Female Entrepreneurship

Question: "Why the world needs women entrepreneurs"- Investing in businesswomen will boost the economy for everyone, says Tory Burch, chief executive and designer, Tory Burch. Analyse this statement. Answer: Women entrepreneurs contribute to the self development, family, community and to the society, as a whole. It is very important to look for ways by which women entrepreneurship can be promoted further so that the number of men entrepreneurs and women entrepreneurs can be equal to that each. There are plenty of countries wherein women arent allowed to work or be an entrepreneur or compete with men in the open world. There are few countries in the world that motivate and help their women to be an entrepreneur and on the other end, there are many countries which dont allow their women to see the world of entrepreneurship. Men entrepreneurs can understand the expectations of men in the society and hence, the needs of the women are felt unnoticed. When women get into entrepreneurship, they will understand the requirements of the women and hence, a product which has been never developed before comes into picture. It is the responsibility of the men in the family to motivate their mother, sister, wife or daughter to set up a business so that they can do something for the economy of the country. This motivation is lacking in the lives of the many. Women have a different perception towards different things and hence, they will come up with a different solution to the same problem. It is not comparison between men and women but it is just that they come up with different and new unique ideas which wouldnt have been thought otherwise. Women have household responsibilities as well and hence, maintain a balance between work and household activities is a task for the women. Due to this, the women in the society avoid taking up other responsibilities than that of the regular household work (Noguera 2013). Access to capital for women is comparatively less than that of capital accessibility for men. There are plenty of small financial institutions which will help women to set up a business but the potential entrepreneurs arent aware of the availability of the funds. The financial institutions should look for ways by which their funds can be increased so that they can help more women entrepreneurs and at the same time, the availability of funds should be advertised so that it can reach the right people. The number of advisers who can help women entrepreneurs are very less. There can be motivational speech so that the women can understand the different aspects of business. These meetings can be held regularly so that the women entrepreneurs can get their queries sorted and at the same time, they can be motivated to grow. Lastly, women need to be educated so that they can be good entrepreneurs. They will get an idea on what are the various things that can be undertaken so that they are aware of the facilities that are available and the facilities that they will have to struggle for. The gender gap should also be reduced so that the women entrepreneurs in the society are given an opportunity to explore and help the society (Brush 2012). References Brush, C, 2012, Introduction:femaleentrepreneurshipand economic development: an international perspective, Entrepreneurship and regional development, vol. 24, no. 2, pp. 1-6 Noguera, M, 2013, Socio-cultural factors andfemaleentrepreneurship, International entrepreneurship and management journal, Vol. 22, no. 3, pp. 294-312

Principles of Management Multi Organ Failure Essay Example

Principles of Management : Multi Organ Failure Essay * Day 6 – 7 /ABC * ABC Principles of Management : Multi Organ Failure /MODS * PRINCIPLES OF MANAGEMENT : ABC / Multi Organ Failure (MODS) * Multiorgan dysfunction syndrome (MODS) is the progressive dysfunction of more than one organ in patients that are critically ill or injured. * It is the leading cause of death in intensive care units (ICUs). * The initial insult that stimulates MODS may result from a variety of causes including, but not limited to, extensive burns, trauma, cardiorespiratory failure, multiple blood transfusions, and most commonly, systemic infection. Schumaker, 2006) * The term MODS has been referred to interchangeably as systemic inflammatory response syndrome (SIRS) and multisystem organ failure (MSOF). (Schumaker, 2006) * A. Determination and Management Multi Organ Failure: Etiology and Risk Factors * Causes of MODS include: * dead tissue * injured tissue * infection * perfusion deficits * persistent sources of inflammation such as pancreatitis or pneumo nitis * High Risk for developing MODS : * Impaired immune responses such as older adults clients with chronic illnesses * clients with malnutrition * and clients with cancer * Clients with prolonged or exaggerated inflammatory responses are at risk, including victims of severe trauma and clients with sepsis * Multi Organ Failure: Classification * 1. Primary MODS – * results directly from a well-defined insult in which organ dysfunction occurs early and is directly attributed to the insult itself. â€Å" * The direct insult initially causes a localized inflammatory response that may or may not progress to SIRS. An example of primary MODS is a primary pulmonary injury, such as aspiration. * Only a small percentage of clients develop primary MODS. * Multi Organ Failure: Classification * 2. Secondary MODS * is a consequence of widespread systemic inflammation, which develops after a variety of insults, and results in dysfunction of organs not involved in the initial insult. * Th e client enters a hypermetabolic, state that lasts for 14 to 21 days.. * During this body engages in autocatabolism : which causes changes in the bodys metabolic processes. rocess can be stopped,. the outcome for the death. * Secondary MODS occurs with condition septic shock and ARDS. (Black,2005 , p2474) * Multi Organ Failure: Clinical Manifestations * There is usually a precipitating event to