative Review

Multiple Choice

Vocabulary Review Tip

Cover the answers, try from memory, then cross out the choices you know are wrong.

1. A healthcare worker's main job with a sick client is to

  1. diagnose the disease
  2. prescribe medicine
  3. notice signs and report them

2. "Dyspnea" means

  1. difficulty swallowing
  2. shortness of breath
  3. heavy sweating

3. The word part "dys-" means

  1. without
  2. half
  3. difficult or bad

4. A bed sore, caused by constant pressure, is a

  1. stasis ulcer
  2. pressure injury
  3. contracture

5. Weakness on one side of the body after a stroke is called

  1. aphasia
  2. hemiplegia
  3. atrophy

6. A client suddenly becomes confused today but was fine yesterday. This is most likely

  1. dementia
  2. delirium
  3. a delusion

7. Which is TRUE about HIV?

  1. It spreads by shaking hands
  2. It is spread by mosquito bites
  3. It is not spread by casual social contact

8. A tumor that is cancerous and can spread is

  1. benign
  2. malignant
  3. a fomite

9. The FAST warning signs help you recognize a

  1. heart attack
  2. stroke
  3. seizure

10. You see a new sign. The BEST thing to say to the nurse is

  1. "I think he had a stroke."
  2. "His face is drooping on the left and this is new since breakfast."
  3. "He seems off today."

Back to Mr. Osei

Read the case and answer in complete sentences. Use the sentence starters if you wish.

The Case: Mr. Osei

You visit Mr. Osei once a week to help him bathe. Today he is still in bed, which is unusual. He smiles at you, but the smile looks crooked — one side of his face is drooping. When you help him sit up, his left arm is very weak. When you ask how he feels, his words are slurred and he seems confused. A few minutes ago he was fine.

1. What might Mr. Osei be experiencing?

Starter: "Mr. Osei may be having a ..."

______________________________________________________________

2. Which specific signs did you observe? List them.

Starter: "I observed that his face ... , his arm ... , and his speech ..."

______________________________________________________________

3. Which letters of FAST match what you see?

______________________________________________________________

4. Why is it important to report these signs to the nurse right away?

______________________________________________________________

5. Write one sentence you would say to the nurse. Report what you saw — do not give a diagnosis.

______________________________________________________________

Instructor Answer Key

Unit 2 — Describing Symptoms and Conditions

This unit introduces the language nursing assistants use to notice, clarify, and report changes in a client’s condition. Learners distinguish signs from symptoms, decode common medical word parts, and study vocabulary related to breathing, skin, muscles, the heart, the brain, confusion, HIV, and cancer. A case study about Mr. Osei connects this knowledge to recognizing stroke warning signs and reporting an emergency quickly. Through illustrated readings, flashcards, knowledge checks, dialogues, and role-plays, learners practice asking follow-up questions, listening actively, summarizing a client’s story, and giving short, factual reports without making a diagnosis.

Practice 1–6 and Review

Warm-Up: 1. difficult swallowing 2. difficult / shortness of breathing 3. paralysis of half the body 4. urinating at night.

Practice 2.1: 1-B, 2-E, 3-A, 4-G, 5-F, 6-D, 7-C. Practice 2.2: 1. orthopnea 2. edema 3. aspiration.

Practice 3.1: 1-B, 2-E, 3-D, 4-A, 5-F, 6-C. Practice 3.2: 1. True 2. True 3. False.

Practice 4.1: 1-B, 2-D, 3-E, 4-A, 5-C. Practice 4.2: 1. without speech 2. half.

Practice 5.1: 1-C, 2-B, 3-E, 4-A, 5-D. Practice 5.2: 1. delirium 2. dementia.

Practice 6.1: 1-B, 2-D, 3-F, 4-C, 5-E, 6-A. Practice 6.2: 1. False 2. False 3. True.

Multiple Choice: 1-c, 2-b, 3-c, 4-b, 5-b, 6-b, 7-c, 8-b, 9-b, 10-b.

Back to Mr. Osei (sample): (1) A stroke (CVA) — but note: the student writes this on paper for the instructor; they do NOT say it to the family or to the client. (2) Face drooping on one side, weak left arm, slurred speech, sudden confusion. (3) F (face), A (arm), S (speech). (4) A stroke is an emergency; fast treatment can limit permanent damage. (5) e.g., "His face is drooping on the left, his left arm is weak, and his speech is slurred — this started a few minutes ago."

Suggested drill — the two-minute story

Give one student a rambling two-minute complaint to deliver (the night, the neighbour, the grandson, and somewhere in the rambling… a real symptom). The listener may take no notes. At the end they must give the nurse ONE sentence: what was observed, where, and since when.