Monday, January 20, 2020
Essay --
Ever since our minds were old enough to comprehend three syllable words, we've been told to be original. Originality by definition means the ability to think independently or creatively. Such a simple task it seems but so many of us find it extremely difficult to fulfill. Staying true to yourself and embracing your individuality isn't a task or concept all will grasp. To be yourself means to embrace and acknowledge that no one else in this universe is just like you and that conforming to their standards will have to take a backseat to your happiness. Only the strong minded can do this and this revelation won't take a day or even a year, but it will embark you on a lifelong journey. "To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment" Ralph Waldo Emerson. We live in a world where society tells you to be yourself and then judges you. We love in a constant fear of being judged or called a weirdo. Though the barons that hold us to this conformity are strong, many manage to break through. No other person in this universe is exactly like you. Everyone has a different quality to bring to the table and that is what makes out world such a diverse place. Embracing your assets to society and not trying to imitate someone else will not only change your outlook on certain situations but on your life as a whole. The phrase only the strong will survive applies to all aspects of life, including individuality. To be able to stand up for who you are and not let the opinions of the world faze you takes a strong mind and a strong spirit. Having a true sense of self is a life long journey and some people reach it more quickly than others. Some reach this place of nirvana while still in thei... ...ted. There are many countries that frown upon standing out to the extent of the Americans. In some Middle Eastern cultures, women are required to cover their bodies from head to toe. They dress in dark clothing so that little attention is drawn to them, if any at all. Differing from the Middle Eastern culture, American people often dress to the extreme; showing them off as if the world is always watching them. Although one covers their body with a black hijab and another prances around in a rainbow dress, the one covered is not any less of an individual as the one standing out physically. In conclusion, we as a society have to realize that individuality goes much deeper than material things and that it is okay to be different. Conforming to what society feels you should do will not only be detrimental to our growth as humans but as a world community as well.
Sunday, January 12, 2020
The Middle Age
The Middle Age has been portrayed as a tumultuous period that started from the fall of Rome in 476 AD to the beginnings of the Protestant Reformation in 1517.à In spite of all the negative depictions of the period, the two most important contributions of this period are: (1) the rise of independent nations out of the fragmentation of the former Roman Empire; and (2) the rise of urban towns which eventually became centers of trade and sustained economic activity in Europe. Morris Bishop, in the book The Middle Ages, describes this period of European history both as ââ¬Å"a continuation and a formation.â⬠It is a continuation in the sense that it continued the Roman legacy and civilizations, assimilating the ââ¬Å"barbaricâ⬠civilizations along the way (Bishop, p. 7). But more importantly, this is a formation, according to Bishop, because out of this period emerged the modern Europe of our times. Out of the ashes of the former ââ¬Å"grandeur that was Romeâ⬠arose independent nations with a common language and tradition. The Carolingian Empire founded by Charlemagne in 800 AD was subdivided into different geographical patches because of inheritance over his grandsons and great grandsons. These geo-political subdivisions of Europe eventually defined the boundaries of modern Europe as we now know it. It gave birth to the independent nations of France, England, and the Italian city-states. Moreover, it was during the Middle Age that the masses of the different regions of the former empire developed their vernaculars (from Latin vernaculus, ââ¬Å"out of oneââ¬â¢s houseâ⬠) that eventually became the modern languages. During the height of the Roman Empire, Latin was used as the language of nobility, politics and church. In medieval times, the Christianized ââ¬Å"barbaricâ⬠tribes gradually developed their own version of Latin. The geo-political subdivisions mentioned earlier hastened the rise of these vernaculars that would later develop into independent languages of Italian, French, Spanish and Portuguese. With common political background and language, the independent kingdoms arose. The Crusades also helped strengthen these newly-created kingdoms by weakening the hold of the nobility and ending the feudal system, thus making the nobles swear allegiance to the king. Indeed, much of Europeââ¬â¢s boundaries, geographically and politically, were in essence created during the Middle Age. Economic activity during the early Middle Age was almost halted by the constant wars that plagued the boundaries of the former empire. Transferring goods from one location to another proved dangerous, and with the rise of Muslim armies controlling east of the Mediterranean, trading between the eastern and western regions of the empire declined. The latter part of the Medieval Period, however, was characterized as a period of relative peace, and even though there were political instabilities, especially within the crumbling Byzantine Empire, trading flourished within commercial districts and towns. The medieval towns laid the foundations of trading that now characterize modern economy. The system of economy shifted from the land-based feudalism to that of money-based mercantilism. Merchants emerged, and they engaged in banking, which financed economic activity. Even kings and nobles borrow money from the merchant class, and they were regarded as an important component of the society. With the rise of the merchant class, the material growth led to the fostering of the arts and literature, as these merchants became patrons of the arts and supporters of artists. Citizens engaging in the businesses or the trades established guilds to promote mutual aid and protection, the forerunners of present-day labor unions. Even the land laborers, who were then very much oppressed, were empowered during this period, as described by Barbara Rosenwein: ââ¬Å"Peasants, like town citizens, gained a new sense of identity and solidarity as they bargained with a lord keen to increase his income at their expenseâ⬠(Rosenwein, p. 224). In summary, the Middle Age created a strong and materially progressive Europe. The independent nations of modern-day Europe owes much to the events that occurred during the period between 500 and 1500 AD.à The Middle Age also created an atmosphere of active trading and economic activity, which in turn caused proliferation of the arts and culture. Bishop, Morris. The Middle Ages. Houghton Mifflin Books, 2001. Rosenwein, Barbara. A Short History of the Middle Ages. Broadway Press, 2004.
