Friday, August 23, 2019

Innovations In The Business World Research Paper

Innovations In The Business World - Research Paper Example The higher the scope of coverage especially in scale, the better it is for the firm, because there is a tendency for it to establish a remarkable level of monopoly, at some point. This means that there is a great chance for that firm to dominate in the industry and achieve the highest possible market share. This will mean some remarkable implications. It is about continuing the business and generating higher profit as possible. There are many methods or strategies used today to achieve these possibilities (Porter, 1998).  An example of a company acquiring more companies from time to time is Google. Google is a search brand (Haig, 2011), but this cannot be made possible without its strategic employment of merger and acquisition. This company has been doing merger and acquisition since 2001, and recently at the early part of this year, it has already acquired at least three companies particularly for its business for internet security, home automation and timely application for Android. Eventually, these newly acquired companies are used or integrated with Google+ and other Google’s relevant line of online businesses.  Acquiring these companies eventu ally help Google improve its covered market and its services in ensuring wonderful experience and high value for its target users. This leads the possibility for Google to become a search brand, which allows it to generate a higher competitive advantage over the other companies in its industry. As a result, the other brands in line with Google’s industry are not remarkably known in the market, and if they are known at some point, Google is still holding a competitive advantage over them due to its wider scope of market coverage as one end result of its merger and acquisition strategy.  Merger and acquisition have been a common trend today in the business world.  

Thursday, August 22, 2019

Racial Prejudices Essay Example for Free

Racial Prejudices Essay What is prejudice? set of learned beliefs and values that lead a person to be biased against other members of other groups. -prejudices are convenient(bequem,brauchbar,passend) and inaccurate. - people are not seen as individuals, biased people label other people to special groups -prejudice is mostly based on inaccurate information about people Prejudice originates from three common parts(these parts make up a prejudiced belief): 1. Generalisations -a very broad , simple statement about a group of people -here is perhaps an appropriate point to provide an example:All catholics or when the word they figures strongly -key words for generalisations are all and they generalisations are also very inaccurate , because we are not justified in saying that all members of these group or race share the same characteristic features. G. are unfair descriptions of people and they are mostly based on very incomplete information. Having met one member from a different group with an extraordinary behaviour ,we often assume that all mebers of this group show this same extraordinary behaviour. 2. Stereotyping. -exaggerated,often negative image of a particular group of people -a stereotyp often contains a grain of truth , but this grain of truth is combined with an exaggerated and undue image of this group. Ethnocentricity -there are two types of prejudices: 1. prejudice against all outsidersyour group is the only right and proper,all other groups are excludud,other groups are portrayed as being strange and inferior. 2. prejudice against specific groups- you are able to cope with some other groups,but you disapprove a special group of their religionthats why you have a prejudice against this particular group. But this kind of prejudice does not express that your religion is the best and that all other religions are worser than your own one. You are only biased against this particular religion. -prejudice against all other groups is called ethnocentricity Prejudice and discrimination Discrimination: -Speaking of Discrimination against a special group we mean the combination of prejudice with actions In this sense the word discriminating means that we are treating a group in a negative way. -the effect of people are discriminated against:loss in terms of money ,housing,education -the forms of Discrimination: 1. verbal abuse(anti-locution)through specific termsundermines their confidence-feeling of I am not desired in this society 2. Discrimination in jobsRefusal of jobs to a groupdisadvantage in terms of jobs,income,personal decline. 3. Attack on propertydestruction of carsExpulsion because there is a lack of physical security 4. Physical attack-Assaults on group members;stabs;deathsfurther lack of security;anger;frustration;formation of self-defence groups 5. Genocidemass murder of allextermination of whole families and cultural groups. Racial prejudice or racism -always aimed at special groups -racism bases on the belief that one group(identified by their physical appearance,the skin colour) is naturally superior to other groups-the superior group therefore holds the view that other groups get inferior opportunities and treatment,the belief in superiority is only the medium or justification for repressing other groups. -racism:hostility of any group towards other groups on the basis of perceived physical features. Why do we have prejudices? several reasons: 1. the warped personality. -children brought up in a tense and repressive family-inclination towards own authoritarian attitudes -individuals resentment about his or her childhood finds an outlet in hostility towards minorities -As to Adorno the prejudice springs from harsh childhoods and defective personalities 2. Scapegoating -frustration-aggression theory combined with the use of the idea of scapegoat= The own failure of people(such as financial security,good job,status symbol) evokes frustration. The people are not acquainted with the real cause of their failure. Their frustration develops into aggression. Frequently,as a result the people search for weaker groups to lay the blame on them. This groups are guilty of an individuals failure and frustration these people taking blame for an failure of other people are described or represented by scapegoats. Conformity -friends ,family your whole environment will induce you to share their views. They prevail upon you to be prejudiced against a special group. -The group pressure will cause you to agree with the group you are member of.

