CHAPTER I

1.1 BACKGROUND
Health is a very important aspect for human life, but not many people are able
to make decisions about the health care they need, and the responsibility to
maintain their health optimally. How important is health, but many people ignore
it. They do not realize that lifestyle, lifestyle, and daily activities can affect health.
They feel healthy when they do not have coughs, flu, or other infectious diseases.
In fact, there is a danger that threatens if a healthy lifestyle is not applied in
everyday life.
Currently many diseases suffered are not caused by germs, viruses, or bacteria
but rather caused by unhealthy habits or patterns of life. Though signs and
symptoms describe the same conditions, these two are different in many
characteristics. While signs are what a doctor sees, symptoms are what a patient
experiences. A symptom can be defined as one of the characters of a disease.
Meanwhile, sign is the definite indication of a specific disease. While signs are
the physical manifestation of injury, illness or disease, symptoms can be described
as what a patient experiences about the injury, illness or disease. When the patient
notices symptoms, it is the others, especially the physician or doctor who notices
signs. A high temperature, a rapid pulse, low blood pressure, open wound and
bruising can be called as signs. Chills, shivering, fever, nausea, shaking and
vertigo are the symptoms. While signs are objective, symptoms on the other hand
are subjective. Signs are called objective in the sense that they can be felt, heard
or seen. Bleeding, bruising, swelling and fever are signs. Symptoms are subjective
in the sense that they are not outwardly visible to others. It is only the patient who
perceives and experiences the symptoms.
It is only when the patient experiences certain symptoms that he or she
approaches a physician. Symptoms help the physician diagnose the problem. As
symptoms are not visible outwards, it is most important that the patient be as
descriptive so that the doctor or the physician may be able to assess and evaluate
the symptoms. Symptoms 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 cannot be verified. But signs on the other hand can be

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verified. Signs can be measured in a clinical setting. High or low blood pressure,
rapid heart rate or fever, can be measured.

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 CHAPTER II

2.1 Sign and Symptoms

Symptoms of subjective presentation of medical problems and illness. This is
a pathological evidence that can be felt only by the patient and / or disclosed by
laboratory results or other researched means.various symptoms of the disease
include the following:
a. Measles
Symptoms of measles generally appear within 14 days of exposure to the
virus. Symptoms include:

 cough

 fever

 red eyes

 light sensitivity

 muscle aches

 runny nose

 sore throat

 white spots inside the mouth

A widespread skin rash is a classic sign of measles. This rash can last up
to seven days and generally appears within the first three to five days of
exposure to the virus. A measles rash, which appears as red, itchy bumps,
commonly develops on the head and slowly spreads to other parts of the
body.

b. Dengue Hemorrhagic Fever

Symptoms of the dengue virus generally include:

 mild, moderate, or high fever

 headaches

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  nausea

 vomiting

 pain in the muscles, bones, or joints

 rashes on the skin

You may feel like you are recovering from dengue fever, and then
suddenly develop new and severe symptoms. These could be symptoms
of dengue hemorrhagic fever. Call your doctor if you begin to
experience:

 restlessness

 acute, or sudden, fever

 severe abdominal pain

 bleeding or bruising under the skin

 cold or clammy skin

 nosebleeds

 large decrease in blood pressure (shock)

c. Tuberculosis
Signs and symptoms of active TB include:

 Coughing that lasts three or more weeks

 Coughing up blood

 Chest pain, or pain with breathing or coughing

 Unintentional weight loss

 Fatigue

 Fever

 Night sweats

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  Chills

 Loss of appetite

Tuberculosis can also affect other parts of your body, including your
kidneys, spine or brain. When TB occurs outside your lungs, signs and
symptoms vary according to the organs involved. For example,
tuberculosis of the spine may give you back pain, and tuberculosis in
your kidneys might cause blood in your urine.
d. Diarrhea
Signs and symptoms associated with diarrhea may include:

 Loose, watery stools

 Abdominal cramps

 Abdominal pain

 Fever

 Blood in the stool

 Bloating

 Nausea

 Urgent need to have a bowel movement

When to see a doctor

If you're an adult, see your doctor if:

 Your diarrhea persists beyond two days

 You become dehydrated

 You have severe abdominal or rectal pain

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  You have bloody or black stools

 You have a fever above 102 F (39 C)

In children, particularly young children, diarrhea can quickly lead to
dehydration. Call your doctor if your child's diarrhea doesn't improve
within 24 hours or if your baby:

 Becomes dehydrated

 Has a fever above 102 F (39 C)