Saturday, January 4, 2020
Cause and Effect of Corruption - 1644 Words
There is a growing worldwide concern over corruption at the present time. Several factors are responsible for this. A consensus has now been reached that corruption is universal. It exists in all countries, both developed and developing, in the public and private sectors, as well as in non-profit and charitable organizations. Allegations and charges of corruption now play a more central role in politics than at any other time. Governments have fallen, careers of world renowned public figures ruined, and reputations of well-respected organizations and business firms badly tarnished on account of it. The international mass media feeds on it and scandals and improper conduct, especially of those in high places. The rising trend in the use ofâ⬠¦show more contentâ⬠¦Thus, price controls, subsidies and the corruption and black markets they generate, can lead to undesirable social and economic consequences. This also illustrates the point that dismantling controls, getting rid of sub sidies and preventing price distortions form a key element in economic reforms and for the establishment of a properly functioning market economy. Unfortunately, corruption places severe constraints on a countryââ¬â¢s capacity to undertake economic reforms. The rich and the powerful, the main gainers of a corrupt system, will therefore oppose reforms. The leadership in a country has a key role to play in combating corruption. It is an Asian tradition to hold leaders and those in authority in high regard and esteem. Hence the top leadership must set a good example with respect to honesty, integrity and capacity for hard work. Since fighting corruption will involve taking difficult decisions, the leadership must also display firmness, political will and commitment to carry out the required reforms. Honest and dedicated leaders are an essential, but not a sufficient, condition to counter corruption. Several other conditions are needed as well. Credibility is one of them. For success, the offenders both on the demand and supply side of a corrupt deal must be convinced that the government is serious about fighting corruption. Publicly try and punish some well-known corruptShow MoreRelatedEffect Of Noble Cause Corruption Essay1159 Words à |à 5 PagesImpact of Noble-Cause Corruption Ethical decision making will have the propensity to suffer with positive results garnered by acts of noble cause corruption. Getting a sense of accomplishment through corrupt means will make an individual more likely to take shortcuts during future events. Law enforcement professionals will be more likely to go to greater extents to get the bad guy off the street. This can be dangerous to all individuals involved. It can leave the officer open to administrativeRead MoreThe Law Enforcement System And The Criminal Justice System Essay1657 Words à |à 7 Pagesconduct follow up investigations if needed.â⬠In addition, in this essay I will be discussing about, the cause and effect of how the law enforcement system relates to unethical behavior, to police subcultures, and finally, corruption prevention programs. First of allUnethical behavior relates to the Law enforcement system, since according to Martin ( 2011), he states that Research into police corruption offers some understanding of the phenomenon in the hope of rooting out this behavior that serves toRead MoreCorruption Is A Universal One1431 Words à |à 6 PagesThe problem with corruption is a universal one, but this challenge is particularly egregious in new and developing democracies. Brazilââ¬â¢s troubles with corruption stem from far before democratization in the 1980s. From the military takeover and the rule of the bureaucratic authoritarian regime to the present day, this nation has struggled with nepotism, clientism, and favoritism as well as a slew of other corrupt practices. The state, federal, and municipal levels of government have all been plaguedRead MoreCorruption And Its Effects On Society1551 Words à |à 7 PagesCorruption is globally regarded to be one of the most immoral and ethically wrong practices in the political realm. There is a reason as to why corruption has such a strong negative connotation associated with it, as impacts caused by its direct and indirect effects on society cause massive consequences. The very nature of corruption undermines almost all processes and goals set fourth by a liberal democracy, while causing high distrust and low public approval between officials and citizens. TheRead MoreAdministrative Corruption Is Now A Buzzword For The Current Era Essay1360 Words à |à 6 PagesAdministrative corruption is now a buzzword for the current era. It differs from country to country as itââ¬â¢s effects are varying on the basis of socioà economic and political structure and the proportion of a nationââ¬â¢s growth. It makes a public or, private organisation