Wednesday, August 21, 2019

Potential renewable energy sources for kuwait

Potential renewable energy sources for kuwait RENEWABLE ENERGY Potential Renewable Energy Sources for Kuwait Kuwaits solution to providing enforcement to the current grid capacity and reliability is by exploring the various available options of renewable energy. Some of the major renewable forms of energy being utilized all over the world include solar, geothermal, wind and hydro energy. Based on the countrys climatic conditions, the potential sources of energy available for Kuwait are as follows. Solar Energy A key source of energy that Kuwait could utilize is solar energy. Solar energy involves converting the freely available and abundant sunlight to electrical power. The country experiences high temperatures and very sunny days between June and September (Salam Mazrooei, 2007). Kuwait can therefore comfortably sustain solar power production throughout the summer. Solar as a form of energy can be looked at from two angles: thermal-where solar energy is used for heating and photovoltaic (PV) which involves solar energy being used for power production. The first form of energy involves converting the heat from the sun into electricity, which is used in homes for water heating and desalination. Utilization in this way would result in much saving in terms of expenditure on energy. This form of energy can be used to cater for all household energy needs. It can also be used in street lighting as well as in industries for food production. It requires little cost to set up and maintain a solar energy system in your house. Apart from this being a cheaper option, it is environmental friendly in that it does not emit any harmful gases. The second option of utilizing sunlight, photovoltaic, would require more complex system put in place. This option is in fact under consideration by the Gulf Cooperation Council (GCC) to be implemented in Kuwait. Plans are underway to invest $3.6 billion in Kuwait alone to achieve photovoltaic energy in the country (Alnaser 2008). Using solar energy is expected to reduce the contribution of Kuwait to the worlds emission of Carbon Monoxide which currently stands at about 0.2% (Alnaser, 2008). Alnaser (2008) has further argued that globally, there has been an average increase of 40% in terms of the volumes of energy produced from solar. There is still more room for improvement because the amount of energy produced in a single day is enough to sustain life for years. Solar as a source of energy has a major shortcoming in that it is susceptible to interruption and thus not stable (ABB, 2011). The supply may be low during the cloudy and rainy days. The power produced may thus not be efficient and reliable for critical uses such as in production industries. Advances in technology should however be able to solve this problem in future. A more complex system that is able to store the solar energy and giving the user the control of the units being consumed is being explored. ABB (2011) has explained how lithium-ion batteries can be integrated with solar energy to provide back up during low production periods. Previous attempts by the Kuwait government to embark on solar energy project were thwarted by sand storm and the prevailing large amount of dust on potential tapping areas. The government has at times appeared not to be too enthusiastic to the idea as it â€Å"fails to give financial incentives to those willing to pursue such projects.† (Hashem, 2011). There is a renewed effort by the countrys government to invest in exploring the solar energy options. Recently, the countrys Chamber of Commerce and Industry, (KCCI), revealed a government-lead project that would cost $120bn. The project is to be implemented within the next five years. It involves the government embracing solar energy as part of its development plans. (Hashem, 2011). The government has also shown interests by partnering with other countries governments to implement solar projects all over the country. Fortune CT from UK and Toyota T Suchu Corporation from Japan are some of the international companies actively participating in implantation of solar energy in different regions in Kuwait. Solar energy has little effect on the environments as not gases are emitted. The costs of acquiring a solar system are also cheaper compared to geothermal and hydro. Maintaining the system costs almost nothing as no fuel is used. Wind Energy Wind energy involves utilizing the strength of wind to move large treadmills which in turn rotate to produce power. Just like solar energy, this form of energy is renewable and has little harm to the environment. Already, countries like Brazil are utilizing this form of energy ABB (2011). Brazil utilizes the offshore wind to generated energy which is then transmitted in the normal power lines for hundreds of kilometers. Countries with similar weather patterns including North African and other Middle East countries are in the process of implementing wind power use. It is projected that in years to come, wind energy will be used to produce about 12% the global energy and in the process a significant alternative energy source in the coming years (Alnaser, 2008). Kuwaits wind speed is above the 1400 per hour threshold which is considered as the minimum wind speed that can sustain economically viable wind production. Salam Mazrooei (2007) have noted that in recent years, Kuwait has been experiencing increasing wind speeds. There has been an increase of wind speeds of up to 0.21 ms-1 between 1999 and 2004. The country could look at the positive side of this effect. Windmills could be set up at strategic places to help trap the wind energy and convert it to electrical energy. Alnaser (2008) has projected that Kuwait would be generating a significant amount of wind and solar energy by the year 2015. For Kuwait to achieve this form of energy, a complex system made up of several wind turbines will have to be put in place at strategic areas. An ideal area would be on the sea shore to capitalize on the sea breeze common in such places. The acquisition of these turbines as well as setting up the plants will cost quite a lot. The government has to therefore provide some funding or offer incentive to private investor