Life Limiting Illness Essay

Sam (name changed to protect confidentiality) is a nine month old boy who was born at 26 weeks and diagnosed with chronic lung disease. He was sent home on 0.3 litres (L) of oxygen per minute with the view of gradually weaning this down as he grew stronger. When I joined the community nurse visiting Sam at home, he had been weaned down to 0.1L of oxygen per minute, so was now having his time on oxygen weaned down; from continuous oxygen eventually to none. The community nurses follow the trust’s nursing assessment guidelines which are based on The Twelve Activities of Daily Living (Roper et al, 1983). This model allows nurses to organise and prioritise care effectively for each individual child (McQuaid et al, 1996). As Sam was recovering from chronic lung disease, his respiratory well-being was the main priority. During the weaning process the community nurses conduct regular respiratory reviews to ensure Sam is coping with the lessening amount of oxygen. This assessment can begin as soon as the nurse enters the home. We were able to assess Sam’s work of breathing by looking at him and listening to him. He was not exhibiting any signs of respiratory distress such as nasal flaring, recession, grunting or wheezing, all of which would tell us he was making excessive respiratory effort (Huband and Trigg, 2000). It is essential to monitor oxygen saturations and vital signs in a respiratory review. The pulse oximeter is used to alert nurses to potential hypoxaemia. It does this by emitting red and infrared light from the sensor into the patient. Oxygenated and deoxygenated blood absorb different amounts of infrared light, so an average value can be calculated to show the percentage saturation (Huband and Trigg, 2000). The nurse ensured Sam’s foot was warm before attaching the probe to it, to determine if he had good peripheral perfusion. This is important for obtaining an accurate reading. The nurse informed Sam’s parents that we would be happy with Sam saturating above 95%. He was sitting around 99-100%, which was a great sign. His respiration rate was within limits at 41. Sam was currently having 8 hours off oxygen per day and this review showed he was coping well. The pulse oximeter also recorded his heart rate at 124 beats per minute, he was peripherally warm to the touch, and he was pink and perfused, so there were no concerns with his circulation. Sam is bottle fed on demand. He was gaining weight and his mum reported he was feeding well 6-8 times a day. There were no concerns with his elimination as he passed urine and opened his bowels regularly. He had no history of pyrexia or hypothermia so it was not necessary to take his temperature. Sam lives at home with his mum and dad, the family appear happy and settled. Both parents seem to have bonded well with him. His mum is very good with him but is often keen to progress with Sam quicker than is advised by healthcare professionals. For example when Sam was having 3 hours off oxygen a day, his mum had disclosed she left him off for 5 hours, although this was against advice given. The nurse’s role is to reinforce the advice given without losing the good relationship with parents. Working in partnership with parents in the community after their children have been discharged involves handing control back to them, but this must be balanced with professional knowledge and expertise (Muller et al, 1992). Sam’s mother also had a tendency to compare his development with other babies of his age, forgetting to correct his age for his prematurity. The nurse reminded her that Sam was doing very well considering he was 3 months premature. As I was playing with Sam I found him to be very alert and receptive. He interacted well with me, smiling and giggling at stimulations. After conducting a thorough respiratory review and discussing Sam’s progress with his parents, the community nurse was able to advise them to advance him to 12 hours off oxygen a day. She informed Sam’s parents that another overnight sleep study would need to be conducted in the next few weeks, so the consultant would be able to confirm he was still coping well. Huband. S and Trigg. E (2000) Practices in Children’s Nursing; Guidelines for Hospital and Community. Harcourt Publishers Limited. McQuaid. L, Huband. S, and Parker. E (1996) Children’s Nursing. Churchill Livingstone. Singapore. Muller. D, Harris. P, Wattley. L and Taylor. J (1992) Nursing Children; Psychology, Research and Practice. Second Edition. Chapman and Hall. London. Roper. N, Logan. W and Tierney. N (1983) Using a Model for Nursing. Churchill Livingstone. Edinburgh.