untrustworthy and increase nullification negligence and in society. Corruption has been the problem belonging ever since from the human civilisation.Corruption is not a new phenomenon Bangladesh. It got heavily engaged with the administrativeRead MoreCorruption And Corruption Of The Public Sector1530 Words à |à 7 PagesBribery and corruption in the public sector, is endemic and unavoidable in all societies 1 The supportive reasons of unavoidable bribery and corruption Bribery and corruption in the public sector have been investigated by government for many years, while such hidden bribery and corruption are the behaviour that members working in the public sector indiscriminately take actions. Bribery and corruption are due to membersââ¬â¢ heart swell and unsound personality so as to break the public welfare natureRead MoreImplementation of Good Governance in Pakistan1095 Words à |à 5 PagesStrategic vision STATE OF GOVERNANCE IN PAKISTAN 1. Institutional Imbalance 2. Poor relations between center and federating units 3. Political Instability 4. Poor planning and development 5. Inability to provide justice 6. Increasing rate of Corruption 7. Inefficient Economic Management 8. Expenditure Mismanagement 9. Poverty 10. Unemployment 11. Illiteracy 12. Lack of control over law and order situation 13. National Sovereignty of Pakistan is being affected 14. Terrorism 15. StrongRead MoreCorruption1154 Words à |à 5 PagesEffects of Corruption in Multinational Corporationââ¬â¢s [Student name] [Professorââ¬â¢s name] [Course title] [Date] Introduction Corruption can be defined as a spiritual or moral deviation from an ideal. Corruption come in different styles and that include bribery and funds embezzlement. Corruption has been the number one menace in many countries of the world. It impacts countries in many ways, impacting economy and development in a negative way. Corruption tends to raise the cost of governmentRead MoreHow Corruption Has Proven Detrimental Effect On Business And Economic Growth1534 Words à |à 7 Pagesand Ross (Corruption entrepreneurship) study, the effects of corruption on the number of establishments in any given municipality have proven to be negative and statistically significant. Over time, corruption has proven to be detrimental to business and economic growth and has long lasting negative effects (entrepernerushipbrazilmuncipalities, 69). Business growth slows or stops all together and only the state owned enterprises are able to persist through an economy riddled with corruption. These stateRead MorePoor Leadership And Internal Conflicts Essay1270 Words à |à 6 Pagessome do not care what happens to them either. Internal conflicts cause poverty because the wars that start put workers out of business, and those workers cannot get work anywhere else so they are soon in poverty. Poverty can also cause conflicts within country. If people are upset with the government and tired of how they have been treated, they will go and cause problems for the government. When the government stop corruption and lets the people know they are spending taxpayerââ¬â¢s money on resourceful
Friday, December 27, 2019
Case Study Legal And Ethical Issues - 1987 Words
Solyndra: Legal and Ethical Issues Barbara Zimmerman BUSN311-D003 American Military University Professor Teresa Knox Solyndra: Legal and Ethical Issues Dr. Chris Gronet founded the Solyndra Solar Company in 2004. Gronet is prominent in the Silicone Valley for being a technological genius, celebrated for his innovations in alternative energy (Weiner, 2012). Less than a year later Solyndra was solicited by the United States Department of Energy, who was very interested in investing in the ââ¬Å"cleanâ⬠alternative energy that Solyndra promised, and the business soared. Solyndraââ¬â¢s practices made headway and even caught the attention of President Obama. But by 2011 Solyndra had declared bankruptcy and became the core of one of Americaââ¬â¢s largest business scandals. Throughout this paper I will discuss the legal and ethical issues surrounding Solyndraââ¬â¢s business practices and offer examples as to how the philosophy of Milton Friedman may have influenced the companyââ¬â¢s executives. Dr. Chris Gronet was the epitome of a Silicon Valley high achiever. After receiving his decorate in semiconductor processing from Stanfordââ¬â¢s School of Engineering, Dr. Gronet founded a startup and jointly filed multiple patents in semiconductor manufacturing (Hull, 2011). Solyndra began as a thriving solar energy company, earning the company a $535 million loan guarantee from the Department of Energy within a year of its conception. It may have been the ferocious competition, the drop of siliconShow MoreRelatedEthical and Legal Issues at the Workplace: A Case Study1053 Words à |à 4 Pagesframe the ethical issue in this case. The first is whether private Internet surfing on company time is unethical, the second is whether