who may be willing to undertake the venture. Wind plans have also been known to have a negative effect on the wildlife in the surrounding area especially the birds. The construction sites of wind power plants require an area that is free from wind obstruction. With buildings built across the country, finding such a place may be a bit hard. Economically sustainable production of wind power requires that there be windy conditions throughout which might not always be the case. Geothermal energy Geothermal energy involves utilizing the heat on the ground to yield energy. Kuwait has the potential of creating geothermal energy that is yet to be fully exploited. Plans are underway to increase this option of energy generation. The Kuwait government has given a go ahead to contractor to construct a water plant, Al-Zour North power plant that is expected to produce about 4,800 megawatts of power (Izzak, 2010). The government is also planning to increase production in existing plants by replacing old systems with more efficient ones. Izzak, (2010) has explained that the government of Kuwait intends to replace about 18 percent of the transformers currently being used with more efficient ones. Other Countries in the Middle East have also been toying with the idea of geothermal energy. In UAE for example, Masdar, a pro environment conservation company has been carrying tests on how to implement a geothermal project in Abu Dhabi since 2009. The implementation was expected to start immediately after the testing. A major set buck to geothermal energy is that the process is a bit expensive to implement as compared to implementing solar energy. This is because geothermal electricity generation depends on water; yet this water has to be gotten through desalination of seawater, which is a costly process. Initial set up of the plant is also costly. Another problem is that Kuwait is quite hot. Achieving the geothermal energy requires some form of cooling. This cooling is quite impossible to achieve without emitting harmful gases to the environment. The depths at which the hot rocks are located vary from place to place. Geologists have to do thorough study to establish such facts and also to evaluate whether such a project is economically feasible in Kuwait. Once a geothermal plant is up and running, maintenance and running costs are relatively low. Hydroelectricity Hydroelectric power productions involve large volumes of high pressure water being used to turn large turbines to produce energy. Kuwait experiences a low amount of rainfall with the average being about 115 mm (Salam Mazrooei, 2007). The country is generally dry with few rivers. For the country to sustain an economical level of hydroelectric energy production, it must utilize other sources: primarily seawater. For this to happen, a fuel consuming process of salination has to be carried out which might be expensive to undertake. Just like the other aforementioned options, Hydro plant set up requires a lot of resources to set up. Such a project would therefore require substantive funding from either the government or private sector. This form of energy would require building of dams. This would result in interfering with the wildlife existing in the rivers as well as the surrounding area. Bio Fuel Another potential source of renewable energy is bio fuel. This is a kind of fuel that is obtained from biomass. The energy produced can be used for heating and lighting in the rural areas. It can be also used for cooking at both rural and urban setting. Bio Fuel energy offers the only alternative to fossil fuel as a renewable carbon based source of fuel that exist is significant quantity (Klass, 2004). Klass, (2004) has argued that the levels of natural gas would not be sufficient to sustain the demand during the beginning of the 21st century. Such a situation would force the world to look elsewhere for their energy supply. This could require the stakeholders in the sector to shift to unexploited biomass as the alternative source of energy. Kuwait can position herself for such an eventuality by investing in the relevant biomass conversion technologies. The country could, for instance, invest in power plants which use wood energy which is burned to generate steam. This steam is in turn channeled to turbines to produce energy. To sustain this way of energy production, there requires a sufficient supply of biomass. Breeding plants that produce high amount of biomass can achieve this. Klass, (2004) has identified particular plant species that can achieve help achive this. Such plants include the unique herbaceous biomass plants and other hybrid flora, which he refers to as ‘energy plants. Klass, (2004) has explained a way of ensuring a constant supply of biomass for biofuel. This is by ensuring that a new growth of biomass will readily come up in place of the biomass collected for energy production. Bio fuel use has an additional advantage in that it has does not pollute the environment and displaces the use of fuel. When used in conjunction with coal or wood, bio fuel reduces the amount of harmful gasses released to the environment. Bio fuel use could also reduce the rate at which fossil fuel is being depleted from earth. Ethanol fuel Closely related to bio fuel is use of ethanol. This ethanol as gotten from plants such as sugarcane, wheat and corn and can be used for fueling vehicles. Setting up plants for ethanol harvesting is relatively cheap. However, getting a constant supply of ethanol producing plants would require a considerable resource allocation. The process of production of energy is also quit costly, as it requires fuel. The fuel used in producing ethanol may also result in production of gases, which may pollute the environment. Conclusion The potential is there for Kuwait to explore other option of energy production. The underlying factor in all these options is some sort of funding for research as well as initial set up. The government of Kuwait can do this either directly or by offering financial incentive. Exhaustive cost-benefit analysis is also necessary to establish the viability of each option. Any option that Kuwait takes would an important enforcement to the current grid capacity which is dominated by natural gas and oil.

