We Have Original History Papers For Sale, Get Free Revisions

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We Have Original History Papers For Sale, Get Free Revisions

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Case study Questions Nursing Coursework - 1650 Words

Case study Questions: Nursing (Coursework Sample) Content: CASE STUDY QUESTIONS-NURSINGQUESTION 1Prioritization of care is an essential nursing process in the care and management of patients. In the five cases provided, I would prioritize my care plan according to the severity of the patientà ¢Ã¢â€š ¬s condition and the presence of other co-morbidities. The respiratory and the cardiovascular systems are the most important in the body, because the functionality of the other systems depends on adequate blood and oxygen supply (Zammit Liddicoat, 2010,p. 338). In prioritizing care, I would consider patients whose disease processes affect the two systems. In this case, I would begin by formulation nursing care plans for Philip, John and Melinda. Philip has an infective exacerbation of a log standing chronic obstructive pulmonary disease (COPD). This could worsen the oxygen supply to the rest of the body and the resulting physiological stress would further make the symptoms worse (Subotic, et al., 2007,p.1293). John, on the other hand, has a cardiovascular disease, precisely, a coronary artery disease. Coronary artery diseases are known to predispose to myocardial infarction and ultimately heart failure if not managed properly at the outset (Kessler, Erdmann, Schunkert, 2013,p. 368). Melinda, as well, has a cardiovascular disease, precisely, a ruptured aortic aneurism resulting into a subarachnoid hemorrhage. Aortic aneurism is a risk factor for stroke syndromes; therefore, early interventions may avert a potential cerebrovascular accident (CVA) (Sule, Aronow, Sateesh, 2008, p. 141). In terms of treatment, I would prioritize my care in lieu of medications that require close monitoring of their levels to prevent toxicity or adverse events. Philip is on oxygen therapy and so needs close monitoring of the saturation levels. Oxygen toxicity results in the production of reactive oxygen species that would damage multiple cellular organs leading to disrupted physiological function (Auten Davis, 2009, p.126). Jo hn is on heparin infusion and so will require close monitoring to prevent heparin toxicity. Heparin results in Heparin-Induced Thrombocytopenia (HIT) (O'Donnell, 2012,p. 25). Melinda, on the other hand, is on anti-hypertensive, Nimopidine. In lieu of an intracranial hemorrhage, she needs close monitoring of her neurological functions.QUESTION 2When reviewing Peter, I notice that his nausea is becoming worse. Peter had undergone an abdominal surgery to remove gall stones after an endoscopic retrograde cholangiopancreatography had been done. He initially presented with a history of epigastric pain for two days; however, hours later post-surgery, he complains of nausea and mild right shoulder tip pain. I review the medication chart and notice that no antiemetic had been prescribed. Anesthesia is known to cause nausea and vomiting. Nitrous oxide when used with other anesthetic agents in laparoscopic surgeries causes nausea and vomiting post operatively (Peyton Wu CY, 2014, p. 1138). Fi rstly, I would consult with the intensive care team and the surgical team about the worsening vomiting of peter. It could be he is not on antiemetic because of a possible drug reaction, or by clinical judgment, it would be wise not to administer anti-emetic. Excessive vomiting results into loss of important electrolytes, in particular potassium, chloride and hydrogen ions. The resulting hydrogen ion loss results in metabolic alkalosis precipitating an increased ventilation manifested by the patient breathing in a faster rate (Khanna Kurtzman, 2006,p. 19). Excessive vomiting causes an increased loss of water from the body. Sodium plays an essential role in the maintenance of total body water volume; therefore, in vomiting the excess sodium loss results in fluid depletion (Khanna Kurtzman, 2006,p. 19). In my care, I would consider a fluid replacement therapy. The fluid of choice is one that has a large amount of potassium ions in order to prevent hypokalemia. In addition, I would e nsure the patient is put on a nasogastric tube feed in order to replenish lost nutrients. After consultation with the intensive care team, Peter may as well be put on an anti-emetic to prevent further electrolyte losses.QUESTION 3While reviewing John, I notice that the last coagulation profile reads an APTT of more than 150 seconds. In the initial