Essay about Malcolm X vs Martin Luther King Jr - 1804 Words

In looking at how the actions of two of the Blount curriculum’s selected writers influenced historical change, progress, and thought I chose to focus on their respective views of race and race relations, in particular the Civil Rights Movement. I chose to write on the two diametrically opposed civil rights activists Dr. Martin Luther King Jr. and Malcolm X. In the 1960’s the African American community became increasingly active in the struggle for civil rights. Although the concept race is an arbitrary societal construct based on the color of an individual’s skin and his or her geographic origin, it has had a profound impact not only on the founding and formation of our country but also the development modern American society. King and†¦show more content†¦Following the non-violent principles of Gandhi, King ignited hope into the eyes of thousands of African Americans for equal rights. Early in his career he realized that non-violent protest was the most efficient way of achieving his goal. He stated that: I had come to see early that the Christian doctrine of love operating through the Gandhian method of non-violence was one of the most potent weapons available to the Negro in his struggle for freedom. In seeking to continue and expand the non-violent struggle against discrimination, King, along with other Black ministers, set up the Southern Christian Leadership Conference. As a result of his consistent commitment to nonviolence, black college students began to launch a series of sit-ins at lunch counters and public places where segregation was existent (King 39). The turning point in King’s career came in 1963 in Birmingham, Alabama. The SCLC launched a major demonstration to protest anti-Black attitudes in the South. Confrontations ensued between unarmed Black demonstrators and Birmingham police and firemen who used clubs, attack dogs, and fire hoses as a show of unnecessary force to quell the crowd. The publication of this demonstration and the incidents that ensued had profound effects across the country. It sparked protests across the country and prompted President John F. Kennedy to push for passage of new civil rights legislation. The Birmingham incident resulted inShow MoreRelatedMartin Luther King Jr. vs. Malcolm X997 Words   |  4 PagesMartin Luther King Jr. vs. Malcolm X Martin Luther King Jr. and Malcolm X both fought for the same goal, but had different ways of achieving this goal. They both fought against civil rights and were leaders in the civil rights movement. The way they were brought up is a good explanation for their differences; King was brought up in a wealthy family, while X was raised in the ghetto to a poor family. Both fought against unfair laws, Social Discrimination, and Racial segregation, but theyRead MoreMalcolm X vs. Martin Luther King Jr.1723 Words   |  7 Pagesthis momentous time in United States history. Speeches during this period served as a means to inspire and assemble a specific group of people, for Dr. Martin Luther King Jr. and Malcolm X it was the black community that needed to rise up in hopes of achieving equal rights and voting rights for the blacks. Dr. Martin Luther King Jr. and Malcolm X were two of the most prominent leaders and orators at the heart of the Civil Rights Movement. Although both leaders possessed the same objectives, theirRead MoreMalcolm X Vs. Martin Luther King Jr. Essay1717 Words   |  7 Pagesthis momentous time in United States history. Speeches during this period served as a means to inspire and assemble a specific group of people, for Dr. Martin Luther King Jr. and Malcolm X it was the black community that needed to rise up in hopes of achieving equal rights and voting rights for the blacks. Dr. Martin Luther King Jr. and Malcolm X were two of the most prominent leaders and orators at the heart of the Civil Rights Movement. Although both leaders possessed the same objectives, theirRead MoreMartin Luther King Jr. vs. Malcolm X1263 Words   |  6 Pages* Dr. Martin Luther King Jr. and Malcolm X are two people on different ends of the scales, with totally different up-bringings. * King was brought up by a rich black family,with a good education, and a good chance at life. He was a black aristocrat, and a wealthy man. * Malcolm X was brought up in the ghetto, and had to learn to defend himself against racist white children. He was deptived of his father, who was found dead, murdered by a white mob. His mother became mentally ill so he wasRead MoreThe Civil Rights Movement712 Words   |  3 Pagesthough the actions taken by Malcolm X were of good intentions, they ended up causing a ripple between African Americans. On the other hand Martin Luther King Jr. identified that if people were going to respond to hatred with more hatred then there will be little chances for change and substance which was never understood by Malcolm. He was, of course, powerful and strong as an Africa American commanding huge followers and believers, but things did not end well as Malcolm X dies in the hand of his ownRead MoreMartin Luther King vs. Malcolm X Essay825 Words   |  4 PagesTwo of the greatest know civil rights speakers in the United States was Martin Luther King Jr. and Malcolm x. Both of these men had two very different views on what they thought would be the best way for blacks to get equality. Martin Luther King Jr. believed in his main philosophy which was non violent resistance. Martin used the teachings from Ghandi to teach African Americans how to use non violent resistance as a way to earn equality. He also believed that blacks should try to find commonRead MoreEssay Philosophies and Tactics of Dr. King and Malcolm X1492 Words   |  6 Pagesminorities. Among them, Martin Luther King and Malcolm X had an everlasting effect on the treatment of minorities in the United States. Although their philosophies and tactics differed greatly, Dr. Martin Luther King Jr. and Malcolm X helped shape the Civil Rights Movement and make the United States a better place for people regardless of their race. Martin Luther King Jr. and Malcolm X had different beliefs and goals for the Civil Rights Movement. While Martin Luther King Jr. took a more peacefulRead MoreMartin Luther King Vs Malcolm X1436 Words   |  6 PagesSelene Sandoval Professor Solheim History 108 CRN # 20244 16 October 2016 Martin Luther King VS Malcolm X Ronald Regan once said: â€Å"Freedom is never more than one generation away from extinction. We didn t pass it to our children in the bloodstream. It must be fought for, protected, and handed on for them to do the same.† In fact, American history has had a great deal of leaders that brought change by improving the lives of others. These leaders introduced new ideas, models, and theories toRead MoreCivil War Movement : Martin Luther King Jr Malcolm X1212 Words   |  5 Pages Research paper History 11.21 December 23, 2014 Civil War Movement: Martin Luther King Jr/ Malcolm X Many years after blacks had received citizenship and the right to vote there was still much bias against them. Because of their skin color African Americans hadn’t been treated fairly and did not have the same rights as whites. In theRead MoreA Research on The Civil Rights Movement1448 Words   |  6 PagesMovement (Martin Luther King Jr. Vs Malcolm X) and will be focusing on two important icons that have an important part of African American History. I am going to further discuss in this research paper, â€Å"What were the views of Martin Luther King. Jr and Malcolm X during the Civil Rights movement? What were their goals and methods to achieve equality and peace?† Both leaders wanted to unite the black race with the white race and achieve equal rights. Martin Luther King. Jr and Malcolm X were both very

Philosophy - 2049 Words

There are three different parts of elements in one’s soul called: Reason, physical appetites and spirit due to the inner conflict. Each part of the soul is doing its own job. A man can have two different responses from his inner world when he has a conflict to decide. For example, a man was thirsty. He wants to drink some water because his appetite is telling him that he needs to quench. While his reason part will list out all the rational reasons for avoiding him from drinking, such as the water can make you sick. When the man’s desire was higher than reason then the sprite will appear to support with appetite (138). However there is another situation when the spirit will help reason out. â€Å"When the soul is divided into factions, it is†¦show more content†¦(3) In Chapter XXIII, how does Socrates use the sun to indicate what he thinks the Good is? According to Socrates â€Å"This, then, which gives to the objects of knowledge their truth and to him who k nows them his power of knowledge, is the Form of the essential nature of Goodness† (220). Therefore Socrates rejected the idea that knowledge is the essential nature of the Good. Because without knowing what the Good is, then, even a person has lots knowledge, it will all become useless. Thus, when Glaucon asked Socrates to define what the Good is, Socrates answer â€Å"It was the Sun†¦Good has created in the visible world, to stand there in the same relation to vision and visible things as that which the Good itself bears in the intelligible world to intelligence and to intelligible objects† (219). The sun has two main functions .Which is similar to the Good. Sun provided the light, enable people to see stuff. Although people have the eyes to see things; however, if they are walking in the dark, their site can unclear compare to the way they see thing during the daytime when there has sunlight, because sunlight gave people the power to see the color and illuminate the world in every little part for people to see all the beautifulShow MoreRelatedThe Philosophy Of Philosophy And Philosophy998 Words   |  4 PagesPhilosophy is the attempt at answering or understanding the questions that the being who is philosophizing yearns to know or wishes to understand. The importance of what the philosopher wishes to know or understand is not a determinate factor in what it means to do philosophy. The act of doing philosophy is not defined by the subject of examination but by the driving passion of knowing and understanding. This means that an individual that wishes to know why a laptop is a laptop or why is it thatRead MorePhilosophy : Philosophy And Philosophy1292 Words   |  6 Pages As a student at Richland college, I have never studied philosophy before, and I have heard very bizarre claims about what philosophy is. For that reason, I wanted to take a philosophy class so I can learn more about it. Due to lack of knowledge, I used to think philosophy as involving a kind of mystical significant, sometimes resulting from observing problems without solutions. In addition, sometimes I accustomed that philosophy is nothing more than a name that does nothing more than feelingsRead MorePhilosophy : Philosophy And Philosophy1035 Words   |  5 Pages As a student in Richland college, I have never studied philosophy before, and I have heard very bizarre claims about what philosophy is. For that reason, I wanted to take a philosophy class so I can learn more about it. Due to lack of knowledge, I used to think philosophy as involving a kind of mystical significant, sometimes resulting from observing problems without solutions. In addition, sometimes I accustomed that philosophy is nothing more than a name that does nothing more than feelings ofRead MoreThe Philosophy Of Philosophy And Philosophy1451 Words   |  6 Pages Philosophy is recognized by the questions being asked, and the methods used to answer them. These questions are usually the ones that are open-ended, abstract, or the ones that lead to controversial answers. Due to the openness in philosophy, the uncertainty, there is not just one viewpoint that is completely accepted by all to be true. This leads to many disputes and conversations that are ultimately driven by th e core of philosophy, which is its latin translation, the love of wisdom. Now, theRead MorePhilosophy And Philosophy Of Philosophy Essay2033 Words   |  9 PagesWhat is philosophy? Philosophy could be defined in many ways, but I believe that the Oxford dictionary defines it best: â€Å"The study of the theoretical basis of a particular branch of knowledge or experience or a theory or attitude that acts as a guiding principle for behaviour†. That definition basically encapsulates the entirety of what we have discussed during the time that we have been in this course. It covers the basic ideals of both eastern and western philosophy quite eloquently over the spanRead MoreThe Philosophy Of Philosophy1122 Words   |  5 Pagesof whether philosophy from hundreds of years ago, are still relevant to today and the society of which we live? The answer, simply put is yes. It is still relevant because we still do question everything, we still wonder about topics that were discussed b ack then, and because philosophy is the basis of critical thinking, a quality that is still useful today. We often ask questions, which in turn led us to the discovery of the discipline of philosophy. The primary reason for philosophy is to gainRead MorePhilosophy And Its Importance Of Philosophy861 Words   |  4 PagesPhilosophy and Its Importance Doing philosophy as many philosophers demonstrate over time and in the present is to simply question the understanding of what is known and not known or accepted and unaccepted. This is to say, that philosophers must question all aspects of life and all the surrounding dimensions of the world. In doing so, the philosopher is trying to grasp a firmer or different understanding of the truth that is either presently or not presently known; whether comforting or not comfortingRead MorePlato, Philosophy, And Philosophy929 Words   |  4 Pages â€Å"Plato is philosophy, and philosophy, Plato.† – Ralph Waldo Emerson. This was the first quote I read regarding Plato when I first picked up the Great Dialogues of Plato, and turned it over to read the back cover. This quote struck me for some unknown reason and I instantly couldn’t wait to begin reading the dialogues of Plato and begin to understand why he is regarded as one of the great philosophers. The first pi ece I read, was The Apology, spoken by the great philosopher Socrates and writtenRead MorePhilosophy And The Modern Philosophy2035 Words   |  9 PagesUpon talking about the history of modern philosophy, one of the most important philosophers, who is considered as the father of the philosophy in this period, is Descartes. He was a pioneer for the movement of the new trend of philosophy and became a break between the medieval philosophy and the modern philosophy. Being educated in the environment of medieval philosophy, specifically in the school of Jesuits, Descartes received the system of scholastic philosophy as his foundation for making a new startRead MorePhilosophy624 Words   |  3 PagesSurname Instructor Course Date Survey of Mexican Philosophical Thought The philosophy of the Mexicans is a production of philosophers from ancestries from Mexico, residing either within or outside the country. The general philosophy surfaced with the introduction of the first school by the Spanish conquerors, with teaching and publications on philosophical treaties. As such, it is critical to deny that these thinkers got education from the European schools, making it quite impossible