An Element of Art and Science Essay

Astrology provides a very debatable kind of knowledge that is generally assessed by the intelligent as a useless kind of knowledge, which only makes sense for the ignorant. At the same time astrology is usually associated with gypsies and hucksters, who are known for their deceptive and fake knowledge, as they try to deceive people for their own financial interest. On the other hand, we find people with high education attempting to study astrology and very much respect the kind of knowledge it offers them. Whether such knowledge offered through teaching astrology in universities is worth doing or to be considered an inapplicable knowledge for high education is a critical decision to make, which requires obtaining a great insight about astrology it self as an academic field in order to be able to make a correct assessment. Astrology is actually a combined form of knowledge that both combine both the element of art and of science in its essence. It contains the mathematical element as well as the artistic element o symbolism (â€Å"Astrology? â€Å"891). Scientists usually disregard the art side of astrology and focus on the basic mathematical part of it, as they judge it as useless and insignificant. This actually destroys the wholeness and balance within the realm itself. This may be considered a reason for misunderstanding the real value of knowledge in astrology. It is also a fact that every field is vulnerable to be used by ignorant people who devoid it totally of its meaning and value, in order to sell it as cheap as possible in a market of ignorance that unfortunately have many customers who are wiling to buy, again this helps in misunderstanding Astrology (â€Å"Astrology? † 891); and as there is the presence of the competent and the incompetent in every field, and people usually search for the best in every profession, so why exclude Astrology (â€Å"Astrology? † 896). Astrology requires a sophisticated kind of thinking as it combines artistic and scientific knowledge, it can therefore never be considered as insignificant knowledge. It may not be appreciated by scientists due to the artistic element provided within it, and their total dependence on reason for discovering reality since the onset of the renaissance; thus reviving such forms of knowledge actually, shows the evolution of knowledge and thinking that reflects the significance of intuitive forms of knowledge besides the pure rational ones. The astrological knowledge in itself consists of a natural balance between intuitive and rational knowledge, and disturbing this balance will only lead to the production of inconsistent forms of knowledge that seem to appear on the surface to help in the generation of misunderstandings regarding astrology. The argument of scientists against Astrology reflects the on going disagreement between scientific knowledge and intuitive forms of knowledge. Scientists never admit the truth in any intuitive understanding, and they usually regarded as invalid. They never accept the fact the mystery is part of reality and that the rational mind can never be able to reach full understanding of the universe. Astrology is a balanced kind of knowledge as it respects both forms of thinking, which in fact a respect for nature and for the human being as part of that nature. I feel that the purpose of a reading is to understand one’s life challenges And potential, to provide an opportunity for self reflection and life Evaluation, as well as to confirm one’s intuitive sense of what one’s Life is about (â€Å"Astrology? † 895). Human beings as well as nature are made of matter and soul that can never be detached from each other as long as life is there. How can scientists reach the truth if they are actually altering the natural balance in life by looking for material proof and ignoring the intuitive reality of nature? The soul remains a mystery that can never be explained by scientific truth, and science can not resolve the question of life and death. There fore, accepting astrology as a significant form of knowledge by a scientist is truly a question of him admitting intuition as a part of reality. From another side, if the issue had not been on intuition, regarding astrology, it is still a form of knowledge that surely provides the individual with some insight about life and introduces him to different kinds of thinking; it should be even credited for this reason alone, â€Å"my studies in Astrology, as well as in other fields, are attempts to understand the grand design of the whole† (â€Å"Astrology? † 894). Scientists also accuse Astrological interpretive knowledge of not being exact â€Å"stars incline but do not compel† (â€Å"A critical? † 882), and this fact works against scientific logic which is sharp and determinant. But actually, life in it self is never exact or straight forward and clear as mathematical knowledge entails for instance. Astrology may actually provide the best for of understanding of life and nature; it allows people to understand reality the way it is without trying to alter its nature. The whole issue of prediction and future related knowledge can never be definite or fully explainable, â€Å"to discuss future probabilities is much like giving a weather report† (â€Å"Astrology? † 896). On the other hand, it should be admitted that Astrological knowledge may help in creating dependent and weak individuals, if they used it wrongly. It might lead them to spin in a cycle, which they might not be able to break. People can stress too much on the intuitive knowledge in Astrology and thus once again altering its balance of logic and intuition and thus getting again a wrong insight about life and nature, with an accompanied change in personality and attitude to life â€Å"Astrology, when practiced as completely as possible, takes away from ach of us our right and duty to make our own personal decisions† (A Critical? † 882). In the case of a scientist who puts great emphasis on logic and excludes intuition, makes him a rough and rigid person who stands weak in front of the scientifically unexplained mysteries of the world; while in the case of the ignorant who does the opposite to give too much significance to intuition and disregards reason suffers another kind of weakness that creates a dependent and shattered personality. But again we must also admit that this would be the case with any field if wrongly interpreted. All in all, I believe that Astrology is a sophisticated form of knowledge that should be respected for the special thinking abilities it provides an individual who studies it. It also reflects on the importance of providing a balance between Art and Science, and thus between logic and intuition, which is found deep within the nature of man and the universe he lives in. I would very strongly recommend all institutions of high education to teach Astrology in order to correct the misunderstanding entitled to it, and thus expose the rich and deep knowledge it provides. Works Cited Bok, Bart J. â€Å"A Critical Look at Astrology. † The Humanist Costello, Priscilla. â€Å"Astrology, Science or Abracadabra? † Wellesley College.