Tuesday, August 20, 2019

Assessment Of Mrs Baker Nursing Essay

Assessment Of Mrs Baker Nursing Essay Upon admitting Mrs. Baker to the ER assist her into a gown. While assisting into the gown notice any skin issues, such as injury from the fall, or irritation from possible prior falls or injuries. Elderly people often have issues such as dehydration, of which the signs may be skin tenting, poor turgor, and red areas from pressure, ask about fluid intake and record capillary refill. Mrs. Baker, as a known diabetic, could have unhealed sores or ulcerations and signs of neuropathy, ask about any numbness or tingling. Assisting the patient into a gown may also determine if there are bladder and bowel continence issues. While assisting to gown use the opportunity to question the patient about what, in her opinion, happened. While asking about the incident, ask if there have been periods of light headedness or dizziness, apply a cardiac monitor and pulse oximeter, for observation. Ask the patient if there are any areas that hurt, or if there is any pain even unassociated with the fall. Whi le questioning the patient about what happened and the patients theory of why, evaluate speech pattern and level of orientation, the patients awareness of time and cognitive ability may be assessed at this time. Determine if the patient can provide an accurate account of the fall and what preceded the fall. While assessing the patient, it is essential to look at each system and watch for nonverbal signs of pain. Observe the patient, for signs of confusion and check for pupil response to light. Auscultating lung sounds, listen for adventitious sounds such as rhonchi, rales, or wheezes. Listen to determine if lung sounds are present in all lung fields. Auscultate heart sounds, listen for irregularities, is there a murmur noted. Evaluate cardiac monitor for arrhythmias. Question the patient about any chest pain, tightness, or heaviness. Palpate peripheral pulses, note if they are equal, note the quality if they are thread /bounding, and are pulses even on each side. Obtain vital signs such as blood pressure, orthostatic if possible as this is common with HCTZ and Lisinopril; maintain a 30 minute check on blood pressure readings, note rate and quality of respiratory effort along with oxygen readings. Ask again if the patient has any pain as pain may increase readings in blood pressure, respiratory rate, and pulse. The elderly are sometimes reluctant to report pain, thinking it is all part of the aging process and accepts it as a part of life. Many may not report physical discomfort due to the fear that they may lose independence or the risk of being viewed as a burden. Anxiety may also raise vital sign readings; attempt to explain all procedures to the patient. This not only contributes to trust from the patient, but also reduces some of the fear from the unknown. Listen to bowel sounds, indicate the presence of or lack of in all quadrants. Ask the patient about bowel pattern if possible when the last bowel movement was, palpate for any sign of tenderness or guard ing. Examine the face, hands, and feet for edema. While checking the lower extremities for edema, indicate the quality of pulses in the legs. Pay attention to color and texture of the skin in the legs and feet, note any sores or red areas, note capillary refill. Pay attention to the temperature of the legs as lower extremities blood clots is common. Again, it is necessary to explain the examination to the patient in order to reduce anxiety and to reassure the patient. If the patient is able, ask about medications and when was the last time they were taken. Ask about the time the last meal was eaten. Once the initial assessment is completed, explain to the patient that there will be some tests to assist in determining the medical problems at present. It is advisable to ask if the patient has questions for the nurse; this may aid in preventing any misunderstandings. Technological tools, uses, and benefits Some of the tools frequently used in the assessment, of any patient, start with auscultation and palpation. Listening to the patients verbal response is an advantage to the assessment; however, listening to the heart, lungs, and abdomen is required. To begin, start an IV site and obtain the needed blood for testing, this may prevent a delay in treatment. Be aware of the length of time the tourniquet is applied to the patient, quality of the lab draw is also a factor in the values obtained. After obtaining the blood work, begin a physical assessment. Listening to heart sounds may provide information about various cardiac problems such as a heart murmur; deviation in heart sounds may indicate a cardiac condition. Lung sounds may determine if there are pulmonary issues such as bronchitis, pneumonia, or pulmonary edema. Listening and palpation of the abdomen may indicate irregularities in the gut, such as an obstruction or potential aneurysm. Asking about pain or tightness in the chest m ay also indicate a