Nursing Standards Related to the Situation

Question: Identify nursing standards related to the situation. Answer: 1. Describe In the current therapeutic communication stimulation practice, Mrs. MacDonald was the focus. She came to the stimulation practice after she collapsed in her garden. I was an observer. I observed that she was not able to walk and came to the center by walking. The nurse, after introducing herself directly asked about her vital signs. However, the nurse did not ask about her current medication. After completion of her complains about the symptoms, she directly asked about her daily diet. Mrs. Macdonald addressed that she is not taking her meals properly. She skips her dinner and takes sandwich for lunch. She is not involved in any social activities. The nurse did not asked about the reasons as to why she did not eat well. In addition, the nurse did not give the proper results about her BP. She showed tachycardia and breathing shortness as her vital sign. Therefore, I have understood that the nurse who was appointed for her stimulation practice did not complete her job properly. Rather she provided wrong information about Mrs. Macdonalds vital signs. When she was asked about her weight, she did not realize that the nurse was talking about her malnutrition. So, the nurse did not played her required role properly. 2. Identifying nursing standards related to the situation The first nursing standard related to the situation is 2.2 communicates effectively and is respectful of a persons dignity, culture, values, beliefs and rights. It is related to the situation because the current practice is therapeutic communication stimulation, where the patient would be stimulated through effective communication. The next standard is 2.3 recognize that people are the experts in the experience of their life (Bamber Anderson, 2012). It is related to the situation because in this process the nurse asked about patients vital signs to identify her health status. The third standard is 4.2 uses a range of assessment techniques to systematically collect relevant and accurate information and data to inform practice. It is related to the situation because the stimulation practices involve assessment of patients physical and psychological status through different techniques (Bradbury et al., 2012). 3. Feelings The therapeutic communication stimulation practice helped me to recall some nursing standards. At the start of the therapeutic communication stimulation process, I started to think that the nurse would take enough time and would use sufficient assessment tools to identify the vital signs of the patient and would stimulate patients thought process about her physical and psychological status. I saw that the nurse started the conversation by introducing herself to Mrs. Macdonald. I felt quite surprised that why she did not asked her about her medication because it is important for the nurse to know patients current medication, as it helps to understand the actual reason behind patients status (Davies, 2012). Finally, which made me more surprised was that the nurse did not give the actual results of her BP. It could be an offensive act because based on the vital sign the action plan is made. Therefore, the session surprised me as to why the nurse did not followed nursing standards while working with a patient. In addition, observing the patients situation, I felt sad for her. I felt sad because I realized that the patient did not get adequate support and appropriate health reports which she was expecting. 4. Evaluation I thought that the nurse would go through an effective session. However, evaluating the nurses action towards the patient, I did not see that she had gone through an effective stimulation session. The nurse directly started the conversation by allowing the patient to complain about her symptoms including breathing shortness, tachycardia and tiredness. After completing this part, the nurse did not ask about her current medication. Next, she asked directly about her diet. She replied that she only takes tea at breakfast and sandwich at lunch. In spite of showing vital signs of cardiovascular symptoms she addressed that she loves ham and stays alone at home, thus is socially isolated. Moreover she even skips her dinner. After listening to these, the nurse did not ask why she skips meal. However, it was very important for the assessment. As an observer I would say that the nurse should be more focused towards patients dignity and should play her role with more in-depth pattern. She attempted to complete the session very briefly and quickly (Dossey et al., 2012). The worst part in the session which based on my evaluation was that, she provided incorrect results the patients health. She did not provide proper results about her BP. It can be a legal issue. Based on the reports, the physician would make her action plan. Therefore, with an incorrect result, the physician can make an inappropriate action plan that can affect her health negatively. 5. Conclusion According to the person centered care plan, the nurse should always focus upon the health benefits after analyzing the basic health needs of the patient, as opined by Hatlevik (2012) However, in this case scenario, the nurse did not assess the patients health needs through a proper assessment plan. The nurse can use some proper assessment techniques for understanding the patients basic health needs. Next, after introducing herself and seeking permission from the patient for their vital sign, the nurse did not attempted to establish a positive relationship with the patient which is the basic factor in the person centered care approach. From the viewpoint of Henderson et al., (2012) a positive relationship establishment can help to enhance her health benefits. Another factor which has been observed was that the nurse did not ask about her current medication, whereas it was a necessary action in regards to making an action plan for the patients health benefit. Therefore, the alternative approach should involve the awareness about her current medication. Another shortcoming of the nurse was that the nurse after addressing patients inappropriate diet, did not attempt to investigate the reason for her inappropriate diet and also she did not try to make the patient aware of her malnutritious status, which was evaluated according to Hilsdon (2012). Finally, she provided inappropriate health report to the patient which was not expected from a health worker. From the viewpoint of Howatson-Jones (2013), a person centered care, collection of cues and establishment of therapeutic communication were the correct processes for the patients health benefit. 6. Action Plan From the therapeutic communication stimulation session, I have learnt about the importance of following the nursing competency standards in health care settings and what negative consequences can happen due to the non-compliance of the nursing competency standards (Thompson Pascal, 2012). I have learnt that the implementation of person centered care would have a more positive impact upon then health and well being of the patient while dealing with the therapeutic communication stimulation. I have observed that the nurse, who attended Mrs. Macdonald, did not meet the nursing standards and showed disrespect towards the proper procedure of patients assessment and their communication process. I have understood that, for gaining a well established nursing career, I have to fulfill all the necessary standards and ethical considerations of nursing. I have understood that collecting cues about the patients health needs, focusing upon patients nutrition and advising the patient about healthy diet and its importance are necessary aspects of person centered care practices and therapeutic communication stimulation session (Gibbs Lowton, 2012). I have also understood that the nurse could do the session better by achieving all the standards and focusing more on patients needs. Therefore, the alternative management for the patient would be the person-centered approach implementation. In this condition, the nurse would be able to provide holistic care to the patient, while meeting all the health needs of the patient. In addition, through the alternative process, the exact health reports of the patient would be provided. Reference List Bamber, V., Anderson, S. (2012). Evaluating learning and teaching: institutional needs and individual practices.International Journal for Academic Development,17(1), 5-18. Bradbury, H., Frost, N., Kilminster, S., Zukas, M. (Eds.). (2012).Beyond reflective practice: New approaches to professional lifelong learning. Routledge. Davies, S. (2012). Embracing reflective practice.Education for Primary Care,23(1), 9-12. Dossey, B. M., Certificate, C. D. I. N. C., Keegan, L., Co-Director International Nurse Coach Association. (2012).Holistic nursing. Jones Bartlett Publishers. Gibbs, C. L., Lowton, K. (2012). The role of the clinical research nurse.Nursing Standard,26(27), 37-40. Hatlevik, I. K. R. (2012). The theory practice relationship: reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education.Journal of Advanced Nursing,68(4), 868-877. Henderson, A., Cooke, M., Creedy, D. K., Walker, R. (2012). Nursing students' perceptions of learning in practice environments: A review.Nurse Education Today,32(3), 299-302. Hilsdon, J. (2012). Rethinking reflection.The Journal of Practice Teaching and Learning,6(1), 57-70. Howatson-Jones, L. (2013).Reflective Practice in Nursing: SAGE Publications. Learning Matters. Thompson, N., Pascal, J. (2012). Developing critically reflective practice.Reflective practice,13(2), 311-325.

Urban Sprawl Essays (1226 words) - Human Geography, Urban Planning

Urban Sprawl Urban Sprawl Introduction I. Each morning, millions of Americans start their engines and grind their way to work. They leave quiet settings for the hustle and bustle of the cities. When evening approaches, these same people make their way home. Home, however, is no longer just across town. Many of these people will commute miles and miles to their *country= homes. II. They are not alone in their commute though - the entire rest of the subdivision is doing the exact same thing, day in and day out. They endure the traffic, lost time, and general inconvenience to be surrounded by farmland and open space and a hundred or so homes exactly identical to theirs. (Transition)Today I am going to discuss urban sprawl, its history, causes and effects. First lets discuss the history. III. Urban sprawl has always been a problem in a sense; however not until the automobile was sprawl a serious issue. With the arrival of the automobile, people could live farther a way from work and not have to live in the city. Up until then mostly farmers and ranchers lived outside the city. So the issue became a bigger issue with faster and better cars. Many people were now able to live the American Dream, rural life. A house of their own, out of town enough to be quiet, but never too far from civilization. a. But then something happens, the *open space= that they fell in love with is slowly devoured by housing, shopping malls, and believe it or not other people. b. The rolling fields that once marked their freedom are now browning and dotted with homes. This makes the *original= homeowner unhappy. They write editorials asking questions and demanding answers. Both silently and aloud they fume: how dare the farmer sell out his heritage, the land is more valuable as farmland, right?, how dare the developer exploit the land (don=t they care about our earth?), how dare the politician allow this activity (aren=t we paying them to represent us?), and how dare the home buyer have the audacity to move there. So sure are they in their quest for justice that they never stop to consider one simple fact: they once were newcomers too. And before them, the land was open space or farmland. The developer *exploited= the land that they fell in love with, the politician *allowed= their home to be built, and they were *audacious= enough to inhabit it. IV. So the circle begins. We as a country are facing an epidemic of unknown proportions: age - old expansionist attitudes. Urban sprawl has made a definite impact on environment, agriculture, and economy. (Transition) So what exactly is Urban Sprawl. Body I. Henry R. Richmond who wrote From Sea to Shining Sea: gives us a good definition: AThe terms Aurban [emailprotected] and [emailprotected] are often used to describe the continuous out-migration of the American economic and population base from its central citiesYmajor cities are surrounded by seas of low density residential development highlighted byYAEdge [emailprotected] or Asuburban [emailprotected], where commercial, retail, office, and entertainment development has [emailprotected] This description describes the trend overtaking rural America. The land that once fed the populace is being used to house the masses. This phenomenon is being met with a variety of opinions - all of them strong one is going to affect us in the most harmful way. (Transition) Now that we have an idea what exactly urban sprawl is, let me inform you of the problems caused, starting with environmentally, then agriculturally and economically. II. One of the strongest positions regarding urban sprawl belongs to that of those concerned with the environment. On such advocate is Kathryn Hohmann, the Sierra Club=s Director of the Environmental Quality Program. The Sierra Club is a national, grassroots environmental organization, with more than a half-million members. She stated in her testimony before the Senate Environment and Public Works Committee that: AThe problems of sprawl can only be solved by a concerted and continuing effort at the local, state, and federal [emailprotected] Hohmann goes on to point out several of the main issues intertwined with sprawl -such as that of traffic congestion. She states that sprawl gives us no choice but to drive further to

Free Essays on Social Equality

in 1964. A month and a day before the historic Civil Rights Act of 1964 would be signed into law by President Lyndon B. Johnson. She speaks for the mood of a race, a race that for centuries has built the nation of America, literally, with blood, sweat, and passive acceptance. She speaks for black Americans who have been secondclass citizens in their own home too long. She speaks for the race that would be patient no longer that would be accepting no more. Mrs. Hamer speaks for the African Americans who stood up in the 1950's and refused to sit down. They were the people who led the greatest movement in modern American history - the civil rights movement. It was a movement that would be more than a fragment of history, it was a movement that would become a measure of our lives. When Martin Luther King Jr. stirred up the conscience of a nation, he gave voice to a long lain dormant morality in America, a voice that the government could no longer ignore. The government finally answered on July 2nd with the Civil Rights Act of 1964. The Civil Rights Act of 1964 is historically significant because it stands as a defining piece of civil rights legislation, being the first time the national government had declared equality for blacks. The civil rights movement was a campaign led by a number of organizations, supported by many individuals, to end discrimination and achieve equality for American Blacks (Mooney 776). The forefront of the struggle came during the 1950's and the 1960's when the feeling of oppression intensified and efforts increased to gain access to public accommodations, increased voting rights, and better educational opportunities (Mooney). Civil ri... Free Essays on Social Equality Free Essays on Social Equality When the Government Stood Up For Civil Rights "All my life I've been sick and tired, and now I'm just sick and tired of being sick and tired. No one can honestly say Negroes are satisfied. We've only been patient, but how much more patience can we have?" Mrs. Hamer said these words in 1964. A month and a day before the historic Civil Rights Act of 1964 would be signed into law by President Lyndon B. Johnson. She speaks for the mood of a race, a race that for centuries has built the nation of America, literally, with blood, sweat, and passive acceptance. She speaks for black Americans who have been secondclass citizens in their own home too long. She speaks for the race that would be patient no longer that would be accepting no more. Mrs. Hamer speaks for the African Americans who stood up in the 1950's and refused to sit down. They were the people who led the greatest movement in modern American history - the civil rights movement. It was a movement that would be more than a fragment of history, it was a movement that would become a measure of our lives. When Martin Luther King Jr. stirred up the conscience of a nation, he gave voice to a long lain dormant morality in America, a voice that the government could no longer ignore. The government finally answered on July 2nd with the Civil Rights Act of 1964. The Civil Rights Act of 1964 is historically significant because it stands as a defining piece of civil rights legislation, being the first time the national government had declared equality for blacks. The civil rights movement was a campaign led by a number of organizations, supported by many individuals, to end discrimination and achieve equality for American Blacks (Mooney 776). The forefront of the struggle came during the 1950's and the 1960's when the feeling of oppression intensified and efforts increased to gain access to public accommodations, increased voting rights, and better educational opportunities (Mooney). Civil ri...