treatment regime, the APTT was to be maintained between 50 and 75 seconds. A quick background past medical history of John reveals that he has a history of angina and a chronic coronary artery disease. He is on intravenous heparin infusion and aspirin at a dosage of 100mg per day. Activated Partial Thromboplastin Time (APTT), in contrast to the Prothrombin Time(PT) is an indicator of the integrity of the intrinsic and the common pathways of the coagulation cascade (Kogan, Kardakov, Khanin, 2001, p. 300). In a normal coagulation process, calcium is essential for the formation of the fibrin clot which covers the defect on the blood vessel t o prevent further blood loss. APTT is the time taken after addition of calcium ions to the time the fibrin clot is formed (Kogan, Kardakov, Khanin, 2001, p. 300). Longer APTT means that the blood takes longer than normal to clot. In Johnà ¢Ã¢â€š ¬s case, this is attributed to the heparin intravenous infusion that he was receiving. The possible explanation is heparin over dosage. The blood is in an un-coagulable state. This condition is life threatening in case there is an undetected internal hemorrhage. The blood loss cannot easily be controlled and the patient can get into shock. In lieu of the ward protocol on intravenous heparin infusion, I would review Johnà ¢Ã¢â€š ¬s medication and adjust it by stopping the infusion for sixty minutes. Then, I would restart it at a dosage 1.0ml/hr less than previous rate for the next six hours. Stopping the infusion would provide time for the body to clear the heparin to lower blood levels. Depending on the type and molecular constitution, t he biologic half-life of heparin ranges from 23 minutes to 2.48 hours (McAvoy, 1979, p. 377). Therefore, stopping it for one hour will give the body enough time to clear heparin to lower levels before the dosage can be adjusted again.QUESTION 4Melinda complains of a feeling of fainting when she gets out to mobilize or when she gets to the bathroom. On assessing her blood pressure, the reading is 80/40. Melinda is definitely in hypotension and soon she may be in shock. Hypotension is a clinical condition in which the blood pressure is less than 90/60 (Ashton, 2013, p. 35). In very severe cases, very low blood pressure can be life threatening. It portends that organs in the body such as the heart, brain and the kidneys do not get enough blood supply (Gordon, 2009, p. 937). Some organs such a s the kidneys when exposed to such an acute shortage of blood supply begins to shut down. Eventually, this would lead to kidney failure (Couch, 2008, p. 9). In a hypotensive state, the heart pumps faster in order to supply the little blood to the vital organs. The resultant increase in the rate of metabolism results in excessive sweating, thereby reducing the blood volume further (Ashton, 2013, p. 37). This worsens the situation.On reviewing her history, Melinda had been admitted at the neurosurgery unit with complains of an acute onset of severe headache. She had undergone a neurosurgical procedure that involved coiling of a cerebral artery aneurism using an interventional radiological suite five days ago. The operation was successful. A CT scan done showed a subarachnoid hemorrhage from the artery that was coiled during the surgery. She also had been put on nimopidine, an anti-hypertensive, dosing at 60mg oral tablets. In my assessment, it could be blood loss in a defect at the initial interventional procedure that involved coiling of the artery. The possible cause is no-compliant to the antihypertensive medications. Rangel-Castillo, Shankar and Robertson (2008), observe t hat intracranial hemorrhage has two causes-primary and secondary. In this case, the important secondary causes are trauma, rupture of an aneurism, coagulation defect or a vascular malformation (p.528). Hypertension by far becomes the most prominent and prevalent cause of intracranial hemorrhages accounting for 60-70% of cases (Rangel-Castillo, Shankar, Robertson, 2008, p. 530). Chronic hypertension results into fibrinoid necrosis, fragmentation and degeneration of the small arterioles that supply the bran parenchyma. Eventually, the walls of the arterioles weaken and they undergo a spontaneous rupture (Ramandeep Weinberger, 2007, p. 705). Non compliance with antihypertensive medication increases the risk of developing an intracranial bleed and a controlled blood pressure reduces the risk of developing an intracranial hemorrhage (Freeman Aguilar, 2012, p. 223).My response to Melindaà ¢Ã¢â€š ¬s clinical situation is to inform the doctors on call about Melindaà ¢Ã¢â€š ¬s worsening signs. Melinda would require first...