possible cardiac condition. Ask about any history of chest pain or tightness. Noting the rate and respiratory effort, along with a continuous pulse oximeter, assist in determining pulmonary problems. Ask if there have been any problems with shortness of breath. Blood pressure readings, especially orthostatic in a falls patient may lead to indications leading to the fall. Along with the possible reason for the fall, this may also assist in the determination of medication misuse. The elderly may sometimes forget they have taken their medication and repeat the dosage. Obtaining a blood glucose level may also determine if the fall is related to hypoglycemia. Knowing or having an idea of when the last meal was eaten, and when the medications were taken, also assist in determining possible reasons for the fall. Having knowledge of the estimated fluid intake may also be useful as a tool in the analysis of causative agents. Dehydration in the elderly can cause confusion a nd light headedness. The continuous cardiac, oxygen, and blood pressure readings are necessary to watch for sudden changes that may occur. Cardiac monitors assist in determining if there are irregularities in the electrical conduction, in the heart, early detection and treatment may prevent further complications. Oxygen readings assist in determining the amount of capillary oxygen and profusion difficulty; this may indicate the need for supplemental oxygen before further decompensation. Frequent checks in blood pressure may be the first sign of sepsis in an elderly person. Other testing and tools used is a chest X-ray, viewing a chest X-ray aids in determining pulmonary issues not noted during the physical examine treatment for pulmonary issues can quickly be obtained. A CT scan of the brain, without contrast, may be used to rule out a brain bleed. A CT scan of the lungs, without contrast, will assess for possible pulmonary embolus. To use contrast, the results of the renal function are needed. Blood testing is critical in determining the bodily functions. Obtaining a complete blood count tells the general hydration, amount of volume and signs of infection with an elevated white blood count, hypervolemia can be promptly corrected; low red blood count indicates the lack of oxygen carrying capacity and may require a transfusion. A complete metabolic profile lends details of renal and hepatic function, as well as levels for key electrolytes such as potassium, sodium, magnesium, and glucose, this also aids in monitoring for metabolic acidosis or alkalosis. With lisinopril, it is common to see an elevation in bun, creatinine, and lowering of glucose levels. HCTZ is known for lowering the potassium, sodium, and magnesium levels. The combination of HCTZ and lisinopril are known to cause dizziness, and palpations and should be monitored closely especially in people with renal impairment and /or of advanced age. Cardiac enzymes are drawn to evaluate the cardiac muscle, to determine if there are cardiac issues. Arterial blood gases assist in determining the pulmonary system function, this also aids in determining respiratory acidosis or alkalosis. Another lab test highly beneficial is a urinalysis with culture and sensitivity. When there is a urinary infection in an elderly person, it may cause dizziness and confusion. The culture helps to determine the proper medication for the organism responsible for the infection. The urine tests also indicate if there are ketones or proteins being spilled in the urine; this is a frequent problem in diabetic patients. Obtaining a twelve lead EKG aids in determining any irregularities in the cardiac conduction, such as heart blocks and ventricular ectopy that are often seen as a result of low potassium. Blood cultures may also be required to determine if there is an infection. Frequently an opportunistic infection may lead to sepsis, and the elderly often do not present that ill until the infection is severe. T he elderly may not always present with an elevated temperature; this cannot be the only sign of illness. All the testing and the physical analysis will help to determine potential health issues, but the best source of information is to monitor the patient. Being aware of changes in the patient status and comfort level is required. Continuous visual monitoring may assist in treating sudden changes in the patient. Frequent questions pertaining to the comfort level are required in the elderly as they may be reluctant to admit pain. Explain that pain, of any level, can be addressed, and that comfort may assist in the treatment. Data collection prioritization It is essential to prioritize the data collection and report findings to the physician. The application of monitoring devices, such as a cardiac monitor, blood pressure machines, and pulse oximeter, may be done as the patient is being gowned. Visual inspection of the skin may also be done at this time. While gowning the patient, asking about medications and history may also be accomplished. Starting