First and Second Triumvirates of Rome

First and Second Triumvirates of Rome A triumvirate is a system of government wherein three people share the highest political power. The term originated in Rome during the final collapse of the republic; it literally means the rule of three men (tres  viri). The members of a triumvirate may or may not be elected and may or may not rule in accordance with existing legal norms. The First Triumvirate An alliance of  Julius Caesar,  Pompey  (Pompeius Magnus) and  Marcus Licinius Crassus  ruled Rome from 60 BCE to 54 BCE. These three men consolidated power in the waning days of Republican Rome. Although Rome had expanded far beyond central Italy, its political institutions established when Rome was just one more small city-state among others failed to keep pace. Technically, Rome was still just a city on the Tiber River, governed by a Senate; provincial governors largely ruled outside of Italy and with few exceptions, the people of the provinces lacked the same dignity and rights that Romans (i.e., people who lived in Rome) enjoyed. For a century before the First Triumvirate, the republic was rocked by slave revolts, pressure from Gallic tribes to the north, corruption in the provinces and civil wars. Powerful men more powerful than the Senate, at times occasionally exercised informal authority with the walls of Rome. Against that backdrop, Caesar, Pompey, and Crassus aligned to bring order out of chaos but the order lasted a scant six years. The three men ruled until 54 BCE. In 53, Crassus was killed and by 48, Caesar defeated Pompey at Pharsalus and ruled alone until his assassination in the Senate in 44. The Second Triumvirate The Second Triumvirate consisted of Octavian (Augustus), Marcus Aemilius Lepidus and Mark Antony. The Second Triumvirate was an official body created in 43 B.C., known as Triumviri Rei Publicae Constituendae Consulari Potestate. Consular power was assigned to the three men. Usually, there were only two elected consuls. The triumvirate, despite a five-year term limit, was renewed for a second term. The Second Triumvirate differed from the first insofar as it was a legal entity explicitly endorsed by the Senate, not a private agreement among strongmen. However, the Second suffered the same fate as the First: Internal bickering and jealousy led to its weakening and collapse. First to fall was Lepidus. After a power play against Octavian, he was stripped of all of his offices except for  Pontifex Maximus  in 36 and later banished to a remote island. Antony having lived since 40 with Cleopatra of Egypt and growing increasingly isolated from the power politics of Rome was decisively defeated in 31 at the Battle of Actium and thereafter committed suicide with Cleopatra in 30. By 27, Octavian had retitled himself  Augustus, effectively becoming the first emperor of Rome. Although Augustus paid particular care to use the language of the republic, thus maintaining a fiction of republicanism well into the first and second centuries CE, the power of the Senate and its consuls had been broken and the Roman Empire began its nearly half-millennium of influence across the Meditteranean world.

Fashion Trends Essay Example | Topics and Well Written Essays - 5000 words

Fashion Trends - Essay Example The essay "Fashion Trends" talks about the role of marketing in the popular fashion trends. Therefore in a way, one of the significant concepts of fashion is to develop a sense of personal importance or self to the consumer. This concept of self is further reinforced through marketing campaigns which tend to confirm consumers’ views and opinions on a fashionable product. Fashion can also be attributed with developing the notion of identity in certain communities. The creation of identities and concept of self is a necessity in the fashion industry, as the consumer has choice, and fashion outlets cannot really distinguish themselves on price. The only differentiation will therefore come from the personalities and identities they are aiming to attract. For example, a certain fashion chain may design clothing for consumers who like to emulate catwalk and celebrity fashion, and this message and product they are offering will need to be communicated to the consumer using the approp riate channels, so that they can attract the most in terms of consumer numbers. Marketing in fashion is therefore responsible for creating a relationship between the manufacturer, retailer and customer. The purpose of marketing in this instance is to influence the consumer and direct their purchasing pattern to the intended product. The need to influence purchasing decisions, and to align products to identities and personalities, has resulted in the new concept of fashion marketing, which is â€Å"the application of a range.... and to align products to identities and personalities, has resulted in the new concept of fashion marketing, which is "the application of a range of techniques and a business philosophy that centres upon the customer and potential customer of clothing and clothing-related products and services, in order to meet the long-term goals of the organization" (Okonkwo 2007, Zavrnik and Mumel 2007:p11). This relationship between fashion and marketing has created interdependence between the two, which has raised the bar in the way fashion design is promoted. This interdependence has changed the view of fashion design and marketing, which previously relied on consumers to define their preferences and choices. The current view of fashion design and marketing has meant that the onus is no longer on the consumer to define the style they want. The diagram below illustrates the relationship between fashion and marketing: Table 1. The fashion marketing concept. Source: M. Easey. Fashion Marketing. Blackwall Science. London 2002, p.7. Table 1.0 demonstrates that if the concern for fashion design, customers and profit is low, then it is likely that an organization will fail to fulfil its objectives, as this situation leaves the organization open to disregarding customers' preferences which will affect profits (Easey 2002). However, by having a high concern for fashion design, customers and profit, objectives will be driven by marketing which is designed to influence and persuade consumers to change certain behaviours, which puts the control back with the organizations, and not with consumer. By controlling demand, organizations will be able to control the trends and the nature of the market. This subject area is important for a number of reasons: marketing has been able to

Green Computing- Annotated Bibliography Example | Topics and Well Written Essays - 1000 words

Green Computing- - Annotated Bibliography Example IT is also used in increasing the energy efficiency of buildings, supply chains, transportation systems, and electrical grids. In addition, the production and use of computers is growing fast in the consumption of global energy and greenhouse gas emissions. This article talks about sustainable IT services and also assesses the effects of green computing practices. The article defines green computing as the practice of efficiently using computing resources while increasing or maintaining their overall performance. The article asserts that sustainable IT services needs the integration of practices of green computing such as virtualization, power management, improving cooling technology, electronic waste disposal, recycling, and optimization of the IT infrastructure in order to meet sustainability requirements. According to the author, recent studies show that power costs utilized by departments of IT approaches 50% of the total organizational energy costs. This paper provides a literature review on sustainable IT and identifies a set of principles that guide sustainable IT service design. This paper addresses the challenges of environmental design for computing systems. The paper argues that pervasive computing do not only provide exciting research challenges and tremendous opportunities, but also negative environmental impacts, especially in terms of energy consumption and physical waste. The paper also asserts that environmental impacts come under consumer scrutiny and increasing government. Just like the rest of the disciplines (e.g. architecture, transportation), pervasive computing adapt accordingly. The paper also discusses specific research questions and issues arising from three phases of lifecycle device: maximizing device lifetime, improving recyclability, and minimizing resource usage for manufacture and operation. This paper addresses green

Class Matters... Short Description of a Section of the Book Essay Example for Free

Class Matters Short Description of a Section of the Book Essay Class Matters by Bell Hooks, the section â€Å"The Me-Me Class: The Young and the Ruthless† examines how the mass media influences ideas that everyone living in the united States is rich, into the minds of foreigners. This section further notes that the media makes it seem as though social and economic backgrounds have little or no influence on the world of spending because most advertisements seem to make items seems affordable and cheap to acquire. The media reveals the fantasies of life to make people think that the things shown in the media are reality, especially in the eyes of teenagers. This section notes that the media brings about the â€Å"psychological torment; envy† amongst teenagers. The way the media presents issues regarding children/students, makes it seem as though it is easier to acquire money wealth on an outward appearance. This may be done to bring about competition into society, which develops envy amongst individuals if they are unable to acquire a particular item. In this section, it states that it is easier to acquire money and goods than it is to find meaningful values and ethics. This is a really profound statement because it portrays the influence the media has had on the youth to the extent that their values and ethics don’t really have as much meaning to them as that of the money and goods the acquire. This further demonstrates the culture of the youth and how materialistic things have an impact on the way youth view today’s world. The media is indirectly educating the youth with items that seem relevant in the world rather than showcasing the importance of education. This may be the reason why many schools have decided to enforce a rule that students need to wear uniforms. This lessens the amount of items students will be competing with each other. Although the world is set up in a way that competition exists, the fact that students have the same items means that they are less likely to be envious of each other.

Timeline of Wars and Reasons for Wars :: History Essays

Timeline of wars/Reasons for Wars Trojan War c. 1200 BC lasted for approx. 9 years Greeks vs. people of Troy Trojan prince Paris abducted Helen, wife of Menelaus of Sparta. The Spartans refused to return Helen to Sparta so Menelaus persuaded his brother Agamemnon to lead an army against Troy. They fought for nine years but never were able to defeat he main city. The Greeks then built a large wooden horse in which warriors were hidden inside. The Greeks appeared to leave and the horse was left at the front gates of the city. The Trojans brought the horse inside the gates and the other Greeks returned at night. The people hidden inside the horse opened the gates for these Greeks and they destroyed Troy. This war could also have another motive as to who controlled trade through the Dardanelles. Punic Wars 264-146 BC Carthaginians vs. Romans The Carthaginians and Romans fought in three different wars over the course of 118 years. Romans fought the Carthaginians to ruin their hold on a chain of islands that would let them control the Western Mediterranean. The Romans wanted to have control. They then fought over land in Italy, particularly Sicily. In the third conflict, Carthaginians tried to save their city and land from being taken over completely by Romans. In these wars, they mainly fought over trade routes in the Mediterranean. Each wanted power and more territorial possession. Crusades (11th Century-13th Century) in the Holy Land The emperor of the Byzantine Emperor was upset with Turks encroaching on his empire. He went to the Pope Urban II and complained. He made up atrocities about the Turks. In 1096, The Pope Urban II promoted the Crusade to reclaim the Holy Land from the barbaric Turks. These crusades lasted till the 13th century. In the process, Jews were persecuted and lots of looting took place. Many countries took interest in the Crusades because they were ready for travel and adventure. They wanted to expand trade with the Middle and Far East and so the Crusades gave them a chance to open up trade routes with those countries. They used Christianity to justify the Crusades. In reality, they wanted to expand trade and gain more territorial land. Chinese History Often countries or leaders try to put too many restrictions on their subjects or territories and then the people rebel.