Homework: Food and Patient

Homework 5 for Lesson 15 (Due on Wednesday, March 20) Read the passage below and answer the question. , , , , , , , , :â€Å" † Questions: (True/False) ( T ) 1. Li You cooked a tofu dish and invited Wang Hong to dinner. , ( T ) 2The tofu dish was the cause of Li You’s stomachache. ( F ) 3. When Li You went to the doctor, it took the doctor a long time to diagnose the problem. ( F ) 4. Li You asked Wang Peng to help her look for a new refrigerator. , , , , :† , , Questions: (True/False) ( T ) 1. Little Qian first met the doctor when she went to the hospital for her allergy. , ( F ) 2. According to Li You, Little Qian has suffered from her allergy for a long time. ( T ) 3. According to Li You, her allergy is Little Qian’s excuse for visiting that doctor. ( T ) 4. Liitle Qian’s allergy symptoms become worse when she sees the doctor. : : , : : : , , , , , : , , , : : : †¦Ã¢â‚¬ ¦? ,! : , : , Questions: (True/False) ( F ) 1. The pa tient and the doctor meet in a restaurant. ( T ) 2.The patient has a stomachache. ( T ) 3. Neither the doctor nor the patient had dinner at home yesterday. ( T ) 4. The doctor urges the patient to take medicine as soon as possible. ( F ) 5. The doctor always dines at expensive restaurants. Multiple choice ( C ) 6. What is the doctor’s advice to the patient about dining out? _______ a. Go to more expensive restaurants where the food is tastier. , b. Go to more reputable restaurants where the food is more expensive. , c.Go to more expensive restaurants where the food is safer. , ( B ) 7. What can we say about the doctor? _______ a. He himself follows the advice he gives to his patient. b. He himself does not follow the advice he gives to his patient. c. He advices his patient to do things his way. ?this is a form that a new patient needs to fill out in hospitals in China. Try to fill out the form as much as you can, according to your own circumstances. And translate the charac ters and phrases that you can understand into English. ? Story telling: write a story in Chinese based on the four cartons below. Mare sure that your story has a beginning, middle and end. Also make sure that the transition from one picture to the next is smooth and logical. ————————————————- ————————————————- ————————————————- ————————————————- ————————————————- ———————— Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€Ã¢â‚¬â€- ————————————————-

Significant detail Essay Example | Topics and Well Written Essays - 500 words

Significant detail - Essay Example The narrator describes her routine with Jorg, how he would order them food and watch television with her, and then â€Å"leave the house again,† and how she would be in bed by the time he gets back (page 22). From this we get the sense that the narrator has fallen into her familiar pattern of pretending nothing that happens is actually happening to her. She describes her life from a distance, as if she is a character in a movie. However, one day while doing this she sees some scissors on a desk and decides to act. The scissors are described in great detail, and in a very strange manner as well. Not only are they â€Å"long† and â€Å"narrow†, but there are â€Å"two angular little men† standing atop the blades (page 22). The narrator then becomes suddenly unsure of who she is sleeping with, describing him not as Jorg but as â€Å"a man whose name was probably Jorg† (page 22). She is starting to lose track of reality, and cannot be certain of anything any more. But this scene gets even stranger, as the narrator decides to kill Jorg. She holds the scissors on top of her â€Å"in the dark† so he cant see them, and he â€Å"flung himself on top of me and the scissors pierced his flesh† (page 23). The matter of fact way the mans death is described is very disturbing. And the details are quite graphic, as she describes feeling the scissors pop through his spine and out of the flesh on his back, and how â€Å"his eyes swelled and popped† (page 23). But probably the strongest part of this episode, and the thing which makes it so important in understanding the narrator and how she relates to the world around her, is how she describes her feelings after what is essentially a murder, even if it is an understandable murder because of how Jorg kidnapped her. As the mans corpse falls next to her in the bed, she felt â€Å"as if there might be peace in the room for a while† (page 23). While peace is a good thing, the narrator feels like the only way she can get