the IV site and obtaining blood work will get information to the physician quickly and should be done as soon as possible. Collect a finger stick for blood glucose, as this may determine if the patient is hypoglycemic. The EKG and ABGs are also critical information needed as soon as possible. A chest X-ray may be done next, along with a CT scan of the brain and lungs, without contrast. Collection of the urine for testing can be collected after the other departments have finished what needs to be done. As the patient is on a continuous monitor for cardiac, respiratory, and blood pressure i t is easy to monitor for changes. It is now appropriate to complete the physical assessment of the patient. This saves time while awaiting the results from lab, x-ray, and cardiopulmonary departments. Report any irregularity in the assessment to the doctor as soon as possible. While obtaining information from the patient, it is necessary to ask about pain and monitor for nonverbal cues during the assessment. Morphine, low dose (0.05mg/kg IV) for pain may be appropriate at this time as it decreases the oxygen demand from the heart and may reduce anxiety. Tylenol may not be the medication of choice until liver function is established. Advise the physician that the patient has been taking HCTZ, Lisinopril, and metformin. The combination of HCTZ and Lisinopril may cause dizziness and dehydration. Lisinopril also aids in lowering blood glucose levels, and should be monitored closely especially in people with renal impairment and/or of advanced age. This combination may also cause palpati ons and dizziness. HCTZ can cause electrolyte imbalances leading to alkalosis. The patient may also be experiencing a drug hypersensitivity to the lisinopril. Signs would include dyspnea, chest tightness, and arterial acidosis, requiring intubation (Hydrochlorothiazide and Lisinopril side effects, If the patient was medicated for pain, check for relief of symptoms. Verbal affirmation should be listed on a scale of 1-10 according to the flacc scale. If the patient has pain relief, note this with the physician. Monitor for lab results and report any findings outside the normal range, the same with EKG, ABGs, x-ray, and CT scan. Monitor the patient for changes in mentation, and visible signs of changes. The elderly may have sudden changes; it is advisable to monitor closely. With continuous monitoring, and noting the change in status of Mrs. Baker, there would be more aggressive measures taken. A rapid response from respiratory therapy would be needed, and a request for the attending physician, for the mental status and respiratory changes and the possible need for increased measures such as intubation. A repeat of ABGs would be needed; STAT results are indicated. Radiology should be available for potential tube placement. All team members should be alerted for the possibility of a code blue alert. The staff needs to be monitoring the cardiac status at all times. With respiratory arrest, cardiac is soon to follow. Rapid response to changes in respiratory status can prevent further complications. Constant monitoring of the flacc scale may assist in monitoring the patients comfort level. A patient may show signs of discomfort by moaning, thrashing about, or facial grimace. Being aware of this may aid in the quality of patient care. The patient may not be a ble to tell that they hurt, but body language speaks volumes. If the patient is indicating that they are in pain, morphine at a low dose may be used (0.05mg /kg IV). Considering the slower metabolism of the elderly, it is necessary to medicate accordingly. This not only aids in pain relief, but also lowers the oxygen demand by the heart. Close observation of the patient is mandatory. If the medication is effective the signs observed will diminish and the patient will appear more relaxed, with little or no signs of pain (possible lower BP and heart rate, no facial grimace, more relaxed, less restlessness). The alert patient can verbalize the effectiveness of pain medications, with an unresponsive person we must rely on physical cues that are presented. Again, it is important to report pain relief to the physician and continue to watch for changes in the patient. Rapid evaluation and assessment, accurate data, and concise information are imperative to patient care. When assessing the elderly it is necessary to remember that due to the aging process, metabolism of medications may be slowed. With advanced age, there is also a reduction in renal and hepatic filtering. The elderly may also be reluctant to report pain. When caring for the elderly, it is necessary to keep their viewpoint in mind, and to explain procedures prior to the procedure. A reduction in anxiety may assist in a trusting relationship and aid in lowering blood pressure and heart rate. It is also helpful to remember that changes can occur rapidly with the elderly and that they may not always present as with a younger person. Keep an open mind and alert at all times.