MOD: * aspiration, * ruptured aneurysm * Septic shock which is associated with resultant hypotension. * The client is resuscitated; the cause is treated; and appears to do well for a few days. * The following possible sequence of events often develops. * Multi Organ Failure: Clinical Manifestations The client experiences SIRS before MODS Within a few days * there is an insidious onset grade fever, tachycardia, increased numbers and segmented neutrophils on the different count (called a left shift), * dyspnea with the diffuse patchy infiltrates on the chest x-ray client * often has some deteri oration in mental reasonably normal renal and hepatic laboratory results * Multi Organ Failure: Clinical Manifestations * Dyspnea progresses, and intubation and mechanical ventilation are required. * Some evidence of agulopathy (DIC) is usually present. * The client is usually stable hemodynamically and has relative polyuria, n increased in cardiac index (greater than 4. 5 l/min), * Systemic vascular resistance of less 600 dynes cm-5 Clients often have increased blood glucose level in the absence of diabetes * Multi Organ Failure: Clinical Manifestations * Between 7 and 10 days: * Bilirubin level increases and continues to increase, followed serum creatinine. * Blood glucose and lactate level continue to increase because of the hypermetabolic state. * Other progressive changes include nitrogen and protein combined with decrease level of serum albumin, pre-albumin, and retinol binding protein * Multi Organ Failure: Clinical Manifestations Between 7 and 10 days * Bacteremia with enter ic organism is common and infection from candida viruses such as herpes and cytomegalovirus are common. * Surgical wound fail to heal, and pressure ulcer may develop. * During this time, the client needs increasing amounts of fluids and inotropic medications to keep blood volume and cardiac preload near normal and to replace fluid lost through polyuria * Multi Organ Failure: Clinical Manifestations * Between day 14 and day 21: * The client is unstable appears close to death. * The client may lose consciousness Renal failure worsens to the point needs dialysis. * Edema may he present because of low serum protein levels. * Mixed venous oxygen level may increase because of problems with tissue uptake of oxygen caused by mitochondrial dysfunction. * Lactic acidosis worsens, liver enzymes continue to increase, and coagulation disorders become impossible to correct. * Multi Organ Failure: Prognosis * If the process of MODS is not reversed by day 21, it is usually evident that the client w ill die. * Death usually occurs between days 21 and 28 after the injury or precipitating event. Not all clients with MODS die; however, MODS remains the leading cause of death in the intensive care unit with mortality rates from 50% to 90% despite the development of better antibiotics, better resuscitation, and more sophisticated means of organ support. * Multi Organ Failure: Prognosis * For those clients who survive, the average duration of intensive care unit stay is about 21 days. * The rehabilitation, which is directed at recovery of muscle mass and neuromuscular function, lasts about 10 months. * Multi Organ Failure: Medical Management * Restrain the Activators: Manifestations of potential infection must be quickly treated to restrain the activators of MODS. * If the agent is known, antibiotics to which the organism is sensitive should be administered. * If the organism is not -known, broad-spectrum antibiotics are given * If the severity of the sepsis is identified early and d rotrecogin alfa (Xigris) is ad ministered, progression to MODS may be prevented * Multi Organ Failure: Medical Management * If there is progression, the lungs are often the first organs to fail and so require special attention. Aggressive pulmonary care is needed in all clients who are at risk of MODS. * Interventions may be as simple as coughing and deep breathing or ambulation. * The clients oxygen saturation should be monitored as well. * Malnutrition develops from the hypermetabolism and the GI tract often seeds other areas with bacteria, some clinicians require the client to be fed enterally. * They believe that feeding enhances perfusion and decreases the bacterial load and the effects of endotoxins * Multi Organ Failure: Nursing Management Care of the client with MODS is multifaceted, balancing the needs of one system against the needs of another while trying to maintain optimal functioning of each system * Nursing diagnoses appropriate for the client with MODS * The number of independent nursing interventions for the client with MODS is limited. * Multi Organ Failure: Nursing Management * The overall goal for nursing is effective client and family coping: * Nurses must remain sensitive to the needs of the family. Caring for the family of critically ill clients is a challenge in that understanding, predicting, and intervening with families in crisis is less exact, than the calculation of oxygen needs. * There are no easy formulas to use to provide hope, courage, coping, and caring. * Nurses must remain alert to the needs of the family as well as the client during this stressful time. * B. Life saving and Intervention * Detailed discussion and return demo will be discussed on EDN and Vines laboratory. * 1. First Aid Measure * 2. Basic Life Support * 3. Advance Cardiac Life support * First aid measures Is an immediate care given to a person who have been injured or suddenly taken ill. * It includes self help and home care when medical assistance is delayed or not available. * Roles of First Aid: * Bridge that fills the gap between the victim and the physician. * It is not intended to compete with nor take the place of the services of the Physician. * It ends when medical assistan ce begins. * Basic Life Support ( BLS) * An emergency procedure that consists of recognizing respiratory arrest and cardiac arrest or both and the proper application of CPR to maintain life or until a victim