Having Suffered A Heart Attack Health And Social Care Essay

This assignment ‘s purpose is, to give the reader a really precise apprehension of the medical journey, a male platinum aged 55 old ages of age named Matthew will travel through, after holding suffered a bosom onslaught ( acute myocardial infarction ) . That was diagnosed in infirmary five hours post patient ‘s initial symptoms while exigency intervention was being implemented. Information both via household and from medical professionals in respects to the platinum ‘s life style and the platinum ‘s consequences to allow medical appraisals, usher and find the way the platinum will medically venture down, towards recovery. Much of the information gathered about the platinum ‘s history will be subjective informations ; this significance information peculiar to our peculiar person that may or may non hold a bearing due to the exactitude, preciseness and proved current cogency ; the information is from the topic or topics household. Still the information mus t be considered. There will besides be information known as nonsubjective informations, intending information that is besides specific to the patient, but more precise, factual, mensurable, not opinionated and demonstrable from professionals in the medical field. The subject of pathophysiology will be explored in several facets associating to the platinum and giving ground to the platinum ‘s physical status and recent marks and symptoms. Management of the patient and his status, by single wellness attention professional ‘s and as collaborative squads and or squad in a holistic mode will be outlined and discussed. Finally of class the pharmacological sector of the platinum ‘s intervention will be delved into, to bespeak the rule characteristics and maps and possible side effects of medicines he was and may be prescribed. The subject of this assignment is highly of import and really relevant due to the current medical tendencies we have in Australia sing coronary art eria disease ( CAD ) , which is incorporated within cardio vascular disease ( CVD ) . â€Å" Cardiovascular disease ( CVD ) A is the taking cause of decease in Australia, accounting for 34 % of all deceases in Australia inA 2006. Cardiovascular disease kills one Australian about every 10 proceedingss. † . † ( Heart Foundation of Australia 30/05/09 ) . â€Å" It is estimated that about 4 % of the population over 45 old ages have chronic HF [ Heart Failure ] . Cardiovascular disease is one of the chief causes of decease in both Australia and New Zealand, the incidence dramatically increases with progressing age and, as the aged population additions, HF incidence and prevalence will increase. HF histories for about 2 % of all deceases and is the 3rd largest cause of cardiovascular-related decease. The life-time hazard of developing HF has been estimated at around 20 % for Western states. The addition in prevalence of HF in Australia and New Zealand has been attributed to the ripening of the population, improved endurance from bosom onslaught, and the increased prevalence of diabetes and fleshiness in the population and the wider usage of sensitive diagnostic engineering. † ( Brown & A ; Edwards 2ed. 2009 pg 883 )PATHOPHYSIOLOGYIn the bulk of bosom failure state of affairss, the left ventricle non working as it should, Cardio Vascular Disease ( CVD ) . â€Å" Three of the more common causes of reduced LV contractility include coronary arteria disease, aortal stricture and systemic high blood pressure † ( Phipps Sands & A ; Marek 6th ed.1999 pg 700 ) . â€Å" Systolic failure, the most common cause of HF, consequences from an inability of the bosom to pump blood. It is a defect in the ability of the ventricles to contract ( pump ) . The left ventricle ( LV ) loses it ‘s ability to bring forth adequate force per unit area to chuck out blood frontward through the hard-hitting aorta. † ( Brown & A ; Edwards 2ed. 2009 pg 884 ) Co ronary arteria disease lowers the Black Marias ability to contract through being the cause of less oxygenated blood being delivered to the chondriosome of the sarcostyles. In aortal stricture, where there is noticeable narrowing of the aortal lms the left ventricle demands to pump harder to acquire the needed volume of blood through the now limited valve. With systemic high blood pressure, where the overall blood force per unit area is already higher than norm, the left ventricle must supply more force per unit area than this overall blood force per unit area to win in pumping out its volume or at least a valid per centum. What finally happens when the left ventricle can non pump out the needed sum of blood ; is blood staying in the left ventricle causes extra blood to stay in the left atrium besides. The effect of excess blood is blood endorsing up into the pneumonic circulation. All this extra blood increases the force per unit area in the pneumonic capillaries coercing blood into the interstitium so the air sac compromising gaseous exchange. High pneumonic force per unit areas negatively effects the blood flow from the right ventricle to the lungs, ensuing in less blood being oxygenated aˆÂ ¦ a barbarous rhythm of deoxygenated blood easy hungering the organic structure of O and taking to an Acute Myocardial Infarction ( AMI ) . The authoritative marks and symptoms that was noticeable with the patient. Was being short of breath and being visible radiation headed after a really small sum of physical activity, which usually the platinum could accomplish without any emphasis. This represents a deficiency of O being circulated finally doing a rise in respiratory rate and visible radiation headedness due to low sums of O to the encephalon. â€Å" Dyspnea, an unnatural uncomfortable consciousness of external respiration, occurs when high pulmonary force per unit areas force fluid out of the pneumonic capillaries into the air sac. The fluid in the air sac interferes with effectual gas exchange. † ( Phipps Sands & A ; Marek 6th ed.1999 pg 702 ) â€Å" Dyspnoea ( shortness of breath ) is a common manifestation of chronic HF. It is caused by increased pneumonic force per unit areas secondary to interstitial and alveolar hydrops. Dyspnoea can happen with mild effort or at remainder † . ( Brown & A ; Edwar ds 2ed. 2009 pg 887 ) It makes sense that Matthew our patient was reported to holding felt nauseous and uncomfortable in his thorax after devouring his dinner. His digestive system would be necessitating oxygenated blood to map and his bosom evidently was non able to provide that. Hence feeling nauseated, due to the lessening in cardiac end product ( CO ) impairing perfusion to critical variety meats such as his tummy and bowels. Pain and or disfunction would be noticeable when the peculiar organ ‘s demands for more oxygenated blood additions. ( Brown & A ; Edwards 2ed. 2009. pg 887 ) An hr subsequently Mathew ‘s symptoms worsen, increasing in badness. His thorax strivings are much worse and are besides radiating down his left arm. â€Å" Heart Failure can precipitate chest hurting because of reduced coronary perfusion from decreased CO and increased myocardial work. Anginal-type hurting may attach to HF. † ( Brown & A ; Edwards 2ed. 2009. pg 888 ) During the execution of exigency interventions, Matthew was diagnosed as holding had an acute myocardial infarction AMI. Information was so gathered both via Matthew his household and via physical medical scrutiny.The information gathered by word of oral cavity through inquiries in interview from Matthew and his household are classified as subjective, of import but ca n't be proven without a shadow of a uncertainty. The information collected via the physical scrutiny is current and can be proven hence classified as aim. Either manner all the information can be categorised as modifiable ( M ) or non modifiable ( NM ) ; mutable or non mutable. The undermentioned appraisal findings are recorded and will now be identified as M or NM. These findings will play a function making the beginnings of a valid attention program. Data is as follows, ‘A history of coronary arteria disease, specifically high blood pressure ‘ This is really of import due to his past being now revisited may give us an thought as to what may hold happened and or a prevue of things yet to come. Data classified as NM because it ca n't be changed, you ca n't alter your yesteryear. ‘States he late stopped taking his antihypertensives as he ‘felt better † . This information decidedly has a bearing because non taking this medicine would raise Matthews blood force per unit area and increase his high blood pressure which in bend additions his Black Marias work load and perchance puting his bosom up to neglect ensuing in AMI. Data classified as M because it can be changed, Matthew could take his medicine. ‘Mother besides has high blood pressure ‘ . Proposing this status being inherited and the particulars of the high blood pressure may be similar, casting visible radiation on what is being dealt wi th by Matthew, perchance salvaging much valuable clip as to the way to be investigated. Data classified NM, because cistrons can non be altered. ‘States he is marginal diabetic ‘ Diabetes – Peoples with diabetes have a two to eight times greater hazard of bosom failure compared to those without diabetes. Womans with the status have a greater hazard of bosom failure than work forces with diabetes. Part of the hazard comes from the disease ‘s association with other bosom failure hazard factors, such as high blood force per unit area, fleshiness, and high cholesterin degrees. The disease procedure besides amendss the bosom musculus. ( Symptoms of bosom disease, n.d. ) Heart failure should, nevertheless, be suspected in anyone presenting with a history of new oncoming weariness, hydrops or shortness of breath. This is peculiarly the instance if the patient has a background of diabetes, chronicrenal damage, ischemic bosom disease, high blood pressure. ( Brady.S, n.d. ) This tells us, if true, that diet will be of paramount importance because diet is an of import direction therapy for both HF and Diabetes. Diet instruction and weight direction are critical to the patient ‘s control of chronic HF. The nurse or dietician should obtain a elaborate diet history, finding non merely what foods the patient chows and when but besides sociocultural value of nutrient. ( Brown & A ; Edwards 2ed. 2009. pg 894 ) Data classified as NM if Matthew is truly without uncertainty diabetic, that ca n't be changed but can be adapted to. ‘Overweight but late lost 5kg ‘ . Because it is, late lost 5 kilogram, it could be as a consequence of him being ailing, but from here onwards his diet will be an indispensable portion of his overall attention program. The diet will hold to be specifically tailored to decrease his fleshiness, and will besides hold to suit his diabetic demands it will likely hold to be low Na low fat and be alert of sugars, to ass ist him in respects to his HF position. Data classified as M, can and must alter. ‘Rarely exercises ‘ detrimental in respects to HF and how he got to where he now is, but his physical activity will hold to be minimised until he is in a healthier place, to so get down remodelling his life style with exercising, ( monitored of class ) , to better his wellness and understate the opportunities of HF re-occurring. Data M aˆÂ ¦very mutable, from inactive to active bit by bit. ‘Has smoked 15-20 cigarettes/day for the past 18 old ages ‘ . This would hold had an inauspicious affect on both Matthews ‘s pneumonic system and cardiovascular system ; smoking deprives the organic structure of O because blood will transport C monoxide in penchant to oxygen plus smoking destroys many of the air sac that absorbs the O for gaseous exchange therefore the lungs are absorbing less O overall for the organic structure, therefore holding damaging consequences on musculuss including the bosom. â€Å" Smoking surcease may non straight cut down BP, but markedly reduces overall cardiovascular hazard. The hazard of myocardial infarction is 2-6 times higher and the hazard of shot is 3 times higher in people who smoke than in non-smokers † ( HeartFoundation.2010 ) .Data M aˆÂ ¦Matthew can be helped to discontinue smoke this is modifiable behavior. ‘Has 3 teenage kids who are doing jobs ‘ This job is a stress direction job, there have been many surveies done, covering this affair and a Psychologist would be the best port of call to assist Mathew cover with this emphasis. â€Å" Family demands chiefly affect lovingness and supplying for kids of married employees. Number of dependent kids is an nonsubjective index of the degree of household demands ( Rothausen, 1999 ) . † ( International Journal of Stress Management 2008 ) Data M this subjective informations can be altered but more specifically can be adapted to by get bying mech anisms being applied aˆÂ ¦ ! ‘Recently experient loss of best friend and concern spouse who died from malignant neoplastic disease ‘ . Besides another emphasis get bying job needed, and would best be suited for a psychologist ‘s expertness. Even though the platinum ‘s nurse would likely hold more contact hours with the platinum aˆÂ ¦this is where wellness attention professionals can join forces, work together as a squad for the platinum ‘s ultimate end, of working better and perchance being discharged. Data M the heartache can be dealt with through a assortment of possible intercessions, so this state of affairs is non inalterable, it is decidedly modifiable. ‘ Oppressing substernal thorax hurting radiating down his left arm and giddiness. Pain mark: 9/10'.This is a text book description of what it feels like to be enduring from an Acute Myocardial Infarction as is described in many pathophysiology texts. â€Å" The hurting typically is terrible and suppression, frequently described as being compressing, smothering or like, â€Å" person sitting on my thorax. † The hurting normally is substernal, radiating to the left arm, cervix, or jaw, although it may be experienced in other countries. Unlike that of angina, the hurting associated with AMI is more drawn-out and non relieved by remainder or nitro-glycerine, and narcotics often are required. † ( Porth.C. 2007 pg 395 ) â€Å" Data M this hurting is a tell narrative that an Acute Myocardial Infarction is in procedure. This hurting is frequently mistaken for dyspepsia and is treated with hydrogen carbonate, alkalizers or even pain slayers which in bend could detain seeking professional medical attending. Siting the individual up with legs lower than the bosom, even swinging the legs may give some alleviation prior to medical attending geting. By understating the Black Marias work load via decreasing venous return. ‘Physical scrutiny ‘ Objec tive information is as follows. Diaphoresis, abruptly of breath and sickness. Diaphoresis [ sudating ] is sometimes due to wound or unnatural cells of the bosom motivating the production of pyrogen. This causes the hypothalamus to react to a higher set point, the hypothalamus initiates heat production behaviors ( shuddering and vasoconstriction ) hence the profuse perspiration, anxiousness the feeling of pending day of reckoning, I am certain plays a function in this excessively. â€Å" Many non-infectious upsets, such as myocardial infarction, pneumonic emboli, and tumor ‘s green goods febrility. † ( Porth.C.2007 pg 288 ) Short of breath or Dyspnea can be because of myocardial infarction oncoming because blood is endorsing up into the pneumonic system and holding an inauspicious consequence on the lungs [ alveoli ] being able to absorb O and interchanging it for C dioxide, which so makes one short of breath because O is low and even C dioxide is low so the trigger to d o one breath is besides non available Dyspnea in this instance is a respiratory manifestation † due to congestion of the pneumonic circulation and is one of the major indicants of left sided bosom failure. † ( Porth.C.2007 pg 426 Nausea is a feeling of unwellness aˆÂ ¦that is sometimes a precursor to purging. â€Å" Perform complete appraisal of sickness, including frequence, continuance, badness, and precipitating factors, to be after appropriate intercessions. † ( Brown & A ; Edwards. 2009. Pg1065 ) â€Å" Nausea often is accompanied by ANS manifestations such as watery salivation and vasoconstriction with pallour, sudating, [ perspiration ] and tachycardia. Nausea may work as an early warning signal of a diseased process. † ( Porth.C. 2007 pg 602 ) . Possibly even an acute myocardial infarction. Diaphoresis, Dyspnea and Nausea are all M, O therapy, cold compress, organic structure positioning i.e. sitting up – pillows support- take downing li mbs and giving antiemetic if ordered ; to modify these symptoms. The implicit in cause of the symptoms will depend on physician diagnosing perchance drug therapy or surgery.BP 165/100 mmHg – Pulse rate 120 beats/min – Respiratory rate 26 breaths/min.Bp is rather high this tells us that the force per unit area is high but the ground could be many, could be that the individual is by and large hypertensive, in the procedure of holding an episode of HF, or on drugs that are doing vasodialation of arterias or rushing up the bosom and many many more possible grounds, the most serious being HF. Pulse rate is besides really high this rate is such you would be anticipating the person to be running non at remainder ; the bosom would merely be working this difficult at rest if there was something incorrect, rather perchance oncoming of HF. Body non having adequate O ; musculuss, major variety meats, including encephalon being starved of O and finally the bosom being a musculus wo uld get down experiencing the effects. Respiratory rate is elevated besides, stand foring the organic structure seeking to do up an O debt. All these symptoms can be minimised and a certain sum of comfort can be achieved, so data classified as M. Through O therapy, stockings, take downing limbs and sitting up. O2 Impregnation: 94 % on room air. Is non improbably low but oxygen therapy via rhinal prongs would decidedly be good at no higher than 4 liters per minute to acquire O2 impregnation over 95 % . So this would be considered modifiable M. Electrocardiogram: A premature ventricular contraction with ST lift in anterior thorax leads V1-V3. Signifies a left front tooth wall myocardial infarction. This could mean that the left anterior falling coronary arteria is occluded