Monday, August 19, 2019

Montana :: essays research papers

MONTANA BY LARRY WATSON EXTENDEND REPSONSE. 1) In his twelfth year, David discovers the pain of growing up- the fragmentation of the secure world of the innocent though the awareness of truths and realities around him. Discuss. ESSAY In the text Montana by Larry Watson, it is evident that they 12 year old David is growing up. He is a typical 12 year old, loving outdoors, riding his horse, fishing, hunting and exploring (Quote page 23), but by the influences and family around him he has a painful, confusing growing up life. As David an only child, he was not the only one that is growing up. In a way his family are still growing, learning from every part of past and present issues. David’s growing up has a lot of different influences. His father Wes is not a typically loving father. His fatherly love is harming David in a way to believe different in him and his self. Wes, David’s father, has a lot of responsibilities to cover, as he is the Mercer County sheriff. This makes David believe to look after him self and be responsible in a way to show and prove his father, as he disappoints David. (Quote page 17) Even though Wes is the sheriff he is a quite and self-effacing male who puts him self down and this shows that he isn’t the typical male stereotype of a Montana Sheriff. As the Hayden’s were well known and had heaps of power in Bentrock, David realises that he is respected because of his name, not because of himself. He didn’t have to earn it. (Quote page 126). David becomes aware of this when he is going to the grocery store, and that the locals didn’t know what was happening to his family of power. The citizens of Bentrock didn’t know that his father had arrested his own brother for sexually assaulting his patients, and murdering Marie. (Quote page 127) David had shame over his family name. Frank, Wes’ brother and David’s Uncle, has a great influence on David’s growing up. Frank shows his heroism and successfulness and this makes David envy Frank. (Quote page 78) Even though David idolised Frank, his views changed within the text. After the truth about Frank and his patients David didn’t like being alone with him. The thought his own uncle as a criminal. (Quote page 49) David changes his innocents when his is hunting and he shot and killed a magpie.