surfing pornography specifically is an ethical issue. Surfing in general is strictly an ethical issue, depending on what the companys specific policy is. Surfing pornography is also a legal issue, as such activity could constitute a hostile work environment (as in Gallagher v. C.H. Robinson Worldwide). There are two key ethical issues at work in this case. One isRead MoreEthical Issue And The Ethical Dilemma882 Words à |à 4 Pagesweekââ¬â¢s assignment, we have been asked to identify an ethical issue presented in the Devise Products Unlimited (DPU) case study. First we will discuss the issue and the ethical dilemma it creates. Next we will look at possible recommendations for the DPU CEO to handle this issue. The Ethical Issue First, letââ¬â¢s start by looking at what the ethical issue that DPU is facing. The issue that I have chosen to focus on is issue two from the case study: DPU outsources some of the manufacturing of partsRead MoreEthical Dilemmas Of Health Care1224 Words à |à 5 PagesEthical Dilemmas in Health Care Nurses are constantly challenged by changes which occur in their practice environment and are under the influence of internal or external factors. Due to the increased complexity of the health system, nowadays nurses are faced with ethical and legal decisions and often come across dilemmas regarding patient care. From this perspective a good question to be raised would be whether or not nurses have the necessary background, knowledge and skills to make appropriateRead MoreNursing Code Of Ethics, Personal And Societal Values, And The Legal Aspects Of The Nursing1251 Words à |à 6 Pagespatient and their family. Every nurse, regardless of his or her specialty, encounters ethical challenges. However, public health nurses may face unique challenges in their distinct focus on the health of the population in addition to individuals (Haugh Mildon, 2005). In this research paper, I will consider two case studies from the perspective of the nursing code of ethics, personal and societal valu es, and the legal aspects and responsibilities of the nurse. The Nursing Code of Ethics According toRead MoreThe Noble Field Of Law1700 Words à |à 7 Pagesto guidelines governing how legal professionals are expected to behave. The history of those guidelines is actually quite interesting. If traced back as far as possible, the rules that govern moral and ethical expectations of lawyers, judges, and other legal professionals were derived from ethical theory articulated by some of the greatest minds of the nineteenth century. One such publication was David Hoffman s A Course of Legal Study (2d ed. 1836).1 Hoffmanââ¬â¢s study covers for distinct articlesRead MoreBusiness Ethics Of International Business : Culture, Consumers And Employees1152 Words à |à 5 Pages11, 2015 Response to Ethical Challenges in International Business: Culture, Consumers and Employees Introduction General business ethics applies in the case of international business. However, international business ethics poses a particularly different difficulty- from domestic business- as a result of the scope of diversity that managers have to deal with: cultural, economic and legal, etc. Although the contents of business ethics are to an extent informed by the legal framework (including lawsRead MoreEthical and Legal Issues in Nursing956 Words à |à 4 PagesETHICAL AND LEGAL ISSUES OF Nursing Many confusing factors make it a task to establish, monitor and sustain ethical and legal issues in nursing. Everyone has various personal views based on experiences of life, religion, education and political affiliations, all nurses should be aware about nursing laws and ethics and understand how nursing legal issues can affect them. The American Nurses Association (ANA) Code of Ethics is very influential to nurses because it is used as a framework for makingRead More: Critically Evaluate Corporate Social Responsibility as an Ethical Tool Basing Some of Your Argument on the Toyota Case Study1711 Words à |à 7 Pagesencourage enterprises to be involved in social issues such as community improvement, improving underdeveloped working conditions and so on that are outside walls of the enterprise. Aleix Ferrer Duch (2009) views Corporate Social Responsibility (CSR) as a continuous commitment by businesses to behave ethically and contribute to economic development while improving the quality of life of society at large. It is about enterprises deciding to go beyond minimum legal requirements and obligations stemming fromRead MoreThe Issues Of Gene Technology867 Words à |à 4 PagesIssues of gene technology include inappropriate applications, religious issues, and what gives us the right to use such technology. The problems on society include disagreements among different groups of people based on views and opinions. There can economic problems when dealing with genetically modified foods. Legislation mainly focuses on HIPAA and the Genetic Information Nondiscrimination Act (GINA). They protect information and prohibit genetic discrimination in health insurance and employmentRead MoreBus309 Assignment Essay1012 Words à |à 5 PagesCompanies Are Viewed as Equal Due Week 4 and worth 175 points In the land of free trade, the public does not view all industries as equal. Do you believe that is ethical? Do you believe that some industries are unfairly targeted? Should it be consumersââ¬â¢ choice to partake in products that are not healthy for them, or do those companies have an ethical obligation to protect people? In this assignment, you will choose one (1) industry to write about. Possible industries to research could be tobacco, soda,