 Has bloody or black stools

Early warning signs are changes that happen just before or at the very
beginning of an asthma attack. These signs may start before the well-known
symptoms of asthma and are the earliest signs that your asthma is
worsening.

e. Asthma

In general, these signs are not severe enough to stop you from going about
your daily activities. But by recognizing these signs, you can stop an asthma
attack or prevent one from getting worse. Early warning signs of asthma
include:

 Frequent cough, especially at night

 Losing your breath easily or shortness of breath
 Feeling very tired or weak when exercising
 Wheezing or coughing after exercise
 Feeling tired, easily upset, grouchy, or moody
 Decreases or changes in lung function as measured on a peak flow
meter
 Signs of a cold or allergies (sneezing, runny nose, cough, nasal
congestion, sore throat, and headache)
 Trouble sleeping

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 If you have early warning signs or symptoms of asthma, you should take
more asthma medication as described in your asthma action plan.

2.2 Grammar focus (reported speech)

We use a 'reporting verb' like 'say' or 'tell'If this verb is in the present tense,
it's easy. We just put 'she says' and then the sentence:

 Direct speech: I like ice cream.

 Reported speech: She says (that) she likes ice cream.

We don't need to change the tense, though probably we do need to change the
'person' from 'I' to 'she', for example. We also may need to change words like 'my'
and 'your'.(As I'm sure you know, often, we can choose if we want to use 'that' or
not in English. I've put it in brackets () to show that it's optional. It's exactly the
same if you use 'that' or if you don't use 'that'.)

But, if the reporting verb is in the past tense, then usually we change the
tenses in the reported speech:

 Direct speech: I like ice cream.

 Reported speech: She said (that) she liked ice cream.

A. Tense Direct Speech Reported Speech

1. Simple Presemt Tense
I like ice cream = She said (that) she liked ice cream.
2. Simpe Present Continuous
I am living in London = She said (that) she was living in London.
3. Simple Past Tense
I bought a car = She said (that) she had bought a car OR She said (that)
she bought a car.
4. Simple Past Continuous
I was walking along the street = She said (that) she had been walking
along the street.

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5. Simple Present Perfect
I haven't seen Julie = She said (that) she hadn't seen Julie.
6. Simple Past Perfect
I had taken English lessons before = She said (that) she had taken English
lessons before.

Modals in Reported Speech

1. Will
I'll see you later = She said (that) she would see me later.
2. Would
I would help, but... = She said (that) she would help but...
3. Can
I can speak perfect English = She said (that) she could speak perfect
English.
4. Could
I could swim when I was four = She said (that) she could swim when she
was four.
5. Shall
I shall come later = She said (that) she would come later.
6. Should
I should call my mother = She said (that) she should call her mother
7. Might
I might be late = She said (that) she might be late
8. Must
I must study at the weekend = She said (that) she must study at the
weekend OR She said she had to study at the weekend

Occasionally, we don't need to change the present tense into the past if the
information in direct speech is still true (but this is only for things which are
general facts, and even then usually we like to change the tense):

 Direct speech: The sky is blue.

 Reported speech: She said (that) the sky is/was blue.

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B. Reported Questions
So now you have no problem with making reported speech from positive
and negative sentences. But how about questions?
 Direct speech: Where do you live?
How can we make the reported speech here?

In fact, it's not so different from reported statements. The tense changes are
the same, and we keep the question word. The very important thing though
is that, once we tell the question to someone else, it isn't a question any
more. So we need to change the grammar to a normal positive sentence. A
bit confusing? Maybe this example will help:

 Direct speech: Where do you live?

 Reported speech: She asked me where I lived.

Do you see how I made it? The direct question is in the present simple
tense. We make a present simple question with 'do' or 'does' so I need to
take that away. Then I need to change the verb to the past simple.

Another example:

 Direct speech: Where is Julie?

 Reported speech: She asked me where Julie was.

The direct question is the present simple of 'be'. We make the question form
of the present simple of be by inverting (changing the position of)the subject
and verb. So, we need to change them back before putting the verb into the
past simple.

Direct Question Reported Question

Where is the Post Office, please? She asked me where the Post Office was.

What are you doing? She asked me what I was doing.

Who was that fantastic man? She asked me who that fantastic man had
been.

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 So much for 'wh' questions. But, what if you need to report a 'yes / no'
question? We don't have any question words to help us. Instead, we use 'if':

 Direct speech: Do you like chocolate?

 Reported speech: She asked me if I liked chocolate.