Sunday, August 18, 2019

Essays --

System approach is a process of considering how different parts of the whole structure influence and integrate with each other and viewing problems in a system as affecting the system overall (Dreachslin, Gilbert, & Malone, 2013). According to Curtis, Dreachslin, and Sinioris (2007), the systems approach requires several steps, and these steps are to determine diversity and cultural competence goals in the context of strategy, measure current performance against needs, design training to address the gap, implement the training, assess training effectiveness, and strive for continuous improvement. Providing patient centered care has been the focus of recent organizational restructuring and quality improvement efforts in healthcare (Lutz & Bower, 2000). In healthcare literature, providing a patient centered care is to provide care and to meet patients’ needs. To provide a patient centered care, it is essential to understand the patient as a unique individual. It also important to be able to explore the patient’s experience of illness and finding common ground regarding treatment through shared decision making (Lutz & Bower, 2000). Given the first patient scenario, as a healthcare provider, it is essential for nurses to tailor our approaches to care for this patient. For this specific ethnicity, being overweight is seen as positive, and their traditional cuisine is rich of carbohydrates and sweets (Caballero & Tenzer, 2007). To provide best care for Mr. Garcia, it is best to provide a Spanish speaking nurse if possible, or an interpreter. It is important to educate Mr. Garcia regarding diet changes, for example, exchanging their simple flour tortilla to corn tortilla or pouring off excess grease after cooking. Increasing physical... ...n, gender, sexual orientation, and ability (Dayer-Berenson,2012). According to Goldsmith (2000), cultural competence does not require that patients be treated by using the same methods used in their country of origin. However, cultural competency does create a compelling case for understanding the different ways patients act in a clinical setting and for communicating with patients to ensure the best possible clinical outcome. Both patient-centered care and cultural competence aim to improve health care quality. As health-care workers we are held to the highest moral and ethical codes. Patients trust their lives in our hands. To live up to this trust we have to be respectful and compassionate, knowledgeable and understanding. Respect, dignity, knowledge, and patience are required to gain mutual trust in every relationship especially patient and doctor relationships.

Women Characters in Midsummers Nights Dream by William Shakespeare Ess

Women Characters in Midsummers Night's Dream by William Shakespeare In Williams Shakespeare's "A Midsummer Night's Dream," many of the play's female characters have strong similarities and differences among one another. Although many of the main female characters in the play come from dissimilar backgrounds, their similarities are brought together by common problems associated with society and love. Of the four main female characters, Hippolyta, Titania, Helena, and Hermia, both Hippolyta and Titania are royalty while Helena and Hermia are commoners. However, a common theme associated with Hippolyta, Titania, Helena, and Hermia, regardless of their social caste, is their similarities and differences in dealing with love in a patriarchal society. Nevertheless, the patriarchal society in which Hippolyta, Titania, Helena, and Hermia live in struggles to hinder the feelings and attitudes which provide them with a distinct conception for love in a male dominated society. Hippolyta is a strong yet silent amazonian beauty who is the love of Theseus, Duke of Athens. Although Hippolyta is largely silent in her dealings with love in the patriarchal society, her physical presence speaks for the untold voice she might profit from. Of the four main female characters Hippolyta is the more silent of the four. However, since Hippolyta is the maiden of Theseus she bears heavy in the decisions Theseus makes about the love quarrels within the play. From the words of Theseus the reader can associate that Hippolyta has a strong impact on the actions he takes when dealing with love and marriage: For you, fair Hermia, look you arm yourself To fit your fancies to your father's will, Or else the law of Athens yeilds you up-... ...) Although Helena fails at wooing Demetrius, the fight for Demetrius's love is not hidden behind the patriarchal community of Athen's. Both Hippolyta and Titania, as well as Hermia and Helena, share common interest in defying the laws of a patriarchal society. The foremost problem associated with a male dominated society in "A Midsummer Night's Dream" was love. Therefore, a common focus associated with Hippolyta, Titania, Helena, and Hermia, in spite of their social standing, is their likenesses and contrasts in handling the idea of love in a patriarchal society. Still, the patriarchal society in which Hippolyta, Titania, Helena, and Hermia reside in strives to impede the feelings and attitudes which make up their idea of what love should become in a patriarchal society. Bibliography: The Bedford Introduction to Literature. By: Michael Meyer