Review of Marie Antoinette the Movie

Movie Review: Marie Antoinette As we all known the reign of Queen Marie Antoinette ended quite brutally with her head being cut off during the French Revolution. However, this movie tries not to displace such gruesome details. It merely ends with the royal family in a carriage on their way to Paris or others might call it ‘their doom’. Marie Antoinette, the movie was written and directed by Sofia Coppola starring Bring It On’s, Kirsten Dunst. In this movie Kirsten Dunst portrays Marie Antoinette how many of us believe she was. My view of Marie Antoinette seems a little bit less innocent however. In this version of the royal families’ life they aren’t mean or vindictive they’re plainly quite naive. They do not realize how much they are spending they just care about having fun and being care free. Being a girl I personally love shoes and the shoes that Marie Antoinette had designed were beautiful. There was a large array of colors and styles that drew them instantly to the eye. As well as shoes the costumes in the film we’re beautiful. There were many different gowns in baby blue, pink, and cream. I extremely liked how in the scenes in the Retreat house Dunst wore white peasantry dresses that almost made her look angelic. Throughout the beginning of the movie there was quite a lot of comic relief. Whether it is from the king’s mistress or something else. The best part by far is when Dunst is standing waiting to be dressed, naked, and her undergarments keep getting handed off because new women of higher class than the last keep coming into the room. Dunst is standing they’re freezing trying to understand French society and so far she thinks it’s quite blatantly absurd. I don’t blame her seeing as how these women are taking quite a long time coming in and taking their gloves off. If you were to only to watch the first half of the film you might even think it to be a comedy. Marie Antoinette was a lovely film. Filled with many twists and turns that were unexpected which in turn made the movie interesting and exciting to watch. Even though it runs for two long hours and twenty horrific minutes, it does not seem so at all and you will be pleasantly delighted by the end I guarantee it.

Miss Havisham first impression Essay Example

Miss Havisham first impression Essay Example Miss Havisham first impression Paper Miss Havisham first impression Paper Essay Topic: Literature One of the main characters of Charles Dickens novel Great Expectations is Miss Havisham. Throughout the course of the novel, we discover lots about her and her life, especially in the first part of chapter 8 in the story. The main thing we discover about Miss Havisham, is that 20 years ago she was unfortunately jilted at the alter, and this has greatly affected her ever since. In this essay, I am going to discuss and explain the ways in which Dickens clever shapes the readers opinion of Miss Havisham, and the views we have on her because of this. The main way I believe that Dickens shapes the readers first impression of Miss Havisham, is by writing about her description through the eyes of Pip. Pip is the main character in the novel, and we learn from earlier that he is from an extremely poor background, and as he is naive and from an age where he is easily influenced by what is around him, especially because of his dream to be a gentleman. Being from such a poor family, as Pip enters Miss Havishams house everything appears even more elegant and expensive that is really is, as he has never seen objects like this before. When Pip explains the room Miss Havisham lives in, we get the impression that Miss Havisham has become a hermit since she was left by her husband to be. She appears to have absolutely no life as nothing appears to have changed in the room since that day, for example, she is still wearing her white wedding dress, which has turned to a rotten yellow due to the length of time she has been wearing it. Because of this, we get the impression she has turned crazy, as she has not changed her clothes for 20 years. We can tell from the way Pip behaves towards Miss Havisham, and her adopted daughter Estella, that Pip believes the way he and Miss Havisham get along could result in his family getting a sum of money from Miss Havisham, and this is extremely important to his sister, who is his guardian. There is proof of this in the novel when Miss Havisham asks Pip if he is afraid of her, and instead of saying yes, he replies that I am afraid of not pleasing you. However, we get the impression that later on he becomes afraid rather than nervous, as he starts to realise that there is something not quite right about her and the way she talks to him. We can tell he feels scared from the way Pip interacts with her and the way he responds to her questions, with lots of pauses, and using broken dialogue, as thought he is terrified to say the wrong thing. The way Pip describes the different objects in the room gives us an impression of what Miss Havishams life is like. The room is filled with rich and expensive objects such as dressing tables and looking glasses lit with candles. He talks about these objects as though he has never heard of or even seen anything like them before. He talks about a draped table with a gilded looking glass, giving the impression he thinks of these thing as elegant and special, and yet Miss Havisham appears to take little care of the things in the room. He describes what she is wearing as rich materials satins, lace, and silks all of white. This gives us the impression she is glamorous and clean looking, whereas we later learn her white clothes have turned yellow from not being washed in 20 years, as Pip says I learn that everything in my view ought to be white, and was white long ago. The room is filled with dirt and everything surrounding her is old and no longer elegant and rich looking as Pip first made out. We then get the impression Miss Havisham is unhealthy, unfed and unclean, from Pips description of how she looks. We understand that she is withered like her dress, this use of simile shows that she has shrunk to skin and bone, and has bright, however sunken eyes. The author then compares Miss Havisham to a ghastly waxwork, and even worse a skeleton. Dickens then goes on to describe Pips fear by stating that I should have cried out, if I could. There is a strong contrast in the novel between white and yellow, it is often mentioned that everything surrounding Miss Havisham used to be white and fresh, but is dirty and yellow. This appears to be comparing colours to Miss Havishams life, where she used to be young and youthful before she was jilted, but has now grown old and ill looking, The fact that Dickens has chosen to describe Miss Havishams surroundings prove to us how important it is to Dickens that we can understand Miss Havishams distress and depression. Dickens uses repetition throughout the novel to show the repetition in Miss Havishams life and how everything is always the same. In conclusion, I believe that seeing as marriage was so important to women in the early 1900s due to the fact they felt as though they needed a man in their lives for financial and emotional security, this is the reason Miss Havisham is like this and Pip, being young and naive did not at all understand why she had turned so crazy and into a hermit, which is the reason Dickens chose to describe Miss Havisham through Pips eyes. Altogether, I believe the way that Dickens has written the novel gives us a view on the rich (Miss Havisham) and the poor (Pip) as he sees them. Money can turn you mad, and is definitely not everything.

The Environmental Costs of Cotton

The Environmental Costs of Cotton Chances are that on any given day we wear some clothing items made of cotton, or sleep in cotton sheets, yet few of us know how it is grown, or what are  the environmental impacts of cotton cultivation. Where Is Cotton Grown? Cotton is a fiber grown on a plant of the Gossypium genus, which once harvested can be cleaned and spun into fabrics used most commonly for linens and clothing. Needing sunshine, abundant water, and relatively frost-free winters, cotton is grown in a surprising variety of location with diverse climates, including  Australia, Argentina, West Africa, and Uzbekistan. However, the largest producers of cotton are China, India, and the United States. Both Asian countries produce the most, mostly for their domestic markets, and the US is the largest exporter of cotton with about 10 million bales a year. In the United States cotton production is mostly concentrated in an area called the Cotton Belt, stretching from the lower Mississippi River through an arc spanning the lowlands of Alabama, Georgia, South Carolina, and North Carolina. Irrigation allows additional acreage in the Texas Panhandle, in southern Arizona, and in California’s San Joaquin Valley. Chemical Warfare Globally, 35 million hectares of cotton are under cultivation. To control the numerous pests feeding on the cotton plant  farmers have long relied on heavy application of insecticides, which leads to the pollution of surface and groundwater. In developing countries cotton growers use a full half of the pesticides used in agriculture. Recent advancements in technology, including the ability to modify the cotton plant’s genetic material, have made cotton toxic to some of its pest. This reduced but did not eliminate the need for insecticides. Farm workers, particularly where the labor is less mechanized, continue to be exposed to harmful chemicals. Competing weeds are another threat to cotton production; generally tilling practices and herbicides are used to knock back weeds. A large number of farmers have adopted genetically modified cotton seeds that include a gene protecting it from the herbicide glyphosate (the active ingredient in Monsanto’s Roundup). That way, the fields can be sprayed with the herbicide when the plant is young, easily eliminating competition from weeds.   Naturally, glyphosate ends up in the environment, and our knowledge of its effects on soil health, aquatic life, and wildlife is far from complete. Another issue is the emergence of glyphosate resistant weeds. This is an especially important concern for those farmers interested in following no-till practices, which normally help preserve the soil structure and reduce erosion. Reliance on glyphosate resistance makes it more difficult to control weeds without turning the soil. Especially problematic in the southeast US is Palmer’s amaranth pigweed, a fast growing glyphosate resistant weed. Synthetic Fertilizers Conventionally grown cotton requires the heavy use of synthetic fertilizers. Such concentrated application means much of it ends up in waterways, creating one of the worst nutrient pollution problems globally, upending aquatic communities and leading to dead zones starved of oxygen and devoid of aquatic life. In addition, synthetic fertilizers contribute an important quantity of greenhouse gases during their production and use. Heavy Irrigation In many regions rainfall is insufficient to grow cotton but the deficit can be made up by irrigating the fields with water from nearby rivers or from wells. Wherever it comes from, the water withdrawals can be so massive that they diminish river flows significantly and deplete groundwater. Two thirds of India’s cotton production is irrigated with groundwater. In the United States, western cotton farmers too rely on irrigation. Obviously, one could question the appropriateness of growing a non-food crop in arid portions of California and Arizona during the current multi-year drought. In the Texas Panhandle, cotton fields are irrigated by pumping water from the Ogallala Aquifer. Spanning eight states from South Dakota to Texas, this vast underground sea of ancient water is being drained for agriculture far faster than it can recharge. In northwest Texas, Ogallala groundwater levels have dropped over 8 feet between 2004 and 2014. Perhaps the most dramatic overuse of irrigation water is visible in Uzbekistan and Turkmenistan, where the Aral Sea declined in surface area by 85%. Livelihoods, wildlife habitats, and fish populations have been decimated. To make matters worse the now dry salt and pesticide residues are blown away from the former fields and lake bed, increasing the frequency of miscarriages and malformations among the 4 million people who live downwind. Another negative consequence of heavy irrigation is soil salination. When fields are repeatedly flooded with irrigation water, salt becomes concentrated near the surface. Plants can no longer grow on these soils and agriculture has to be abandoned. Salination has happened on a large scale in much of the former cotton fields of Uzbekistan. Are There Environmentally Friendly Alternatives? To grow environmentally friendlier cotton, a first step must be to reduce the use of dangerous  pesticides. This can be achieved through different means. Integrated Pest Management (IPM) is an established, effective method of fighting pests which results in a net reduction in pesticides used. According to the World Wildlife Fund, using IPM saved some of India’s cotton farmers 60 to 80% in pesticide use.  Genetically-modified cotton can also help reduce pesticide application, but with many caveats.   In its simplest form growing cotton in a  sustainable manner  means planting it where rainfall is sufficient, avoiding irrigation altogether. In areas with marginal irrigation needs, drip irrigation offers important water savings. Organic farming takes into consideration all aspects of cotton production, leading to much reduced environmental impacts and better health outcomes for the farm workers and the surrounding community.  A well-recognized organic certification program helps consumers making smart choices, and protects them from greenwashing. One such third-party certification organization is  the Global Organic Textile Standards. Sources World Wildlife Fund. 2013. Cleaner, Greener Cotton: Impacts and Better Management Practices.