recovers or advanced life support is available. C-A-B steps : * Circulation restored * Airway opened * Breathing restored * ADVANCE CARDIAC LIFE SUPPORT (ACLS) * Refers to a set of clinical interventions for the urgent treatment of cardiac arrest and other life threatening medical emergencies, as well as the knowledge and skills to deploy those interventions. [1] * ADVANCE CARDIAC LIFE SUPPORT (ACLS) * Extensive medical knowledge and rigorous hands-on training and practice are required to master ACLS. Only qualified health care providers * (e. g. hysicians, paramedics, nurses, respiratory therapists, clinical pharmacists, physician assistants, nurse practitioners * and other specially trained health care providers) can provide ACLS, as it requires the ability to manage the patie nts airway, initiate IV access, read and interpret electrocardiograms, and understand emergency pharmacology. * Fluid Resuscitation (Study) * The infusion of isotonic IV fluids to a hypotensive Pt with trauma; aggressive FR may disrupt thrombi, ^ bleeding, and v  survival * Intravenous literature: Boyd, J. H. , Forbes, J. , Nakada, T. A. , Walley, K. We will write a custom essay sample on Principles of Management : Multi Organ Failure specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Principles of Management : Multi Organ Failure specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Principles of Management : Multi Organ Failure specifically for you FOR ONLY $16.38 $13.9/page Hire Writer R. and Russell, J. A. (2010) * Fluid resuscitation in septic shock: A positive fluid balance and elevated central venous pressure are associated with increased mortality. Critical Care Medicine. 2010 Oct 21 * FLUID RESCUCITATION * Fluid replacement or fluid resuscitation is the medical practice of replenishing bodily fluid lost through sweating, bleeding, fluid shifts or pathologic processes. * Fluids can be replaced via oral administration (drinking), intravenous administration, rectally, or hypodermoclysis, the direct injection of fluid into the subcutaneous tissue. Fluids administered by the oral and hypodermic routes are absorbed more slowly than those given intravenously. * FLUID RESCUCITATION * Procedure * It is important to achieve a fluid status that is good enough to avoid oliguria (low urine production). * Oliguria has various limits, a urine output of 0. 5mL/kg/hr In adults is adequate and suggests adequate organ perfusion. * The parkland formula is not perfect and fluid t herapy will need to be titrated to hemodynamic values and urine output. * The speed of Fluid Replacement may differ between procedures. * The planning of fluid eplacement for burn victims is based on the Parkland formula (4mL Lactated Ringers/kg/% TBSA burned). * The parkland formula gives the minimum amount to be given in 24 hours. * Half of the value is given over the first eight hours after the time of the burn (not from time of admission to ED) and the other half over the next 16 hours. * In dehydration, 2/3 of the deficit may be given in 4 hours, and the rest during approx. 20 hours * FLUID RESCUCITATION The initial volume expansion period is called the fluid challenge, and may be distinguished from succeeding maintenance administration of fluids. During the fluid challenge, large amounts of fluids may be administered over a short period of time under close monitoring to evaluate the patient’s response. * Fluid challenge, as the procedure of giving large amounts of fluid in a short time, may be reserved for hemodynamically unstable patients, distinguished from conventional fluid administration for patients who are not acutely ill, who receive fluids as part of a diagnostic study, or for less acutely ill patients in whom fluid administration can be guided by fluid intake and output recordings. VARIOUS FLUIDS USED IN FLUID RESCUSITATION * Crystalloids are solutions of mineral salts or other water-soluble molecules. * we are talking about salt (saline) ; Since isotonic fluids have the same concentration as the normal cells of the body and blood, when infused intravenously, they will remain in the intravascular space. * Normal saline (0. 9% NaCl) and lactated Ringers solution are typical isotonic fluids with sugar in (dextr ose) * Hypertonic fluids –( 3% NaCl) have a higher particle concentration than in normal cells of the body and the blood. These agents draw fluid into the intravascular space from cells. * Hypertonic saline (3% NaCl) is a common hypertonic fluid. * Hypotonic fluids * (0. 45 normal saline, 0. 33 NaCl) are composed mostly of free water and will enter the cells rather than remain in the intravascular space. * Normal saline and lactated Ringers are the two balanced salt solutions most commonly used in current fluid resuscitation * Other products * Albumin, * one of the original plasma expanders, is a protein that maintains osmotic pressure in a cell and helps the cell maintain its internal fluid. When we read about protein in urine, especially in diabetics and those with kidney disease, we are talking about albumin. * Blood transfusion is the only approved fluid replacement capable of carrying oxygen * C. Life Maintaining Intervention * C. 1 AIRWAY MANAGEMENT By: Angkana Lurngnat eetape, MD. * Indication for tracheal intubation * ? Airway protection * ? Maintenance of patent airway * ? Pulmonary toilet * ? Application of positive pressure * ? Maintenance of adequate oxygenation * Oral endotracheal tube size guideline During Laryngoscopy ; Intubation * ? Malposition * – Esophageal Intubation * – Bronchial Intubation * ? Trauma * – Tooth damage * – Lip, tongue, mucosal laceration * – Dislocated mandible * – Retropharyngeal dissection * – Cervical spine * ? Aspiration * C. 2 Managing Patients on Ventilators Clinical Nursing Skills * By Sandra F. Smith * Managing Patients on Ventilators * Preparation: * Double check the ventilator settings against those ordered by the physician. * Plug the machine and turn it on. * Familiarize yourself with location of alarm