Thursday, December 19, 2019
Analysis Of Acute Care Hospitals - 712 Words
Baylor Scott and White Mckinney is the primary hospital I selected for this assignment being compared with Texas Health Prysbeterian Hospital Allen. I chose these two acute care hospitals not only for their geographical location but moreso on the similarities of services they catered to the locals. My focus is on the structural and process of care measures under the category of Patient Experiences specifically on the survey question, ââ¬Å"Patients who reported that they Always received help as soon as they wanted. According to reports from Hospital Compare Baylor got 67% compared to Texas Health which got 75% with a state average of 70% and national average of 69%. The data is gathered through a survey called Hospital Consumer Assessmentâ⬠¦show more contentâ⬠¦I find this very interesting because time is very important especially for stroke. Though there is another category for stroke care but some patients canââ¬â¢t express their complaints and requires more time to share it to the healthcare provider. Baylor HCP sees patients in 7 minutes while Texas Health is 22 minutes compared to 19.5 minutes for state average and 23 minutes for national average. The dimension focuses on timeliness. Per data, Baylor is doing good so far and Texas Health may need to review where they could improve on this data. This data of structural measure are reported under the Hospital Inpatient Quality Reporting(IQR) and Outpatient Quality Reporting OQR) programs. Patient overflowing in emergency department is a national crisis. So strategies are on the rise as being influenced by lean healthcare focusing on flow orientation, reduction in unnecessary work elements through clinical pathways, continuous quality improvement initiatives and teamwork (Oredsson, S. et al., 2011). The last measure I want to look on from Home Compare report is the outcome measure particularly the complications related to healthcare-associated infections. Outcome measures data is also a good indicator that shows how the organization is performing with regards to national benchmark. Baylor and Texas health both has no available data with regards to central line - associated bloodstream infection (CLABSI) in ICU and select wards. This kind ofShow MoreRelatedHealth Services Research And Evaluation Methods1184 Words à |à 5 Pages HA 8700: Health Services Research and Evaluation Methods Name: Kimberly Wu Assignment: Paper 1 Date: 10/6/14 Executive Summary Through statistical analysis, there were ten AHRQ inpatient quality indicators that are statistically different from that of the reference population. To determine which ones were significant, the reference population was compared to the risk-adjusted confidence interval. Those whose reference population was outside the risk-adjusted confidence intervalRead MoreLiterature Search992 Words à |à 4 Pages(2009). Patient falls: acute care nurses experiences. Journal of Clinical Nursing, 18(3), 357-365. doi:10.1111/j.1365-2702.2007.02260.x. Retrieved from EBSCOhost on August 20, 2012. Abstract This study describes an acute care nursesââ¬â¢ experiences with patient falls in hospital settings. Patient falls have became a major public health concern in hospitals, thus safety is theRead MoreAn Explanatory Quantitative Methodology Utilizing A Multisite, Cluster Randomized Control Trial ( Rct )1539 Words à |à 7 Pagesrandomization of subjects (Langford Young, 2013). RCTs allow for the generating of groups that are relatively comparable thereby reducing the potential for confounding by extraneous variables (Pourhoseingholi, Baghestani, Vahedi, 2012). Acute care hospitals will be randomly assigned to utilize the daily soap and water bathing protocol (control) or the CHG impregnated washcloths (intervention) on all admitted patients to the medical-surgical unit for a six month study period. The prediction forRead MoreEvaluation Of A Research Design1601 Words à |à 7 Pagestransplant Surgery and Patient Care Summary: Facial transplantation has potential to greatly improve the functional health and quality of life of persons with severe facial disfigurement, but the procedure raises ethical, psychological, and