Technology Evaluation and Recommendation Research Paper - 2

Technology Evaluation and Recommendation - Research Paper Example Information Security Project Plan There are many differences between physical security, and information security. Information security is concept that entangles most aspects of the society, majorly because of the ubiquitous adoption of computing technology in the modern world. In our daily lives, we use computers at work place for our employers, play on computers in homes, study online, do business, and check emails, and so on. The level of development in the modern world has greatly improved especially with the increased rate of innovation, and growing technology. Everyone in the modern world is impressed at how the level of technology is increasing so fast because they benefit from it in very many different ways (Matford & Whitman, 2012). Owing to the fact that most people have the urge to make things easier in the modern world, everyone is turning towards the direction of Information technology because online seems to be the future of everyone, and everything. The web is viewed as the future of most activities in the world today since currently it serves as a very useful tool even though it also has some intimidating proposition. Although technology enables more productivity and allows access to much information, it also carries a lot of security issues. Employers preserve information about their companies, employees, and other important documents on the computer systems. Banks also store vital information on money transaction between them, and other clients. One of the most common challenges in the modern technology world is hacking, and piracy. When someone hacks information about a company, then this leaves the company in danger of either breaking down or losing credibility from the public that it serves because this interferes with its reputation, and competitors can take advantage of this situation. Employers can lose millions of dollars, and suffer damage of reputation, face legal prosecution through system configuration when hackers accesses personall y identifiable data. These issues are more common in the media, and they have disturbing regularity (Matford & Whitman, 2012). The rapid growth of technology brings many security issues, and this means that security standards need to be put in place with effective implementation. When discussing security issues, it is often helpful to use a model that has a baseline or foundation. This provides consistent concepts, and set of terminologies, which professionals can refer to when security issues arise. Information security has three primary concepts that are confidentiality, integrity, and availability triad since it focuses on security in relation to available data. Concept of confidentiality is similar but not the same as privacy. This component entails protecting data from those who are unauthorized to view it. One of the best examples of implementation of concept of confidentiality is when a person goes to the ATM to withdraw money; he or she is very keen on maintaining, and prote cting the account number, and card pin number. This is how simple concept of confidentiality operates (Matford & Whitman, 2012). This concept of information security goes hand in hand with that of physical security because the idea of confidentiality is still applicable in many ways. With the rapid expansion of global networks through interconnecting information systems in the modern

Taxation Master Case Study Example | Topics and Well Written Essays - 5000 words

Taxation Master - Case Study Example On the other hand, in computing tax liability of corporations, we use the Financial Year. Financial Year runs from 1 April in one year and ends on 31 March of the following year. For taxation purposes, taxable profits by a corporation for Financial Year 2008 are those obtained from 1 April 2008 to 31 March 2009. Income tax is a tax on income. Not all income is taxable and you're only taxed on 'taxable income' above a certain level. Even then, there are other reliefs and allowances that can reduce your Income Tax Bill - and in some cases mean you have no tax to pay ("Income Tax - the Basics"). Non - taxable income are certain sorts of income that you never pay on tax. These include certain benefits, income tax exempt accounts, Working Tax Credit (WTC) and premium bond wins. These income sources are ignored altogether when working out and how much Income Tax you may need to pay. ("Income Tax - the basics") Married Couple's Allowance (includes civil partnership)- if you are married or in a civil partnership, you or your partner may get Married Couple's Allowance (MCA) if you are living together and you and your spouse or civil partner were born before 6 April 1935. The amount you will receive depends on the age of the oldest spouse/civil partner and the level of claimant's income. Your tax bill will be reduced by ten per cent (10%) of the amount of the MCA you can claim. ("Introduction to tax allowances and reliefs") Other allowances, reliefs and expenses You can get tax relief for different expenses, depending whether you are an employee or director or self-employed. If you are an employee or a director, you can get tax relief for business expenses you have paid for and if: they were for the cost of travelling you had to do in doing your job, and other expenses you

Discussion 2 Assignment Example | Topics and Well Written Essays - 250 words - 2

Discussion 2 - Assignment Example Therefore, this means that cultural diversity increases the sales of a business, as well as its profit. If a business plans to sell in a diverse marketplace, then it must be totally able effectively to utilize its diverse workers in significant strategic ways. The aging populace is both an advantage and a disadvantage for small businesses (McCarthy, 2012). One certain thing, however, is that small organizations will have to reorient their strategies to hurdle the exceptional challenges and opportunities aging people offer (McCarthy, 2012). In the 90’s, among the biggest hurdles facing small businesses was access to government regulations, capital and taxes. Nevertheless, in the new millennium, they can add a new hurdle to the list, the persistent labor shortage. Therefore, businesses lack the required labor, which would enable them to work efficiently (McCarthy, 2012). On an optimistic note, small organizations can exploit this growing section of the population. Marketing strategy and new products will need to be created targeting the elderly

Relationship Between Management And Leadership In Childhood Setting Nursing Essay

Relationship Between Management And Leadership In Childhood Setting Nursing Essay In this report I will discuss the relationship between management and leadership in an early childhood setting. I will do this by making reference to the Integrated Inspection Report from the named nursery, government expectations and my findings from other sources. HM Inspectors of Schools have responsibilities which include raising and improving standards and quality of the service offered by settings through self-evaluation, and they do this by inspection of premises and the service these premises provide. They work within the National Care Standards, Scottish Executive (2006) which is underpinned by The Child at the Centre, HMIE (2007) and the performance indicators within. Part of their inspection includes looking at the overall leadership in the nursery setting and using government advice to rate the standards of leadership within the setting. In the named Integrated Inspection Report, the opening statement comments: The headteacher provided excellent leadership. HMIE, (2008) and this shows how this early years establishment has followed government expectations to build on good practice and deliver a professional, caring, quality service of education to children and parents who use this setting. HMIEs comments towards the headteachers leadership reflect the performance indicators laid down in The Child at the Centre HMIE (2007) and these indicators expect settings to have standards of: 9.1 Vision, values and aims 9.2 Leadership and Direction 9.3 Developing people and partnerships 9.4 Leadership and improvement and change These performance indicators help settings to aim for excellent practice through leadership and self-evaluation and encourage professional reflection using the same themes as How Good is our School and The Journey to Excellence and are used to build plans and guide any actions for improvement there be. HMIE (2007) Hay (1997) believes the successful running of a nursery setting relies on someone who portrays a combination of both management and leadership skills. Leadership qualities include being able to influence others to meet goals, not because the leader has asked them to do so but because they want to do it whereas management qualities would include the necessity to get things done constantly and routinely. Hodgkinson (1991) cited by Hay (1997) I agree with Hay (1997) that a combination of skills are required for the efficient running of a nursery and in order for settings to reach the government expectations whilst carrying on with the daily routines, they would need to secure the help and shared focus from colleagues and this can be accomplished by effective leadership and teamwork. Effective teamwork can have a positive impact on the routines of daily life in the setting and if everyone in the team have the same shared focus and they are all engaging in professional reflection and self-evaluation of the quality of service they are providing, the quality of service will not be compromised. Rodd (2006) believes good teamwork is important for meeting the requirements of early education settings and cites Ebbeck and Waniganayake (2003) comments of building effective teams is fundamental to early childhood practice. The headteacher in the report has shown how effective her leadership is by receiving positive comments of her leadership skills. I believe she has been able to achieve effective leadership through building and nurturing a high standard of teamwork within the practice. This was done by using her interpersonal skills of communication, motivation and inspiration, Rodd (2006) and by empowering her team to work with her with the same high standards and aim for the same objective she has succeeded in achieving high-quality teamwork. HMIE (2008) Rodd (2006) believes that this human resource management is typical of an early childhood leader and she cites Taylors (2005) argument that a leaders own behaviour, their actions, beliefs and values, will determine how they are seen by their colleagues and how this behaviour will be rewarded. Leaders can determine whether or not their team will work with them or work against them and being a positive role model can help bring your team together and reach the objective. It is clear in this report that this leaders direction allows her team to work alongside her as they all have the same commitment to the continuous improvement of their setting. This includes their own personal professional development and also relates to the performance indicator 9.3 Developing people and partnerships HMIE (2007) The report comments on how the staff in this setting have the opportunities to continue in their own development through training courses, leadership support and self-evaluation. Another key element of effective leadership is having the ability to allow the personal development of others and use this ability to improve the quality of the team and the service they provide. Rodd (2006) Performance Indicator 9.3, HMIE (2007) states how an important feature of effective leadership is to develop positive working relationships with others and to have the ability to delegate roles and responsibilities within the setting. This can be done through continuous development of staff and relates to the National Care Standards, Standard 12, Confidence in Staff, Scottish Executive (2006) where it states a setting has an effective system for identifying and monitoring staff development needs. Hay lists another of Hodgkinsons views of differences between manager and leader as managers being more concerned with material resources rather than human resources. The leader in this setting is highly involved with her team showing excellent human resource management by allowing each member of the team to develop through on-going training and personal development without impacting on daily routines and allowing team members to use their own individual abilities and talents to benefit the group. Through effective teamwork, leaders can share with her team knowledge and skills, provide support and helpful feedback and in return gain the trust and support of the group and continue to produce a high standard of service. Dawson (2000) HMIE (2008) report that the staff in this setting were fully involved in systematically reviewing, evaluating and improving the nursery. This positive involvement helps to produce the high quality service that this setting provides and also relates to Standard 14 of the National Care Standards, Well managed Service. Scottish Executive (2006) Effective leaders will work with the team, examine their setting and holistically reflect with a view to change or improvement. This reflection will include analysing individual actions, actions of the group or individuals, routines or policies and most importantly analysing if the childrens learning experiences are adequate and can help an early years setting to move forward in terms of the quality of service provided. This setting does this through staff, children and parent involvement and they have received positive comments from HMIE. Reflective practice also relates to The Child at the Centre, 9.4 Leadership and improvement and change and the Codes of Practice for Social Service Workers and Employers. Staff in this setting are all registered with Scottish Social Services Council and work within the Codes of Practice, a list of statements describing professional conduct and practice expected within any setting. I agree with Rodd and Hay that effective leadership requires individuals to be equipped with both management and leadership skills and qualities. The successful, efficient running of an early years setting requires leaders to be able to balance factors of work, legislation and quality in the setting with the commitment to look after the people they need and work with.

Newscasters :: essays research papers

Newscasters are a big part of who and what America is today. The newscasters have a lot of influence on what America does, and when they do it. Still, it is not something that happens overnight. It takes a lot of experience to become a newscaster to the public.   Ã‚  Ã‚  Ã‚  Ã‚  A newscaster will influence the public that will make or break a morning, afternoon, or evening. The weatherman will help people be prepared for the day ahead. While, the sportscaster tells which team won or lost and who got signed and let go. On-the-scene newscasters tell what is happening right then and there. Still, the anchors bring it all together by presenting the news at5am, 6am, 7am, noon, and 5pm. When they all come together America knows what is going on, which is what you want.   Ã‚  Ã‚  Ã‚  Ã‚  In order to inform America, a newscaster must have college experience as well as on-the-job experience. When an aspiring newscaster comes out of college, they don't become a newscaster immediately. Many become journalists or studies. Some may realize that they want something else and change jobs. Becoming a newscaster and informing the public, is something that takes experience and know-how. Anything can happen, and newscasters need to be prepared.   Ã‚  Ã‚  Ã‚  Ã‚  The pressure on newscasters is very intense. They need to report the truth and many want to change the view of newscasters. The media in general have the stereotype of being pushy, annoying, and untruthful. Reporting the truth is key. The journalists who research the information are under a tremendous amount of pressure to make sure the information is correct. This way, both America is happy, and then so are the newscasters.