system Connect the ventilator tubing to patient’s endotracheal tube or traheostomy tube * Procedure: * Monitor pt VS every 5 minutes until stable * Obt ain ABG 15 minutes after ventilation is established. * Monitor ventilation setting. * Check humidifier fluid level. * Records I and O and daily weight Positive pressure may cause positive water balance due to humidification of inspired air. * C. 3 Managing Patients on Ventilators * Suspend ventilator tubing from an IV hook or support it on a pillow to reduce traction on the endotrachael tube. Change ventilator tubing every 24 hours. * Check VS and auscultate lungs every hour. Rationale: Positive pressure ventilation may decrease venous return and cardiac output. * Observe and listen for possible cuff leaks around TT or ET. * Empty accumulated water on ventilator tubing. Disconnect tubing and stretch it to release water trapped into corrugated areas and drained to water basin DO NOT drain water back to humidifier. * Provide patient a method of communication. , such as magic slate. * Test nasogastric drainage pH every hour and administer antacid to maintain pH above 5. Test nasogastri c drainage and fecal matter daily for occult blood. * Assess lungs compliance * Implement methods of stress reduction. * Keep ventilators alarms on * C7 Fluid and electrolyte problems By Canthera Cancer Therapy Center * Fluid and electrolyte problems 1. Water retention * Water retention is simply the buildup of excess fluid in tissues. * Swelling of the feet, ankles and hands are generally the first sign of water retention. * But it can also affect other parts of the body such as the abdomen, chest cavity, face and neck. Possible causes include: * Certain medications (some chemotherapy drugs can cause water retention) * Heart, liver or kidney disease * Blockage of veins or lymph system * Fluid and electrolyte problems * Some symptoms to look for and report to your physician include: * Feelings of tightness in the arms or legs. * Difficulty fitting into clothing. * Rings, wristwatch or shoes fit tighter than usual. * Pitting of the lower legs and arms – when you press on your skin with your finger is there an indentation that remains for a few seconds. * A sense of heaviness or weakness in the arms or legs. Skin that feels stiff or taut. * Any redness, changes in skin temperature or pain in swollen areas can be a sign of infection and should be reported immediately. * Fluid and electrolyte problems * Things that you can do to help manage swelling are: * Do not stand for long periods of time. * When sitting or lying keep feet/legs elevated as much as possible. * Avoid tight clothing (including s ocks) * Do not cross your legs when sitting or lying. * Try to reduce your salt intake. Avoid foods that are high in salt content such as chips, tomato juice, cured meats, and canned soups. Weight yourself daily – a weight gain of 5 pounds or more in one week should be reported to the physician immediately. * If your physician has prescribed medications for your swelling take them exactly as prescribed. Do not reduce or increase the dose. * Treatment of fluid retention depends upon the underlying cause. Since some of the causes of water retention can be related to organ disease/damage and are potentially severe, it is important that you speak with your physician or nurse promptly if you are experiencing this problem. * Fluid and electrolyte problems 2 Electrolyte imbalance * Electrolyte imbalance could also be caused by * vomiting, * diarrhea, * sweating, * high fevers, * kidney disease, * medications unrelated to cancer therapy, * certain chemotherapy drugs such as Cisplatin and targeted therapies such as Erbitux. * Fluid and electrolyte problems * Because electrolytes regulate activity of nerves and muscles, their imbalance could lead to malfunctions in multiple organ systems. * It could cause : * muscle spasms, * weakness and twitching; * irregular heartbeat and blood pressure changes; * lethargy, * confusion, and neurological problems. * Severe electrolyte imbalance can result in death. Monitoring for electrolyte imbalance is a simple process and is accomplished through routine lab work. * Fluid and electrolyte problems * Treatment of electrolyte imbalance is based on identifying and treating the underlying problem causing the imbalance, * and actively correcting the imbalance itself. * Treatment may include intravenous replacement of fluids or electrolytes, dietary changes and/or oral replacement of a particular electrolyte. * Fluid and electrolyte problems * 3. Tumor lysis syndrome Tumor Lysis Syndrome is a serious and sometimes life-threatening c omplication of chemotherapy. * . It is caused by release of breakdown products from dying cancer cells and most frequently occurs in patients with leukemia or lymphoma that have a high tumor burden (large tumor). * Patients with pre-existing kidney disease are also at increased risk for this complication * Fluid and electrolyte problems * Symptoms of tumor lysis syndrome include: * Muscle weakness * Paralysis * Heart arrthymias * Seizures * Tetany * Changes in emotional stability * Decreased urine output Changes in electrolyte and uric acid levels. * Fluid and electrolyte problems * Treated prophylatically with hydration and medications which decrease uric acid levels like Allopurinol. * Treatment for tumor lysis is directed toward stabilizing electrolyte and uric acid levels. * Aggressive hydration with IV fluids and use of diuretics may be instituted. In some cases persons have undergone renal dialysis. * C8 NUTRITION BY Schumaker and Chernecky critical Care and Emergency Nursing * Energy expenditure during respiratory failure is high and is caused by the increased work of breathing. The goal of nutritional support is to provide the needed nutrients to maintain the patients current level of : * metabolism * energize the immune system * and maintain end-organ function. * NUTRITION BY Schumaker and Chernecky critical Care and Emergency Nursing * Enteral