clinical challenges. Furthermore, uncertainty regarding patient outcomes after technologically advanced interventions has been associated with an intensification of ethical and moral dilemmas for caregivers in acute care settings. Health care team members involved inRead MoreThe Problem Of Population Health933 Words à |à 4 Pagesaddress disparities in care (Darves, 2015). The stratification measures allow the provider to track trends and improve the health of patients. This process often requires population health councils, leaders, providers and employees and breaking away from hospital or practice centric and focusing on the patient (Darves, 2015). The change will require special handling with a physician leader and a non aggressive management (Darves, 2015). Develop care continuu m models in the hospital and community systemRead MoreA Description And Defense Of The Change1346 Words à |à 6 Pagesin policy, procedure or program Description: Detailed Process mapping for coordination of care Developing strategies to achieve ideal transition in care can be described as better ââ¬Å"discharge planning, complete communication of information, availability, timeliness, clarity and organization of information, medication safety, educating patients to promote self-management, advance care planning, coordinating care among team members, monitoring and managing symptoms after discharge and follow upâ⬠(KripalaniRead MorePreventing Patient Falls : Evidence Based Practice Applied Nursing Research759 Words à |à 4 PagesMissed Nursing Care, Staffing, and Patient Falls. Journal of Nursing Care Quality: January/March 2012 - Volume 27 - Issue 1 - p 6ââ¬â12 doi: 10.1097/NCQ.0b013e318225aa23. A2. Background and Introduction Patient falls in hospitals continue to be a major and costly problem. The definition of a patient fall is an unplanned descent to the floor, assisted or unassisted, with or without injury to the patient. The authors of this article wanted to investigate the effect ââ¬Å"missed nursing careâ⬠has on patientRead MoreA Presentation Of A Strategic Analysis Of Hospital At Home Program Of Presbyterian Healthcare Services1595 Words à |à 7 PagesThe paper is a presentation of a strategic analysis of hospital at home program of Presbyterian Healthcare Services in New Mexico, which seeks to improve care quality and patient satisfaction while reducing costs. The analysis identifies the key issues, conducts a situational analysis, presents strategy formulation, offers recommendations, designs the implementation of strategies, and concludes with benchmarks for success which utilize contingency plans. It is outlined how Presbyterian HealthcareRead MoreUnderstanding The Patient Discharge Instructions Essay1589 Words à |à 7 Pagesinstructions genre emphasizing that care does not stop at discharge, but follows a patient home. Although multiple health care settings utilize patient discharge instructions, the focus of this analysis is instructions provided to cardiovascular patients before discharging them home from a hospital setting. The main goal of the patient discharge instructions genre is to assist patients in reaching optimal health and wellbeing. Research identifies the period following hospital discharge as a vulnerable timeRead MoreMontefiore Medical Center Case Analsisy1308 Words à |à 6 Pagestype of an organization. Brief summary of Montefiore Medical Center: * MMC started off in 1884 as a home for the chronically ill that other hospitals couldnââ¬â¢t help, dedicated in honor of Sir Moses Montefiore. * In 1963, Montefiore agreed to operate the patient care facility of the Hospital of the Albert Einstein College of Medicine. Both hospitals remained as distinct entities with separate administrations for the next 13 years. * By 1986, Montefiore was under severe management and financial
Tuesday, December 10, 2019
Antifungals Drugs
Questions: Case Study Assignment: AntifungalsNaomi Unger, age 27, has recently returned from South America, where she was working as a Peace Corps volunteer. She complains of fatigue, cough, and a high unrelenting temperature for the past 5 days. She is diagnosed with aspergillosis pneumonia and is hospitalized. She is prescribed IV amphotericin B. She uses condoms as her birth control method and has not had sex for 5 months. Her menstrual periods are regular but she reports heavy blood loss. Data obtained from the nursing assessment include the following: Vital signs: temperature, 103.1F; pulse, 120; respiration, 28; blood pressure, 100/70 Weight: 110 pounds CBC: WBC, 18.3; RBC, 3.2; Hgb, 10 g/dL; Hct, 35% UA: Within normal limits Chemistry: sodium: 136 mEq/L; potassium: 4.0 mEq/L; chloride: 100 mEq/L; glucose: 100 mg/dL; BUN: 20 mg/dL; creatinine: 1.2 mg/dL; ALT 40; AST 36 ABGs: pH, 7.45; PCO2, 30; HCO3, 29; O2 Sat, 94% Chest x-ray: infiltrates to left upper and lower lobes Bronchial washing: positive for aspergillosisThe patient is currently on ferrous sulfate, 325 mg PO qd. Prescribed medication includes amphotericin B, intravenous, 250 mg/h over 2 hours.Case Study Questions1. Provide the rationale for why Ms, Unger is prescribed amphotericin B.2. What contraindications or precautions would eliminate the use of amphotericin B for Ms. Unger?3. What other drugs could be considered for the treatment of Ms. Ungers infection?4. What patient variables are most important to consider for Ms. Unger when assessing her drug therapy? 