Human Immunodeficiency Virus Essay

Meet the Client: Jeff Smith Thirty-two-year-old Jeff Smith is admitted from his healthcare provider’s office to the acute care facility. Jeff was diagnosed HIV positive 2 years ago. His history includes fatigue, a productive cough, and weight loss. A tuberculosis (TB) skin test was administered in the healthcare provider’s office. Admission prescriptions include â€Å"isolation precautions for possible tuberculosis.† Admission Procedure The nurse welcomes Jeff to a private room at the end of the hall. According to hospital protocol, the nurse puts on a mask before starting the admission process. Jeff tells the nurse that his partner is downstairs and that he would like his partner to stay in the room with him. 1. How should the nurse respond? A) â€Å"Your healthcare provider wants you to get some rest.† INCORRECT Jeff is requesting an opportunity for psychosocial support, which should be honored by the nurse. B) â€Å"Your partner may stay, but only after we have the results of his tuberculin skin test.† INCORRECT Significant others may stay with appropriate protective equipment. C) â€Å"Your partner may stay, but he needs to wear a mask.† CORRECT Jeff’s partner may stay in the room, but he should wear a mask to help decrease the possibility of contracting the TB organism. D) â€Å"You don’t want to risk infecting your partner with TB, do you?† INCORRECT Jeff’s partner has already been exposed. In addition, this response denies Jeff the support he is requesting. Jeff’s partner, Anthony, arrives. Jeff wants to know why a mask is necessary for people entering his room. 2. What teaching should the nurse implement? A) Explain the use of a private room and mobile high-efficiency particle filters placed in the room. INCORRECT These are necessary precautions against infectious, airborne diseases such as TB. However, providing this information does not answer Jeff’s question. B) Explain that the tuberculosis organism is most often spread through the air. When an infected person coughs or sneezes, they produce infectious droplets that can be breathed in by another person. CORRECT This answer gives Jeff the scientific rationale for wearing a mask. C) Tell Jeff that tuberculosis will not be spread to others, and everything will be okay if the mask is worn. INCORRECT This is false information. Wearing a mask will not prevent the contraction of tuberculosis (TB), but it will reduce the risk of contracting the disease. D) Tell Jeff that masks are required for those persons who do not agree to be vaccinated with BCG vaccine. INCORRECT The BCG (Bacille Calmette-Guerin) vaccine is not generally recommended for use in the United States. It is only used here for very select persons who meet specific criteria. Isolation The unlicensed assistive personnel (UAP) asks why Jeff could not be in an empty semiprivate room closer to the nurse’s station so the staff would not have to walk so far to provide care. 3. What information should the nurse provide to the UAP on infection control practices? A) The client needs to be at the end of the hall because he requires privacy. INCORRECT This is not the reason for the location of Jeff’s room. B) The implementation of airborne precautions for possible TB requires a private, negative pressure room assignment. CORRECT According to the Center for Disease Control (CDC), in addition to isolating Jeff by using a private room, engineering controls can help to prevent the spread of TB. Controlling the direction of the airflow can prevent contamination of air in adjacent areas. C) A private room is required to implement contact precautions for possible TB. INCORRECT Airborne precautions, rather than contact precautions, are required to prevent the spread of TB. D) The client needs to be at the end of the hall for confidentiality. INCORRECT Confidentiality is provided for every client, regardless of the client’s room location. The nurse notices the UAP about to enter Jeff’s room to deliver a meal tray without wearing any protective apparel. 4. What information should the nurse provide to the UAP? A) A mask is required for healthcare workers entering the room of someone suspected of having active TB. CORRECT TB is spread by airborne transmission of droplet nuclei. A well fitting, high-efficiency particulate air (HEPA) mask is necessary to filter the mycobacterium tuberculosis bacillus. B) Wearing a mask, gown, and gloves is required for healthcare workers entering Jeff’s room for any reason. INCORRECT The only protective apparel required when entering the room is a HEPA mask. C) The UAP will only be in the room for a brief moment to deliver the tray, so no intervention is needed by the nurse. INCORRECT Since TB is spread by airborne transmission of droplet nuclei, a HEPA mask is necessary for the UAP to wear. The nurse needs to inform the UAP of this and ensure that appropriate PPE is worn in Jeff’s room. D) Non-sterile gloves are necessary to deliver the meal and prevent the spread of TB. INCORRECT Gloves do not prevent the transmission of an airborne organism. Specimen Collection An acid-fast bacilli (AFB) stain is part of the initial admission prescriptions. Early morning sputum specimens will be collected for 3 consecutive days and sent to the lab. 5. Which task(s) may the nurse delegate to the UAP? (Select all that apply.) A) Tell Jeff that the specimen must be collected in the early morning. CORRECT This task may be delegated. B) Provide Jeff with 3 sterile specimen cups at his bedside. CORRECT This task may be delegated. C) Teach the client how to cough to obtain sputum from deep in the bronchi. INCORRECT Teaching is a responsibility of the nurse that cannot be delegated. Jeff needs to be taught to cough deeply, using the diaphragm to produce sputum from the bronchi instead of saliva from the oral cavity. D) Document the time and date that each sputum specimen was collected. CORRECT This task may be safely delegated. However, it is the nurse’s responsibility to ensure that the documentation is completed and sent with the specimen to the lab. E) Assess Jeff’s abilty to expectorate a sputum specimen. INCORRECT This task may not be delegated. Jeff is scheduled for several activities the following morning. 6. Which activity should Jeff perform first upon awakening? A) Eat a nutritionally dense, early morning snack sent from the food services department. INCORRECT While small, nutritionally dense meals and snacks are necessary for clients with HIV and/or TB, another action is of greater priority. B) Obtain the first of 3 sputum specimens for laboratory testing. CORRECT Because secretions collect during the night, Jeff should take the opportunity to cough and expectorate upon awakening before performing other morning activities. C) Take a shower and get ready to go to radiology for a chest X-ray. INCORRECT Another action is of greater priority. D) Weigh to determine if weight loss from the disease is continuing. INCORRECT Although daily weight monitoring may be done, another action is of greater priority. Legal/Ethical Concepts A female staff nurse tells the nursing supervisor that she does not want to be assigned to care for Jeff. She states, â€Å"I have never cared for a client with HIV and do not want to start now. I have babies at home that need me.† 7. The nursing supervisor should base her response on what information about the right of a nurse to refuse to care for clients with HIV? A) The registered nurse has the right and responsibility to protect the health of self and family and may therefore refuse to care for clients with contagious diseases. INCORRECT This answer does not meet the professional guidelines set forth by the ANA Code for Nurses that guide ethical nursing practice. B) The registered nurse may refuse to care for a client in circumstances where risk to the nurse outweighs the nurse’s responsibility to care for a client or if the assignment conflicts with the nurse’s ethical standards. CORRECT According to the ANA Code for Nurses, a nurse may morally refuse to participate in care, but only on the grounds of either client advocacy or moral objection to a specific type of intervention. Exceptions may be made when risk of harm outweighs the nurse’s responsibility to care for a given client. For example, an immunosuppressed nurse may refuse to care for clients with certain infectious processes. The pregnant nurse may refuse to care for the client with HIV who has secondary infections such as toxoplasmosis or cytomegalovirus, both of which can cause severe damage or death to the fetus. C) Refusal to treat or care for a person based on race, gender, or age is discrimination, which the federal government prohibits. INCORRECT The nurse in this case is not refusing to care for the client based on these  parameters. If the nurse did refuse, it would be illegal. D) The required staffing ratio of licensed personnel to client population does not allow for professional nurses to refuse to care for a client. INCORRECT Staffing ratio is a budgeting issue. Nurses in many states may claim â€Å"safe harbor† if they feel staffing is unsafe, but this is not the reason given for refusal in this case. 8.  How should the nursing supervisor respond to the staff nurse who does not want to care for Jeff? A) â€Å"I understand. I will assign you to a different client and give Jeff to one of the other nurses.† INCORRECT This response does not provide an opportunity to assess if something else is needed. B) â€Å"I understand you are concerned, but I am concerned about you losing your job over this.† INCORRECT Not only is addressing possible dismissal of the nurse premature, this response does not provide an opportunity to assess whether something else is needed. C) â€Å"I understand your fears, but do you realize this will cause a hardship on your fellow staff members?† INCORRECT This response does not help develop the nurse as a team member, nor does it provide an opportunity to assess if something else is needed. D) â€Å"I understand you want to protect your children. Please tell me your concerns regarding caring for a client with HIV.† CORRECT This response by the nurse supervisor demonstrates compassion and provides an opportunity to discover if education of the staff nurse is needed. Client Education The nurse checks on Jeff and finds him reading a brochure about TB. 9. Which statement by Jeff indicates that he understands why he is at risk for TB? A) â€Å"I realize my helper T cells are diminished from HIV. Those are the cells needed to fight TB.† CORRECT HIV attacks the CD4 receptors on the helper T cells that help the body fight off diseases such as TB. B) â€Å"I may get tuberculosis because my viral load count is diminished.† INCORRECT An increased HIV viral load indicates disease progression and puts the client  at risk for opportunistic infections. A decreased viral load count is desirable. It is a goal of anti-HIV therapy. C) â€Å"I am at risk for developing TB because I was born with a low number of helper T cells.† INCORRECT This may indicate Jeff is in denial or lacks correct information. The human immunodeficiency virus is acquired rather than genetic in origin. D) â€Å"I realize I am at risk for acquiring TB because I used intravenous drugs in the past.† INCORRECT Jeff could have been exposed to HIV and hepatitis virus from a contaminated needle. However, the mode of transmission of the mycobacterium tuberculosis bacilli is through respiratory secretions, not blood-borne routes. After 3 days, the nurse receives the results from Jeff’s tuberculin skin test that was administered at his healthcare provider’s office. Even though Jeff’s reaction to the tuberculin skin test measures only 5 mm in diameter, the healthcare provider documents a positive test result. A new graduate nurse finds this confusing. She tells her preceptor that she thought a 10 mm induration was the minimum size for a positive reading. 10. How should the nurse-preceptor respond? A) â€Å"This confuses me, too. I think we need to consult with the healthcare provider.† INCORRECT The nurse-preceptor should be able to explain the tuberculin skin test result. B) â€Å"That is not always true. A 5 mm induration is considered positive for TB in a person with HIV.† CORRECT The person with HIV has diminished T cell immunity, which compromises their ability to react to skin tests. Therefore, an induration of 5 mm is considered a positive reaction, rather than the standard of 10 to 15 mm for other groups. C) â€Å"It may be that you are confusing induration with inflammation in skin testing results.† INCORRECT The hardened, raised area of induration at the site of the skin test is measured. Any flat, reddened area of inflammation is not measured. The graduate nurse did not indicate confusion between the two. D) â€Å"Let’s ask the nurse-practitioner who specializes in caring for clients who are HIV  positive.† INCORRECT Although the practitioner is an excellent resource, the nurse-preceptor should be able to explain the tuberculin skin test result. Pharmacotherapeutics/Medication Administration Before breakfast, the nurse brings Jeff the HIV medicines that are due. Jeff inquires about his other medications, stating, â€Å"I take all my HIV pills at once before breakfast. I don’t want to bother with this disease all day long!† 11.  How should the nurse reply? A) â€Å"To be most effective, HIV medications are prescribed on different schedules.† CORRECT Some HIV inhibitors need to be given on an empty stomach and some need to be given with food for best effectiveness. Many need to be taken around the clock, even if sleep is disrupted, to ensure drug efficacy. B) â€Å"All right. I will give the rest to the UAP to bring in as soon as possible.† INCORRECT This is not the correct way for Jeff to take his medication, nor is it within the UAP’s scope of practice to give medications. C) â€Å"We are just trying to provide you with the best nursing care possible on this unit.† INCORRECT That is a defensive reply, which does not contribute to educating Jeff. D) â€Å"We need your cooperation to help fight this disease.† INCORRECT This reply is judgmental and implies that Jeff is uncooperative, which he is not. Jeff responds by agreeing to take his medications as prescribed. He then states, â€Å"However, I don’t know what good they will do. Do you?† 12.  How should the nurse respond? A) â€Å"I honestly do not know, but I would give it a try. What is there to lose?† INCORRECT This response does not educate Jeff about the purpose of the HIV meds. B) â€Å"The main purpose of these medicines is to block the replication of the HIV virus.† CORRECT The purpose of the antiretroviral and inhibitor medicines is to block the replication of the HIV virus and prevent opportunistic diseases. C) â€Å"You should talk to your healthcare provider about your medications.† INCORRECT The nurse should be able to answer Jeff’s question about his medications. D) â€Å"Tell me about the experiences your friends have had with these medicines.† INCORRECT Exploration of how Jeff formed his opinion would be better if left until after the nurse answers Jeff’s question. Jeff’s healthcare provider has also prescribed the antibiotic Rifater. This drug is a combination of isoniazid, rifampin, and pyrazinamide. 13.  