No problem? Here are a few more examples:

Direct Question Reported Question

Do you love me? He asked me if I loved him.

Have you ever been to Mexico? She asked me if I had ever

been to Mexico.

Are you living here? She asked me if I was

living here.

C. Reported Requests
There's more! What if someone asks you to do something (in a polite way)?
For example:
 Direct speech: Close the window, please
 Or: Could you close the window please?
 Or: Would you mind closing the window please?

All of these requests mean the same thing, so we don't need to report every
word when we tell another person about it. We simply use 'ask me + to +
infinitive':

Here are a few more examples:

Direct Request Reported Request

Please help me. She asked me to help her.

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 Please don't smoke. She asked me not to smoke.
Could you bring my book tonight? She asked me to bring her book
that night.
Could you pass the milk, please? She asked me to pass the milk.
Would you mind coming early She asked me to come early the
tomorrow? next day.

To report a negative request, use 'not':

 Direct speech: Please don't be late.

 Reported speech: She asked us not to be late.

D. Reported Orders
And finally, how about if someone doesn't ask so politely? We can call this
an 'order' in English, when someone tells you very directly to do something.
For example:
 Direct speech: Sit down!

In fact, we make this into reported speech in the same way as a request. We
just use 'tell' instead of 'ask':

 Reported speech: She told me to sit down.

Direct Order Reported Order

Go to bed! He told the child to go to bed.

Don't worry! He told her not to worry.

Be on time! He told me to be on time.

Don't smoke! He told us not to smoke.

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E. Time Expressions with Reported Speech
Sometimes when we change direct speech into reported speech we have to
change time expressions too. We don't always have to do this, however. It
depends on when we heard the direct speech and when we say the reported
speech.
For example:
 It's Monday. Julie says "I'm leaving today".
 If I tell someone on Monday, I say "Julie said she was leaving today".
 If I tell someone on Tuesday, I say "Julie said she was leaving yesterday".
 If I tell someone on Wednesday, I say "Julie said she was leaving on
Monday".
 If I tell someone a month later, I say "Julie said she was leaving that day".

So, there's no easy conversion. You really have to think about when the direct
speech was said.

 Here's a table of some possible conversions:

 now then / at that time
 today yesterday / that day / Tuesday / the 27th of June
 yesterday the day before yesterday / the day before / Wednesday / the
5th of December
 last night the night before, Thursday night
 last week the week before / the previous week
 tomorrow today / the next day / the following day / Friday

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 CHAPTER III

3.1 CONCLUSION

Symptoms of subjective presentation of medical problems and illness. This is

a pathological evidence that can be felt only by the patient and / or disclosed by
laboratory results or other researched means.various symptoms of the disease
include the following meales, DHF, tuberculosis, diarrhea. Early warning signs
are changes that happen just before or at the very beginning of an asthma attack.
These signs may start before the well-known symptoms of asthma and are the
earliest signs that your asthma is worsening. Symptoms are vague but signs are
visible. Sign is only an objective indication of some medical fact that may be
detected by a physician. These signs may not have any meaning to patients but
they are significant for a physician to diagnosis the medical conditions. One can
describe symptom as one that is experienced and reported by a patient. Meanwhile
the doctor discovers signs of a disease during a patient’s examination. In
Summary:

1. Signs are what a doctor sees, symptoms are what a patient experiences.

2. While signs are the physical manifestation of injury, illness or disease,

symptoms can be described as what a patient experience about the injury,
illness or disease.
3. Signs are objective. Symptoms on the other hand are subjective

We use reported speech a 'reporting verb' like 'say' or 'tell'If this verb is in the
present tense, it's easy. We don't need to change the tense, though probably we do
need to change the 'person' from 'I' to 'she', for example. We also may need to
change words like 'my' and 'your'. (As I'm sure you know, often, we can choose if
we want to use 'that' or not in English. I've put it in brackets to show that it's
optional. It's exactly the same if you use 'that' or if you don't use 'that'.)

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 BIBLIOGRAPHY

Annie McKay: School Nurse Pioneer" (PDF). American Association for the
History of Nursing Bulletin. Access on Satuday, 30th September 2017

Dewi, Dilia. 2015. Survival English 1 For Beginner Level. Denpasar: DMEC

Fundamental English Grammar in year 2006

Herdman, TH (Ed.) Nursing Diagnoses: Definitions and classification 2009-2011.

Wiley-Blackwell: Singapore.

https://www.healthline.com/health/ access on Satuday, 30th September 2017

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