Gi feeding is the route of choice to provide the calories and nutrients needed and to assist in maintaining normal GI: function. * if the patient is unable to tolerate enteral feedings, then a parenteral (intravenous) route is necessary until the patient can tolerate enteral feedings. * Medical Management of the Client Receiving Parenteral nutrition by Joyce Black * Parenteral Nutrition (PN). PN is indicated to maintain nutritional status and prevent malnutrition when the client has inadequate intestinal function or cannot be fed orally or by . tube feeding. * The PN prescription is guided by the nutritional assessment and the definition of nutrient goals for calories. and protein. The PN solution contains carbohydrates' as glucose, fats, triglyceride, and protein as amino acid levels designed to meet the caloric and protein need of the client. * C 9 Perioperative Problems by Carl Balita, Nursing Review * D. Psychological and Behavioral Intervention * 1. Measure to relieve anxiety * 2. Fear * 3. Depression * 4. Critical concerns life: * a. Immobility * b. Sleep deprivation * c. Sensory overload * d. body image alteration * e. Grieving * f. sexuality * g. spirituality * Psychosocial and Behavioral Intervention http://www. uspharmd. com * Anxiety * Vague uneasy feeling of discomfort or dread accompanied by an autonomic response (the source often nonspecific or unknown to the individual); a feeling of apprehension caused by anticipation of danger. It is an alerting signal that warns of impending danger and enables the individual to take measures to deal with threat. * Anxiety * Defining Characteristics Nursing Diagnosis Anxiety * Expressed concerns due to change in life events; * insomnia * Fear of unspecific consequences * Shakiness * Anxiety * Nursing outcome Nursing Care Plans For Anxiety: * †¢ Appear relaxed and report anxiety is reduced to a manageable level. †¢ Verbalize awareness of feelings of anxiety. †¢ Identify healthy ways to deal with and express anxiety. †¢ Demonstrate problem-solving skills. Use resources/support systems effectively. * Nursing Priority Nursing Care Plans   For Anxiety †¢ Assess level of anxiety †¢ Assist client to identify feelings and begin to deal with problems †¢ Provide measures to comfort and aid client to handle problematic †¢ To promote wellness; teaching/discharge considerations * Fear * Fear is a feeling of anxiety and agitation caused by the pr esence or nearness of danger, evil, pain, etc. ; timidity; dread; terror; fright; apprehension respectful dread; awe; reverence a feeling of uneasiness or apprehension; concern: * Interventions. The client needs an explanation of the disease and all treatment options. * Reinforce information to the client as needed. * The client also needs information concerning operative procedures and postoperative interventions (NPO status, NG tubes, other drains, intravenous infusions). * This information helps decrease the clients fear. * Understanding Depression by Health Guide . org * Feeling down from time to time is a normal part of life. But when emptiness and despair take hold and wont go away, it may be depression. * Common signs and symptoms of depression : * Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation. * Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure. * Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month. * Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia). * Common signs and symptoms of depression : * Irritability or restlessness. Feeling agitated, restless, or on edge. Your tolerance level is low; everything and everyone gets on your nerves. * Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete. * Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes. * Concentration problems. Trouble focusing, making decisions, or remembering things. * Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain. Depression * Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. * Thoughts of death or suicide are a serious symptom of depression, so take any suicidal talk or behavior seriously * Depression * Intervention: * Lifestyle changes are not always easy to mak e, but they can have a big impact on depression. * Lifestyle changes that can be very effective include: * Cultivating supportive relationships * Getting regular exercise and sleep * Eating healthfully to naturally boost mood Managing stress * Practicing relaxation techniques * Challenging negative thought patterns * Critical Concerns life: * Immobility * Sleep Deprivation * Sensory overload * Body image deprivation * Grieving * Sexuality * Spirituality * Immobility * Immobility is complications that are associated with a limited or absolute lack of movement by the patient; various members of the health care team may collaborate to assist the patient in avoiding these problems. * Nurses must -Prevent the complications of immobility, such as :pneumonia , pressure ulcers, with frequent turning or the use of an oscillating bed. Intervention: * Continue to reposition the patient to relieve skin pressure unless the bed provides more, than 40 degrees of rotation. * The eyes may need to be taped closed to avoid corneal abrasion. * Suctioning may be needed to keep the airway clear and prevent pneumonia. * Passive range-of-motion exercises keep joints mobile and minimize muscle wasting. * Position the extremities in correct alignment to prevent contractures. * Use sequential compression stockings to prevent deep venous thrombosis (DVT); low-dose heparin may also be ordered. All these complications are continually assessed for and are treated promptly if they occur. * Sleep Deprivation Sensory overload * Sleep Deprivation is a sufficient lack of restorative sleep over a cumulative period so as to cause physical or psychiatric symptoms and affect routine performances of tasks. * Sensory overload is a condition in which an individual receives an excessive or intolerable amount of sensory stimuli, as in a busy hospital or clinic or an intensive care unit. * Sleep