What information is important to teach Jeff about the use of Rifater? (Select all that apply.) A) Rifampin stains urine, stool, saliva, sweat, and tears reddish-orange. CORRECT This teaching can help Jeff prepare for this side effect without anxiety. B) Liver function tests should be routinely conducted and monitored. CORRECT The major side effect of isoniazid, rifampin, and pyrazinamide is drug-induced hepatitis. Therefore, Jeff must be taught the importance of having blood samples drawn to monitor his liver function. C) There is no need to wear sunscreen when exposed to sunlight while taking Rifater. INCORRECT Pyrazinamide may make the skin sensitive to sunlight, and this should be taught to the client. D) Supplemental Vitamin B6 may be prescribed. CORRECT Jeff may be prescribed Vitamin B6 to prevent peripheral neuritis, a side effect of isoniazid (INH). E) Rifater has been known to cure HIV within a few months of taking it. INCORRECT Rifater is a first-line anti-tubeculin drug Nursing Diagnosis Jeff has been diagnosed with the opportunistic disease TB. He has experienced weight loss and has a CD4 cell count of 240 cells/mm3. The healthcare provider moves Jeff from the HIV asymptomatic stage (CDC HIV Infection Stage 1) to the HIV Infection Stage 3 (AIDS). 14. What is the priority nursing diagnosis for Jeff at this time? A) Risk for new opportunistic infections related to decreased immune function. CORRECT Since Jeff’s immune system is no longer competent, he is at risk for additional opportunistic infections. Immune problems start when the CD4 cell count drops below 500 cells/mm3. Preventing infections is a basic need and is a high priority in the immunocompromised client. B) Social isolation related to worsening of condition. INCORRECT Social isolation should be addressed, but there is a higher priority nursing diagnosis. C) Imbalanced nutrition, less than body requirements related to medication side effects. INCORRECT Although this is frequently a side effect of taking HIV and TB medications, there is a higher priority nursing diagnosis. D) Fatigue related to altered body chemistry. INCORRECT Although the client initially complained of fatigue, there is a nursing diagnosis with a higher priority. Infection Control One of the unlicensed assistive personnel (UAP) says, â€Å"Now that Jeff’s condition has worsened and he has been moved to the HIV Symptomatic stage, shouldn’t added precautions be posted on Jeff’s door to protect staff members?† 15. What information should the nurse give the UAP? A) Following standard precautions will minimize the exposure to blood and body fluids. CORRECT Standard precautions are designed to prevent contact with blood or body fluids, which are the mode of transmission for HIV, and are used no matter what the stage classification of the disease. B) Reverse isolation procedures should be implemented to protect the staff. INCORRECT Reverse isolation protects the immune-compromised client, not the staff. C) Respiratory precautions are all that are needed, and those are already posted on the door. INCORRECT This does not address the UAP’s concerns about prevention of HIV transmission from client to staff. D) Staff members caring for Jeff should begin prophylaxis medications. INCORRECT Unless HIV exposure occurs, staff should not begin the postexposure prophylacis regimen. The UAP has been assigned to help Jeff bathe. As the UAP prepares to enter Jeff’s room, the nurse observes her putting on a gown, gloves, mask, and goggles. 16. What should the nurse say to the UAP? A) â€Å"I see you are putting on a gown, gloves, mask, and goggles to go into the client’s room. Help me understand this choice.† CORRECT This type of open-ended statement seeks clarification and invites the UAP into a dialog where teaching can take place. The nurse can then educate the UAP concerning the proper use of equipment. Standard precautions (for HIV) require that gloves be worn, and respiratory precautions (for TB) require that a mask be worn. Goggles and a gown are not necessary. B) â€Å"Don’t you know all that equipment is not necessary?† INCORRECT This statement is overly aggressive and may seem demeaning to the UAP. C) â€Å"Wearing all that equipment is a waste of hospital supplies.† INCORRECT While it is important to ensure effective use of resources, this statement is critical and negative and may cause the UAP to become defensive. D) â€Å"Wearing all that equipment may frighten Jeff.† INCORRECT While the excessive equipment may frighten Jeff, there is a better response. Oral Candidiasis The nurse notices that Jeff has left most of his dinner untouched. The nurse offers to order something different for Jeff, but he replies that his mouth is sore and he just doesn’t feel like eating. 17. Which assessment finding by the nurse would be indicative of oral candidiasis, a common secondary infection in persons with compromised immune systems? A) Blisters on the tongue or oral mucosa. INCORRECT This is a sign of herpes simplex type virus 1 (HSV-1) infection. B) Inflammation of the gums. INCORRECT This is a symptom of gingivitis. C) Painless white lesions on the lateral surface of the tongue. INCORRECT This is a description of leukoplakia. D) White-yellow patches on the tongue or oral mucosa. CORRECT This sign is indicative of a Candida albicans infection. It is a common finding in people with HIV, and it frequently occurs with a falling CD4 cell count. The nurse notifies the healthcare provider, who prescribes nystatin (Mycostatin) 6 ml PO 4 times per day. 18. What instruction should the nurse give Jeff about the use of liquid Mycostatin? A) Place all of the suspension in the mouth, then swish and swallow immediately. INCORRECT This is not the proper way to take liquid Mycostatin. B) Sip the suspension over 5 minutes, swishing and swallowing after each sip. INCORRECT This is not the proper way to take liquid Mycostatin. C) Place the suspension in the mouth, then swish for several minutes before swallowing. CORRECT This â€Å"swish and swallow† technique is the proper way to take liquid Mycostatin. Providers also recommend gargling, as well as swishing, prior to swallowing. D) Use the applicator to paint the medication on the infected sites and swallow the remaining dose. INCORRECT This describes the recommended procedure for young children or infants taking Mycostatin. Nutritional Interventions Jeff Smith is 5 feet, 11 inches tall. He has a large frame and weighs 152 pounds. His current BMI (body mass index) is 17.4. Jeff says he realizes he should eat, but he does not have the energy or the appetite, even when he has no oral pain. The nurse identifies the nursing diagnosis of, â€Å"Imbalanced Nutrition: less than body requirements.† 19.  To achieve the goal of improving Jeff’s nutrition, which nursing intervention should the nurse perform? A) Consult with Jeff to assess his food preferences. CORRECT Determining Jeff’s food preferences is a good first step. It is essential that Jeff be an active participant in his care so he has some control. If a favorite food is not on the menu, it can be requested. B) Request a prescription for total parenteral nutrition (TPN). INCORRECT While this may eventually be needed, it is not the best intervention at this point. C) Inform Jeff that adequate nutrition is essential. INCORRECT Jeff has already indicated he understands the need to eat. D) Instruct Jeff to focus on breakfast, the most important meal of the day. INCORRECT It is not necessary to focus on breakfast. Adequate nutrition can be achieved from meals eaten throughout the day. 20.  Since Jeff now has thrush, in addition to fatigue and anorexia, which food best contributes to improving Jeff’s nutrition? A) Broiled steak. INCORRECT Although steak is a good source of protein, it requires energy to chew, and it may be irritating to Jeff’s mouth. B) Milk shake. CORRECT A milk shake is a nutrient-dense food. It provides needed calories, calcium, and protein. Jeff can drink the nutritious snack without using the energy it would take to eat a full meal. Jeff may find the cool liquid is soothing to his sore mouth. C) Tomato soup. INCORRECT Although liquid soup is not difficult to eat, (note, the warmth could be soothing), the acidity of the tomato soup may be irritating to Jeff’s mouth. D) Lettuce salad with raw vegetables. INCORRECT Although a salad with raw vegetables is a good source of vitamins, it  requires energy to chew, and it may be irritating to Jeff’s mouth. A Complication Occurs Jeff develops severe diarrhea with occasional incontinence that could be caused by an opportunistic gastrointestinal infection or by one of his medications. While stool cultures are pending, other interventions can be initiated. 21.  Which task(s) should be delegated to the UAP? (Select all that apply.) A) Weigh Jeff each morning before breakfast. CORRECT Weights can be obtained by the UAP. B) Measure the urine output. CORRECT Measurement of the urine output can be delegated to the UAP, then reported to the RN. C) Count and record the number of watery stools. CORRECT The UAP can legally count and record the number of watery stools. However, it is the nurse’s responsibility to be aware of the client’s condition and promptly report any significant changes to the healthcare provider. D) Evaluate the rate and quality of Jeff’s pulse. INCORRECT The nurse must evaluate the quality and rate of Jeff’s pulse because this requires judgment and expertise beyond the scope of practice of unlicensed personnel. E) Check Jeff’s skin turgor to determine if he is dehydrated. INCORRECT The nurse conducts physical exam procedures, including assessing for alterations in skin turgor, to determine hydration status. This expertise is not within the scope of practice for the UAP. When performing Jeff’s morning physical assessment, the nurse discovers that he has a weak, rapid pulse. He also has decreased skin turgor and dry, sticky, oral mucous membranes. His weight is 2 pounds less than it was yesterday morning. 22.  What is the priority nursing diagnosis? A) Fatigue. INCORRECT Fatigue may be present with diarrhea, but it is not the priority nursing diagnosis. B) Disturbed sleep pattern. INCORRECT While diarrhea may certainly disrupt sleep, this is not the priority diagnosis. C) Deficit Fluid Volume. CORRECT A weak, rapid pulse; decreased skin turgor; dry, sticky, oral mucous membranes; and weight loss are signs of dehydration. D) Situational low self-esteem. INCORRECT Incontinence of stool may lead to low self-esteem, but this is not the priority diagnosis. 23.  Which action should the nurse take first? A) Hold Jeff’s breakfast tray to provide bowel rest. INCORRECT While clear liquids or another diet that promotes bowel rest may be prescribed, another action should be performed first. B) Perform oral care and moisten mucous membranes. INCORRECT Another action should be performed first. C) Take Jeff’s blood pressure to assess for postural hypotension. CORRECT Postural hypotension can result from dehydration. Therefore, it is important for the nurse to obtain this vital information because it directly impacts Jeff’s safety. D) Notify the healthcare provider of Jeff’s weak, rapid pulse. INCORRECT Another action should be performed before notifying the healthcare provider. 24.  The health care provider is notified of Jeff’s physical exam findings indicating possible dehydration and vital signs, including a blood pressure of 100/50. It is determined that Jeff could use a bolus of IV fluids. The HCP prescribes 1000 cc of normal saline to run over 6 hours. The drop factor tubing set is 15 drops/ml. How many drops/minute will the IV run? (Enter the  numerical value only. If rounding is required, round to the whole number.) 42  CORRECT 1000/360 X 15 = 41.66 = 42 gtts/minute Jeff’s stool cultures are negative. After treatment with fluids and diet modification, his diarrhea resolves in 24 hours. Jeff’s fluid balance is restored and his oral candidiasis is resolving. Discharge Instructions Before Jeff is discharged home, it is important that he understands how to prevent the spread of HIV. When discussing infection control practices with the nurse, Jeff says, â€Å"I have heard that condoms don’t always prevent HIV.† 25.  How should the nurse respond? A) â€Å"If used correctly and consistently, latex condoms are highly effective in preventing the transmission of HIV.† CORRECT Jeff’s misinformation and misunderstanding is a common myth regarding the effectiveness of latex condoms. Studies prove that condoms work. B) â€Å"I know you would feel terrible if you passed HIV to someone because you did not use a condom.† INCORRECT Not only is this statement judgmental, the nurse also presumes to know how Jeff will feel. C) â€Å"I will have an AIDS educator discuss condom use with you.† INCORRECT The nurse has the knowledge to respond to Jeff’s question. D) â€Å"What is your source of information about condom failure?† INCORRECT While it may be helpful to know where Jeff got his information, this response does not answer Jeff’s question. Jeff assures the nurse that he will use a condom with each sexual encounter. He also expresses concern that he may become dehydrated again. 26.  What resource can be provided for Jeff in the event this complication occurs? A) Meals on Wheels. INCORRECT Meals on Wheels is a national nonprofit organization that delivers food to the elderly, the disabled, and the homebound. Jeff would not be a candidate to receive help from Meals on Wheels. B) HIV/AIDS support group. INCORRECT Although an HIV/AIDS support group can be a valuable resource, it cannot prevent Jeff from getting diarrhea or becoming dehydrated. C) Access to the services of a registered dietitian. CORRECT It is essential that the nurse arrange a consult for Jeff with a registered dietitian before he is discharged home. The dietitian will give Jeff specific information on suggested foods and liquids to include in his diet to help prevent dehydration if diarrhea occurs at home. The clinical dietitian will provide Jeff with resources, such as a phone number, that will give him access to the dietitian on an outpatient basis. Breast cancer Evolve Case Study Breast Cancer – Patient: Sandra Williams 1) â€Å"Select whatever day you can best remember to perform BSE consistently every month.† 2) â€Å"When lying down, your arm should be positioned over your head.† 3) The combination of yearly CBE and monthly BSE is the best approach for early detection.† 4) Teach Barb that even women with no identified risk factors are at risk 5) â€Å"You may experience some discomfort, but only for a few minutes.† 6) â€Å"It’s hard to believe that this is happening, isn’t it?† 7) â€Å"Are you saying that you do not want to have surgery?† 8) Anticipatory grieving 9) â€Å"To ensure your safety, I need to notify the surgeon of the snack you ate.† 10) Nonmaleficence 11) Notify the surgeon that further explanation of the procedure is necessary 12) Observe the Jackson-Pratt drainage device, Administer a PRN dose of prescribed analgesic, Monitor vital signs and pulse oximetry 13) Encourage Sandra to continue performing these exercises 14) Advise the UAP to immediately stop and obtain a larger cuff so the BP reading can be taken in the leg 15) Both the GN and UAP are at fault for the incorrect action of the UAP. 16) Ask Sandra to clarify how she learned this information so  that a plan for further teaching can be developed 17) Blood clots 18) â€Å"The medication decreases estrogen levels, which is what also causes the symptoms of menopause 19) Diarrhea, Alopecia 20) Label the two lumens as non-functional, and use one of the remaining lumens 21) Oral temperature of 99.5 ° F 22) Altered tissue perfusion 23) Apply a sequential compression device, Elevate the affected arm. 24) Fifteen minutes prior to administration of the next dose of the drug. 25) 63 26) Candida superinfection 27) A 65-year-old woman, who is a retired teacher and who never married or had children. 28) Younger sister 29) Unusual skin texture. 30) Hard, irregular, and does not move freely