5. What aspects of core drug knowledge (pharmacotherapeutics, pharmacokinetics, and pharmacodynamics) are especially relevant to consider because they may interact with the patient variables? 6. Which of the findings from the nursing assessment demonstrate the effectiveness of drug therapy with amphotericin B? 7. Which of the findings from the nursing assessment demonstrate possible adverse effects from amphotericin B?8. What nursing actions are indi cated to maximize therapeutic effects? 9. What nursing actions are indicated to minimize adverse effects? 10. What teaching is required for Ms. Unger regarding her drug therapy? Include list of any additional data needed to determine appropriate teaching. Answers: 1. Ms. Unger is prescribed amphotericin B, because it shows high order of activity against different species of fungi. In this case study the patient is diagnosed with aspergillosis pneumonia, which is a fungal infection. Ms. Ungers bronchial washing results positive for aspergillosis. Amphotericin B binds with the substance ergosterol, which is a fungal cell wall membrane component. This medicines form leakage within the fungal cell membrane and that causes the fungal cell death. Hence it is recommended as a good antifungal agent. 2. The use of this drug would be eliminated if the patient is hypersensitive to Amphotericin B and if the patient is pregnant or a lactating mother or if the patient is suffering from renal impairment, severe pulmonary reactions or leukoencephalopathy. 3. The other drugs that could be considered for the treatment of Ms. Ungers infection include Voriconazole, Voriconazole in combination with Caspofungin, Itraconazole, Posaconazole. 4. Patient age, sex, race, medical or surgical comorbiditis, health status, lifestyle, habits, diet, inherited traits, culture, environment, pharmacogenomics, analgesic responses, pain perceptions and coping skills are the patient variables, which are most important to consider for Ms. Unger when assessing her drug therapy. These influence the effectiveness and safety of sophisticated and modern forms of the administration of analgesics or antimicrobial agents. 5. The aspects of core drug knowledge in terms of pharmacotherapeutics include: the required therapeutic effect of the drug; in terms of pharmacokinetics: the alterations, which take place to the drug while the substance is inside the human system and in terms of pharmacodynamics: the drug effects on the human system (Kee, Hayes McCuistion, 2012). 6. The nursing assessments which demonstrates the drug therapy effectiveness with amphotericin B includes cronchial washing positive for aspergillosis, infiltrates to left upper and lower lobes of the lungs, low red blood count which might represent pulmonary complication. 7. Possible adverse effects from amphotericin B may demonstrate numbness and tingling sensations in the fingers and toes. Prior to the initiation of the drug administration, the nursing professional should check for antiemetic drug and antipyretic drug. 8. The required nursing actions to increase the effectiveness of amphotericin B administration may include administration of amphotericin B intravenously under strict clinical surveillance by experienced personnel (Lilley, Savoca Lilley, 2011). Speedy intravenous infusion is associated with arrhythmias, hypokalemia, shock and hypotension; hence this medicine should be slowly administered. 9. The required nursing actions to diminish the adverse effects may include administration of an antiemetic and an antipyretic drug before starting the infusion, the nurse should also check for patient hypersensitivity particular for this drug, reduction of the recommended dosages and if the patient complains numbness and tingling sensation in her fingers and toes, the charged nurse should immediately stop the infusion. 10. The care professionals should make the patient understand when to start and to stop taking this drug. To determine appropriate patient teaching the care personnel can enquire the patient what has she understood regarding her therapy. The personnel can also provide her with a template that can include dos and donts, dosage timing and side effects of this dosage. References Kee, J., Hayes, E., McCuistion, L. (2012).Pharmacology. St. Louis, MO: Elsevier Saunders. Lilley, L., Savoca, D., Lilley, L. (2011).Pharmacology and the nursing process. Maryland Heights, MO: Mosby.