Testing in Hong Kong - 844 Words

Introduction There are many different kinds of test, as Hugh (1989) stated that test could be regarded as proficiency tests, achievement tests, diagnostic tests and placement tests. In this article, we would like to have some simple analysis on the quality of the reading test in the Hong Kong Diploma of Secondary Education (HKDSE) Examination of 2013. This is a newly implemented public examination in 2002 which serve with different purpose and format as the former public examination: Hong Kong Certificate of Education Examination (HKCEE) and the Hong Kong Advanced Level Examination (HKALE). â€Å"Achievement tests are directly related to language course, their purpose being to establish how successful individual students, groups of students, or the course themselves have been in achieving objectives.† (Hugh, 1989) according to this definition, HKDSE should be an achievement test. Since it is a stepping stone to get into university in Hong Kong, the DSE examination paper should have relatively high quality. By using a high standard testing paper, the quality of the universities’ candidates can be guarantee. Bachman (1996) has said that test qualities include reliability, construct validity, authenticity, interactiveness, impact and practicality. In this paper we will focus on the construct validity, authenticity and interactiveness to see how well is the KHDSE. Section 1 – Reading paper Part A Background Reading paper Part A is a compulsory section, candidates need to attemptShow MoreRelatedAnalysis on New Drug Policies in Hong Kong1555 Words   |  6 PagesAnalysis on New Drug Policies: The drug policy in Hong Kong is a complete ban on drugs. While some statistics have shown lesser drug use in recent years, its probably due to more hidden use. (CSD FA1. 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The main objective is testing and reliabilityRead MoreChina Sea And Pearl River Delta1432 Words   |  6 PagesBACKGROUND Hong Kong, is located on the southeast coast of China, the diplomatic location of Hong Kong on the South China Sea and Pearl River Delta helps it to become one of the world growing and worldly cities (Hong Kong Tourism Board, 2015). Before 18th century, Hong Kong was still an agricultural and manufacturing industries. In early 80’s to late 90’s, Hong Kong lost the comparative advantage in manufacturing as the opening up and reformation of the Mainland China, but the comparative advantageRead MoreHong Kong Is A Modern Fast Paced International City Saturated With Skilled Workforce1325 Words   |  6 PagesI. Background Hong Kong is a modern, fast-paced international city saturated with skilled workforce and a desired destination of many immigrants. Due to such nature of Hong Kong, it is a highly competitive society. 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By comparison between the definition of creativity provided by the Hong Kong Curriculum Development Council (CDC) and prior definitions provided by Guilford (1950) and Amabile (1983), the authors have stated at the end of the first paragraph of the article that â€Å"by seekingRead MoreChoi Fung Hong Company Limited Essay1332 Words   |  6 Pagesï » ¿Choi Fung Hong Company Limited with Activity Base d Techniques 1. Background of chosen Hong Kong Company Choi Fung Hong Company Limited (Choi Fung Hong) incorporated as private limited company since 1995. The main business Choi Fung Hong is wholesale or retail of their skincare products. At 1995, the company has invested on manufacturing factory and start the business from the telephone order only. As a well-known skincare brand in Hong Kong, Choi Fung Hong was successes to expand their businessRead MoreThe Development of Technology Negatively Affect Relationship between People700 Words   |  3 Pagesour smartphones at the same time; we are not just chatting with our friends in the gathering, all of us are bowing our head and using our own handy devices. According to Google’s research, the rate of mobile Internet usage in Hong Kong is the highest in Asia Pacific. In Hong Kong, 96% of the smartphone users use their phones in a daily basis. (Google, 2013) Moreover, according to the Pew Research, â€Å"Teens, Social Media, and Privacy†, People habitually use social media to interact with others. Though

Native American Self Determination Movement - 1441 Words

Indeed following on from this last point the Native American self-determination movement has achieved almost all of its victories without outside help. Indeed many organisations such as the National Congress of American Indians (NCAI), Native American Rights Fund (NARF) and National Alaska Native American Indian Nurses Association (NANAINA) are run by and for Native Americans and their interests. As with most civil rights movements but even more the case as Native Americans have their own sovereign citizenship, for real change to be affected there had to be self-organisation. To build on this point, the overarching aim for native activism is the abidance of treaties signed between tribes and the Federal government and the acceptance of†¦show more content†¦Hopefully this causes a ‘surge of wide-spread expressions of collective identity that challenges globalisation and cosmopolitanism on behalf of cultural singularity.’ (Castels, 1997, pp1). In which case the pr essure of wider American society to assimilate the Native Americans will subside. Although Clicktivism significantly changed Indigenous struggles over land and resources through protest and activism it is not responsible for introducing new concepts of the self and identity. The first true Native American nationalist movement was led by American Indian Movement in the 1960s and struck a different cord to the National Congress of American Indians. The first successful pan-Indian movement was the Society of American Indians (SAI) which stressed unity ignoring tribal affiliation as a factor causing division among Native Americans. Ironically this organization set up by and for Native Americans was in part caused by the education of Indian children in government run boarding schools to assimilate them. It had the reverse effect causing members of disparate tribes to become friends and allies and many of the leaders of the SAI came from these boarding schools. Indeed it is important to stress the point that in many tribes and in many reservations there is not a unified consensus regarding engagement with the United States or its culture. Many Native Americans are understandably worried about education, jobs, assimilation and healthcareShow MoreRelatedIndian Self Determination And Education Assistance Act Of 19751476 Words   |  6 PagesIndian Self-Determination and Education Assistance Act of 1975 The Self Determination era is defined as the revolution of perception, recognition, and assistance by the Federal Government towards the Tribal Community. This Era recognized that Native Americans ability to govern themselves and that the Federal Government should provide assistance through funding various programs such as education, reservation development, and cultural renewal(Castile 1998). 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The Harlem renaissance was a pivotal time for the recognition of black culture in the US, andRead MoreThe Fight For Civil Rights1061 Words   |  5 Pages The fight for civil rights was one of the most significant events of american history in the years of 1960. It was an era to struggle and to look forward for a better future. In that era American people witnessed the rise of the Red Power Movement. This movement was a way for Native American to get back some of their rights and pushing for more and more. There are two major aspects of the Red Power movement. The first one the political aspect which attempts to solve problems through the politicalRead MoreCommentary on Erez Manela’s The Wilsonian Moment 1081 Words   |  4 PagesErez Manela’s The Wilsonian Moment Self-Determination and the International Origins of Anticolonial Nationalism is a monograph that attempts to reconstruct the story of colonial world at the end of Wilsonian moment. 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The methods of decolonization employed by various racial groups affected by colonialism interact with one another in various waysRead MoreIndian Reorganization Act of 19341466 Words   |  6 Pagesor the IRA, had a major impact on the everyday lives of Native American Tribes that were scattered across the United states. The Indian Reorganization Act provided the means and tools for tribes to form their own governments and constitutions. The IRA stopped the general allotment act that was put into effect by the Dawes of 1887. The Indian Reorganization Act granted the Secretary of Interior a tremendous amount of power over Native American affairs ranging from land, livestock, employment, government