Deprivation Sensory overload * Sleep deprivation is of particular concern for clients in critical care units. Causes of the following: * The noise level * 24-hour lighting * and frequency of caregiver interruptions create sensory overload and sleep deprivation, which is thought to be a major factor contributing to postoperative psychosis (Joyce Black) * Sleep Deprivation * Causes: * Clients who have had surgery are also at risk for sleep pattern disturbance because of disruptions in circadian rhythms. * The cause is unclear, but the disruptions may be related to the length and type of anesthesia, postoperative analgesia, or mechanisms associated with the procedure itself. * Sleep Deprivation Techniques used to promote sleep include : * massage * relaxing music * progressive relaxation techniques * Medications to promote sleep * Body image deprivation * Body image is the attitude a person has about the actual or perceived structure or function of all or part of his or her body. * This attitude is dynamic and is altered through interaction with other persons and situations and influenced by a ge and developmental level. * As an important part of one’s self-concept, body image disturbance can have profound impact on how individuals view their overall selves. * Body image deprivation In cultures where one’s appearance is important, variations from the norm can result in body image disturbance. * The importance that an individual places on a body part or function may be more important in determining the degree of disturbance than the actual alteration in the structure or function. * Therefore the loss of a limb may result in a greater body image disturbance for an athlete than for a computer programmer. * Body image deprivation * The loss of a breast to a fashion model or a hysterectomy in a nulliparous woman may cause serious body image disturbances even though the overall health of the individual has been improved. Removal of skin lesions, altered elimination resulting from bowel or bladder surgery, and head and neck resections are other examples that can le ad to body image disturbance. * Body image deprivation * Defining Characteristics: Verbalization about altered structure or function of a body part * Verbal preoccupation with changed body part or function * Naming changed body part or function * Refusal to discuss or acknowledge change * Focusing behavior on changed body part and/or function * Actual change in structure or function * Refusal to look at, touch, or care for altered body part * Change in social behavior (e. . , withdrawal, isolation, flamboyance) * Compensatory use of concealing clothing or other devices * Body image deprivation * Therapeutic Interventions * Acknowledge normalcy of emotional response to actual or perceived change in body structure or function. Stages of grief over loss of a body part or function is normal, and typically involves a period of denial, the length of which varies from individual to individual. * Help patient identify actual changes. Patients may perceive changes that are not present or rea l, or they may be placing unrealistic value on a body structure or function. Encourage verbalization of positive or negative feelings about actual or perceived change. It is worthwhile to encourage the patient to separate feelings about changes in body structure and/or function from feelings about self-worth. * Body image deprivation * Therapeutic Interventions * * Assist patient in incorporating actual changes into ADLs, social life, interpersonal relationships, and occupational activities. Opportunities for positive feedback and success in social situations may hasten adaptation. * Demonstrate positive caring in routine activities. Professional caregivers represent a microcosm of society, and their actions and behaviors are scrutinized as the patient plans to return to home, to work, and to other activities. * Body image deprivation * Education/Continuity of Care * Teach patient about the normalcy of body image disturbance and the grief process. * Teach patient adaptive behavior (e. g. , use of adaptive equipment, wigs, cosmetics, clothing that conceals altered body part or enhances remaining part or function, use of deodorants). This compensates for actual changed body structure and function. Help patient identify ways of coping that have been useful in the past. Asking patients to remember other body image issues (e. g. , getting glasses, wearing orthodontics, being pregnant, having a leg cast) and how they were managed may help patient adjust to the current issue. * Body image deprivation * Education/Continuity of Care * * Refer patient and caregivers to support groups composed of individuals with similar al terations. Lay persons in similar situations offer a different type of support, which is perceived as helpful (e. g. , United Ostomy Association, Y Me? , I Can Cope, Mended Hearts). http://nursingcareplan. blogspot. com * Grieving by Carl Balita * Sexuality * Sexuality. Sexuality is the behavioral expression of ones sexual identity. * It involves sexual relationships between people as well as the perception of ones maleness or femaleness (gender identification). * Sexuality * Many aspects of sexuality affect health status and are significant to nursing care and client outcomes. * * Aspects include: * (1) physical health problems that affect sexual behavior * (mastectomy, colostomy, skin lesions, venereal diseases, paralysis, physical deformities) * (2) concerns with sexual performance (impotence, premature ejaculation, inability to achieve orgasm, infertility), * (3) issues of sex role function * (homosexuality, bisexuality, sexual ambiguity, transsexual surgery), and * (4) effects of environmental restrictions on sexual performance * (residency in a longterm care facility). * Sexuality * Sexuality and sexual behavior are sensitive topics. * Clients may want to discuss sexuality issues and may look for permission to do so. * Become comfortable with sexuality issues and do not allow