Tuesday, December 3, 2019
Skin Of A Lion By Ondaatje Essays - Michael Ondaatje,
Skin Of A Lion By Ondaatje "Let me now re-emphasise the extreme looseness of the structure of all objects" How Ondaatje makes use of "loosness" in the novel. In "In The Skin Of A Lion" by Michael Ondaatje, "the extreme looseness of the structure of all objects" is carried into the themes, characters and into the nature of the novel itself. Ondaatje uses a "looseness" in the style of the novel - post modernism, and "looseness of structure" in the way that people are able to stretch and expand their boundaries: transform or mask themselves into someone not typical of their social group. This novel was written in the late 1980s and is classified as a post-modern work. Essentially, "In The Skin Of A Lion" has many traits of a post-modern novel, it deals with chaos and order, has multi-layered interpretations, provokes an ambiguous and mixed reaction from the reader, and has varied approaches to the conventional storyline; beginning, exposition, and closure. There are liberties taken with the time structure of the narrative. The story itself is like a "mural, [the] falling together of accomplices." Ondaatje tells of ordinary people who's stories interlock and intersect, with many "fragments of human order". Ondaatje does not tell the stories loosely and scattered with no real purpose in mind, he employs recurring images and motifs, for e.g. moths and insects, feldspar. This is to provide continuity and relevance, and helps him to give a view on the untold history of Toronto. An emphasis is placed on the story that comes from different viewpoints and angles - the "chaos", and then structures it so that its order of history is "very faint, very human" as opposed to official histories. It takes every single word from the first page to the last, in order to make sense of the meanings, which "travel languorously like messages in a bottle". The novel's storyline is not linear, it slides from one character to the next, then slips and loses itself in the time that it created, "five years earlier, or ten years into the future..." The prologue only makes sense once the end is reached, and the bits in between all mingle and melt into one another until most of the completed narrative is achieved. In fact, it takes a few good readings to pick up the events and stitch them together to create order, and only then are the meanings apparent. "Meander if you want to get to town". Even when the book is finished, there is no distinct closure and finality of the narrative; the story itself is in the process of being told. "This is a story a young girl gathers in a car...", and in that same way, it tells of how that car trip started, so the tale backs up on itself. The novel constantly brings attention that it itself is a work of fiction. There are constant references to art, music, drama, film, photography, and literature, as well as devices used "You reach people through metaphor". It implies that it is a creation, "Only the best art can order the chaotic tumble of events.." and even "The first sentence of every novel should be...". Authors, painters, singers and actors all feature highly in a book about peoples' creation of their lives and history. Ondaatje's language in the novel borders on poetry. Imagery, figurative language and emotive words abound whenever he is being descriptive, or making a point. The second paragraph at the beginning of "Caravaggio", "by noon [...] onto the blue metal", has a certain rhythm in the words and sentences, "Taking an innocent step/He would fall through the air and die", "joined by a rope - one on each slope", that somewhat mirrors lines in poetry. Poetic devices are in the scene of the puppet-show. Similes "Machine locked in habit", economic use of words"exhausted statuary", and repetition "There. There. There" effectively convey a vivid image to the reader. There is not just flexibility in the structure of the novel and how it is written, it is also carried into themes. One of the issues deals with the looseness of boundaries, especially the boundaries of stereotype and class, "Gestures, and work and bloodline are the only currency". This attitude is one that Ondaatje aims to challenge in the novel. Boundaries could be physical, e.g. the bridge with the "lanterns tracing outlines". This kind is symbolical, the nun loses the boundaries and falls over into a new existence. She takes on a new character and her past life is obliterated, just by
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