Are Ceos Overpaid Essay Example For Students

Are Ceos Overpaid? Essay â€Å"The answer to the question of whether American CEOs are overpaid is clearly yes; for those who earn large bonuses and generous stock options when their companies are doing badly, either absolutely or relative to competitors. As mentioned in an article written by Gary Beckner and Richard Posner. This research paper will discuss in details the facts that have been research as to why CEOs are being overpaid. It will discuss the pros and cons of the CEOs salary and compensation and how employees should share part of the profits accordingly. In the business world of today, ones pay should reflect the amount of work he or she has done. This rule should apply to all individuals in the workforce including CEOs. However, it is well recognized that there have been doubts on whether some high placed CEOs are being overpaid. A Chief Executive Officer is not supposed to obtain an unusually high salary if his or her company were to file for bankruptcy. According to an online article written by Michael Winter, the Financial Times newspaper stated that CEOs themselves claim that they are being overpaid. He also states that, The issue is particularly sensitive because the gap between rich and poor in America has reached its widest point in more than 60 years. These results came from a survey that was conducted on the major U. S. business leaders. There has to be a boundary because it is morally and financially incorrect for any corporation or company to continue to operate in such a fashion. These unfair procedures sometimes lead to economic instability or employee strikes. Top CEOs are partly responsible for the welfare of the nations economy. If these CEOs lead their companies to financial distress, then their shareholders will have to suffer due to the loss of money they have invested. According to F. John Reh ( a writer on About. com), In the 1980s CEOs of large companies made about 42 times what the average employee would make in an hour. He also states that in the year 2000 their salaries escalated to a startling 531 times what the average employee made hourly. It is quite reasonable to suppose that CEOs would understand the value of the Dollar considering the fact that they might have had to work their way up to their current position in the company. It is sad to see our financial leaders reaping the benefits of other peoples hard work. The world population is dramatically increasing and so is the value of money. It is essential for companies to start realizing that corporate competition is intensifying and that everyone should work for every dollar they make. Economic equality has to be established for the benefit of the society as a whole. Many CEOs do not earn their money. Some CEOs believe that the value of their company is due to their own talent, and that they should not be appreciated. Down through the years, executives have tried to use the financial success of their company as the base of their compensation. The CEOs compensation package has nothing to do with his/her future performance and the CEO may not make that much of a difference on whether the company is a success or failure. At this point in time, many companies are facing bankruptcy and other companies are losing thousands of dollars on a daily basis. With this said, it is not fair for CEOs to get paid what they use to when the company was standing strong and wealthy. Unless the CEO is actually taking actions to thrive the company to success, they should not receive a large salary. The companies profit should be divided and contribute to the CEOs and/or employees who are help, care and give a lot the company. REFERENCE: 1. ) Winter, Michael. CEOs Say Theyre Overpaid (Seriously), October 15, 2007, Retrieved on April 7, 2008 from http://www. huffingtonpost. com/2007/10/15/ceos-say-theyre-overpaid_n_68573. html 2. ) Reh, F. John. CEOs Are Overpaid, 2008, retrieved on April 6 2008 from http://management. about. com/cs/generalmanagement/a/CEOsOverpaid. htm 1. Cote, Marcel Nov 2007 CA Magizine Vol. 140 Issue 9, p80-80, 1p-Retrieved on March 21, 2008 from http://search. ebscohost. com/login. aspx? direct=true=bah=27434188=ehost-live 3. ) Tobak, Steve. September 12, 2007, â€Å"Are technology CEOs overpaid? † Retrieved on March 26, 2008 from http://www. news. com/8301-10784_3-9776770-7. html 4. ) Brush, Michael (2008). While pensions fall short, CE Os fly high. Retrieved March 27, 2008 from http://moneycentral. msn. com/content/P119362. asp 5. ) Bush, M. : The 5 most outrageously overpaid CEOs. Retrieved on March 25, 2008 from Moneycentral. msn. com