personal beliefs and values to interfere with professional care. Accept and interact with clients without judging them or their behavior. * Spirituality * Spiritual beliefs have implications for well-being, such as sustaining hope or assisting with coping during periods of stress. * Include spirituality assessment as part of the, health history and explain the purpose for asking about it * Spirituality * . This portion of the history is usually addressed at the end of the interview after a trusting nurse-client relationship is established. * Because spirituality is personal, respect a clients wishes not to discuss this topic. Ask whether the client prefers to consult someone else wh en spiritual support is needed. * Spirituality * Nurses may be aware that patients have spiritual needs, but in many cases are unable to respond to these needs. * This may result from an inadequacy in nurse education that does not prepare nurses to provide spiritual care. (Michelle Wensley, 2011) * Supportive Management * Supportive Management * (Discussed already on MODS = Medical and Nursing Management on the previous slides) * Preventing Complications * Preventing ICU Complications * Lee-lynn Chen, MD * Assistant Clinical Professor Catheter Related Blood Stream Infection * CRBSI Prevention Bundle : * Hand hygiene * Maximal barrier precautions (mask, gown, gloves and full barrier drapes) and full barrier drapes) * Chlorhexidine skin antisepsis * Optimal catheter site selection, with subclavian vein as the preferred site for non non-tunneled tunneled catheters in adults * Ultrasound guidance * Daily review of line necessity with prompt removal of unnecessary lines * Ventilator Asso ciated Pneumonia * A leading cause of death among hospital acquired infections * Increased length of time on ventilator, in both the ICU and hospital. Estimated cost is $40,000 (2004) * Continuous Aspiration of Subglottic Secretions * Requires intubation with special tube * Separate dorsal lumen that opens in to subglottic area * Aspiration may be continuous or intermittent * Requires frequent monitoring * Pressure Ulcers * Incidence and Cost * Incidence ranging from 0. 4% to 38% * 2. 5 million patients treated annually in US acute care facilities for pressure ulcers related complications * Once pressure ulcer develops, mortality is increased by 2-6 fold with 60,000 deaths * Total annual cost $11 billion * Pressure Ulcers Definition: Localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure or in combination with shear or friction. * Identifying patients at risk and identifying early skin changes can allow early intervention to pr event a pressure ulcer from developing * Pressure Ulcers: Sites * Sacrum -most common site (30%)Slouching in bed or chair * Higher risk in incontinent pts * Heels-2ndmost common (20%)Immobile or numb legs * Higher risk with PVD diabetes neuropathy * Trochanter * Device related * Minimize pressure * Frequent small position changes (every 1. to 4 hrs) * Keep reclining chair and bed below 30 degree angle to decrease pressure load * Sitting: may need hourly position changes * Increase mobility/Consult PT/OT * Order air mattress if turning protocols are ineffective * Reposition off of any know ulcers * Use pillows to pad bony prominences * Float heels with pillow lengthwise under calves * Minimize friction and shear * Use draw sheet under patient to assist with moving * Do not drag over mattress when lifting up in bed * Avoid mechanical injury-use slide boards, turn sheet, trapeze, corn starch * Manage Moisture Cleanse skin at time of soiling and use absorbent * Provide a non-irritating surface * Barrier ointments and pads * Utilize appropriate fecal/urinary collection devices * Nutrition/hydration * Skin condition reflects overall body function * Skin breakdown may be evidence of general catabolic state * Increase hydration caloric needs * Nutritional goals: ^protein intake1. 2-1. 5 gm/kg body weight daily—unless contraindicated * Consider vitamin supplementation * Rehabilitation * Rehabilitation will be properly coordinated with the Physical Therapy Department

Birth Order and Effects on Personlality essays

Birth Order and Effects on Personlality essays Birth Order and the Effects on Personality The psychological effects on personality resulting from birth order have been studied for over a century and psychologists have recorded many fascinating results. First borns are reported to be more responsible and achievement oriented then later-borns, who are in turn reported to be more socially successful than their older siblings (Sulloway p. 55). First borns deal with pressure from their parents to be the exceptionally better at everything. Brand-new parents tend to be a paradox when it comes to their first born child. One side of them is overprotective, anxious, tentative, and inconsistent. The other side can be strict in discipline, demanding, always pushing and encouraging more and better performance (Leman p. 62). Personality although not completely dependent on birth order relies heavily on which order one was born in. Birth order effects are a result of a competition among siblings as they Alfred Alder worked extensively with the effects of birth order on personality. He said that the firstborn child was dethroned by the birth of the latter child. As Alder reasoned Sometimes a child who has lost his power, the small kingdom he ruled, understands better than others the importance of power and authority (Sulloway p. 55.). It is natural for firstborns to identify more strongly with power and authority. They arrive first within the family and employ their superior size and strength to defend their special status (Sulloway p. 19). Alder felt that firstborns develop a striving to imitate their parents, to feel responsible for their siblings, and to protect others. They are often serious and dont like surprises. They thrive on control, being on time and organized. First borns automatically fit into the category labeled advanced&qu...