Nursing -Activity homework Essay Example | Topics and Well Written Essays - 1250 words - 1

Nursing -Activity homework - Essay Example 345). Depending on the condition of the patient, monitoring should be either continuous or intermittently. Bubbling and swinging are assessed with the patient’s respiration. In normal respiration, the fluid within the tube rises with inspiration and falls with expiration (Paul and Williams, 2009 p.45). Absence indicates that the tube is blocked, or it is out of the pleural space. Intermittent bubbling in the water seal chamber shows an air leak when the patient coughs or exhales. Continuous bubbling indicates air leak between the patient and the drain. Volume, color and consistency of the drainage are monitored (Smeltzer et al., 2010, p. 234). The drain insertion site is also assessed for signs of infection and inflammation. The sutures are checked if they are intact and secure and that the dressing is clean and intact (Smeltzer et al., 2010 p. 252). The rationale for clamping the chest drain is to reduce the risk of tension pneumothorax. Smeltzer et al., (2010 p. 252) recommend disconnection of the chest drain in the case of sunction or the patient are ambulant. However, during the transport, the chamber should be kept below the patient’s chest level to enable draining (Smeltzer et al., 2010, p. 123). This allows gravity drainage and prevents backflow of fluid. However, Paul and Williams (2009, p. 13) suggest that clamping can also be done when the drainage bottle requires a replacement or to locate any air leak in the drainage system. Therefore, the suggestion that chest drains should only be removed when the patient is to be moved is false. If the water in the chest tube was—swinging but not bubbling or draining it means the air has been removed from the pleural space but that the pneumothorax has not resolved. When bubbling initially stops this should be further assessed by instructing the patient to cough. When monitoring for the patient with chest pneumothorax the bubbling shows the presence of air in

Birthday Story of Private John G. Burnett Assignment

Birthday Story of Private John G. Burnett - Assignment Example In May 1838, federal army troops under the command of General Winfield Scott began arresting the Cherokee and moving them in the stockade until they could be removed west. In this exodus, he even lost his wife, who succumbed to pneumonia after giving out her only blanket to a child (Byers 8). Party politics in a big way contributed to the removal. The U.S. government formally adopted a removal policy, carried out in the 1830a when President Andrew Jackson, from Tennessee, who was a forceful proponent of Indian removal. President Jackson began aggressively to implement a broad policy of extinguishing Indian land titles and relocating the Indian population. Out of altruism, the troops treated the tribe members so unkindly, and the roundup was very cruel. Families were separated; the elderly and the ill were forced out at gunpoint and herded into forts with minimal facilities and food, something which resulted in many deaths of the Cherokees (Byers

Psychiatric Mental Health Nurse Practitioner Research Paper

Psychiatric Mental Health Nurse Practitioner - Research Paper Example Additionally, they also consult with the various stakeholders such as legislators, communities, corporation and groups involved in mental health. One major requirement that these nurses should have is that they have to attain a master’s degree or one in doctoral in psychiatric mental health in order for them to qualify to be registered nurses in this field. Most of them operate private owned practices that allow them to provide primary care services to populations affected by psychiatric mental health. Based on this over view, this research paper will evaluate all the requirements that Psychiatric –Mental Health Nurse Practitioner Advanced Practice Registered Nurses in the US specifically looking at the ones applied in the state of Florida. Before an individual qualifies to be a Psychiatric-mental Health Nurse Practitioner, it is a requirement for them to attain a Bachelor of Science degree in Nursing and a Nurse Practitioner degree that might take at least to four additional training years. Further, these individuals also have to obtain Master’s of Science in Nursing or obtain a Doctor of Nursing Practice, which is usually an advanced program in nursing education where one has to practice for at least six hundred clinical working hours. In 2015, the DNP degree became the minimum degree requirement for those seeking to be enrolled for a degree in advanced practice registered nurses. b) The applicant is then authorized by the Board to practice under the supervision of a professional and registered nurses as a graduate or graduate practical nurse. The Board might require irregular reports from the supervisors and employers of the graduate nurse or graduate practical nurse to ascertain whether the individual has been in violation of Section 464.018(1) F.S. d) Further, any applicant that does not physically appear to sit for the licensing examination shall also not be