Witchcraft In Hollywood Essays (1886 words) - Religion, Culture

Witchcraft In Hollywood Hollywood provides falsified information It is said by many that Hollywood is persuasive. People see something on television or in a motion picture and believe that what is shown is, in reality, true. Misconceptions will occur, and unless people are shown evidence against the delusions, it will be taken as fact. In the past, many groups have been poorly represented onscreen. Organizations such as the Mafia, the government, the military, spies, gods, monsters, and others are just a small example of those prejudiced. Since the misconceptions have occurred, much of the truth has come through for those mentioned. However, one topic that is repeatedly misrepresented in Hollywood is the practice of the Craft, more commonly known as witchcraft or Wicca according to Jeffrey Mann (personal communication, April 14, 1999). Witchcraft has been shown onscreen as evil, black magick, rather than a faith, and most people see spells cast by wiggling the nose or pointing a finger to be valid of the ?witchcraft fable' (1997, Bewitched online) . Is witchcraft a true, spiritual religion, and if so, are people willing to tolerate it? Many are uninformed of the religious aspect of the Craft, and those that are, believe it to be false or wrong according to Jeffrey Mann (personal communication, April 14, 1999). In today's society, religious tolerance of different groups of people or cultures is extremely important. By understanding and accepting the differences of real versus imaginary using witchcraft as the prime example, people will be able to see these groups as part of actual society and not just a fictitious, magickal portrayal in entertainment such as Bewitched, Charmed, Sabrina the Teenage Witch, and The Craft. Hollywood's portrayal of witchcraft in movies and shows is invalid. Now on reruns, the television show, Bewitched, was once very popular. Samantha and Tabitha are shown casting spells nearly every other minute of the half-hour (1997, Bewitched online). The show brought forth a revival of the knowledge of witchcraft. In history, before Christianity, Paganism was a primary religion in Europe. Witchcraft is a form of Paganism, just as Wicca, Shamanism, and others are. When the Christian religion was being formed, many Pagan beliefs were still used (1998, A witches overview of Wicca online). The Pagan tradition of Yule, the winter solstice holiday, was to bring a live tree into the house and decorate it with food, balls, and a star on top to protect the household from the evil spirits (Adler, 1997). In the past century, a man named Gerald Gardener came forth with his ancestor's religious practice that has been passed down generation after generation called Paganism. He began bringing forth the Wiccan movement to modern witches according to Jeffrey Mann ( personal communication, April 14, 1999). Bewitched was made in the midst of the sort of ?coming out' of all that was practiced. Romanticizing witchcraft started with Bewitched, and from then on, a new fetish of shows and movies had begun. The Warner Brothers Network recently aired a new hour-long show featuring three sisters who have just discovered their witchy powers (see attached graphic one of Charmed sisters). They are referred to as the ?Charmed Ones', which are the most powerful of a long line of good witches. Their mission is to protect the innocent against all evil (1999, Charmed online). The show features many distinct realities of witchcraft. The show refers to the Book of Shadows, which is a book of memoirs, spells, thoughts, and goals, which must be handwritten and personal to that witch (1998, A witches overview of Wicca). The three sisters use this book for casting spells against evil, which is the basis for entertainment on the show. Freezing time, traveling to the past or future, and evaporating monsters are just some of the sisters' outlandish powers (1999, Charmed online). Religion has no part in the hour that the sisters are fighting the darkness. Witchcraft, in reality, has no ?natural' witches as implied in Charmed. Having ?power' is a belief that comes from within your soul, not from genetics (Valiente, 1998). The power of spells to witches is like the power of prayers to Christians. If Charmed was based on three Christian sisters, the show would be primarily about how they pray