Management accounting Essay Example | Topics and Well Written Essays - 3000 words

Management accounting - Essay Example But, desirability and effectiveness of accounting for organization control is a critical issue because accounting procedures consists of few integrative devices of organizations where business activities are not only drawn together by values but those are integrated in a quantitative manner. So, accounting is most efficient tool of organizational control system where standard qualitative procedures are followed to evaluate qualitative performance of the organizations for management control over the organizations. These facilitates other external stakeholders of the organizations like investors, creditors etc. for their valuable financial decision making which are highly depends on actual performance of the organizations. So, this study analyzes the effectiveness or relevance, desirability, faithfulness or reliability of accounting information for management control over organizations. Introduction Organizations show stable and consistent types of behaviour in interaction with the bus iness environment which is consistently changing. They have wide range of external influences from external business environment but have enough capability to change internally to protect their integrity. This stability and flexibility of organizational internal behaviour and control possess through effective and integrative control mechanism. One of the most important control mechanisms of organizational is internal accounting system. This consists of integrative process of accounting for implementation of accounting information in management control. So, management accounting systems has major importance in organizations as it consists of some integrative mechanisms that are capable for summarizing the qualitative effect of organizational actions or activities in quantitative values. This study review the major functions of accounting information that helps the management in the area of integrative process of organizational control. Efficient accounting provides integrative langua ge for analysing the impact of diverse internal and external influences on organizations that have substantial positive or negative impact on organizational performance. Nature of organizational control with respect to implication accounting information is qualitatively reviewed in this paper to assess the necessary conditions for control. These conditions are derived and applied in management control. Main objective of accounting policy is to produce fair valued accounting information that is highly reliable and relevant to the purpose and objectives of financials statement (WBS, 2012). The extent of desirability and effectiveness of accounting information are analysed with respect to management control and strategic decision making process. Further, scope of faithful or reliable accounting information on organizational control by management is also analysed. Again, measurement process of organizational performance both quantitative and qualitative is analysed with reference to the implication of relevant and reliable accounting information in organizational performance measurement and essential internal reconstruction with respect to change in external business environment. Desirability and Effectiveness of accounting information for organizational control There are two broad purpose of accounting information, external and internal. External purpose includes the investment decision making by the shareholders and potential new investors of an organization, credit

Philosophy of Education Essay Example | Topics and Well Written Essays - 1250 words

Philosophy of Education - Essay Example I believe that Education is the key to success and it is through education that a person receives the fundamental skills and tools that are important in building a life that is successful and prosperous. The quality of education in a country will determine the level of its success and prosperity. Therefore, as a teacher I believe that it is important for every child to receive quality education. Although quality in education is something that cannot be achieved by the teachers only, I believe teachers play a major role in improving the education quality of a country. To improve the quality of education, teachers, parents and all stakeholders in education must work together. Quality in education includes the health and participation of learners, support from family and community, availability of good learning environment, content that is relevant in real life situations and teacher’s organization and proficiency. As a teacher, I believe that everyone has the ability to learn. However, for effective mastering of concepts and skills, a student must show interest in learning and willingness to participate in the learning activities. My work as a teacher is to provide good learning environment in the classroom and improve the quality of education. The arrangement or organization of the classroom can improve or inhibit learning depending on the learning patterns of each child. Therefore, by accommodating the students’ different patterns of learning, the teacher creates an environment that is conducive for learning. Although education has always been associated with economic growth, I believe that with better quality education the economic retu rns can be much higher. It is also evident that increased investment in education increases political stability, democratization, improves the health of the people and reduces poverty and inequality. Thus, I am strongly convinced that it is the role of teachers to ensure that the education provided in schools is of good quality so as to realize the maximum benefits of quality education. Young minds are very critical and delicate, and teaching them is challenging and frustrating. Any indication by the teacher that he or she is not interested in a particular subject or area of study and lacks passion for learning will make the children to lose interest in the same. A teacher must convince the children of his or her knowledge and expertise for them to be willing to learn and show interest in learning. My job, as a teacher is to develop an environment that promotes learning. I am a teacher and an instructor because I posses the passion for guiding children through the process of learnin g and one of the best ways of fostering learning is to show the children these feelings I hold over education. I promote learning by providing a relaxed atmosphere for children, stimulating conversations on presented ideas and organizing ideas in an easy way that can be understood by the learners. I believe subject matter are interconnected thus I emphasize that everything that people learn form a world of understanding from which they develop their personal views. I also believe that showing respect to my students is important because it encourages them to be open and inspires them to respect each other and all other people. My method of teaching is that which acknowledges diversity in teaching methodologies and techniques. I believe that hands on and minds on learning are important because supplementing curriculum with other activities promotes the learning process. I am certain that by involving the learners in fascinating lessons and making use of strategies which address their learning styles, they can achieve success in academics and have self confidence in the learning process. Learning only takes place when the children are fully engaged in the learning process, are personally connected to the concept taught and use the knowledge acquired in real life situations. Therefore, when this happens a child is encouraged to be engaged over and

The Women Of Beowulf

The Women Of Beowulf An epic tale of heroes and monsters, the story of Beowulf is filled with excitement and adventure, However Beowulfs importance goes far beyond that of just an excellent literary piece. It also offers many insights into the world of the seventh-century Anglo-Saxon culture. One of the things that is very prevalent in Beowulf is how women are portrayed and expected to act in this society. Anglo-Saxon women that are peaceful and unassertive are considered to be following their roles in society, by greeting guests and serving mead to the men in the mead hall. One such example of the Anglo-Saxon women following this role is Welthow, the queen of the Danes. Women are also portrayed on the opposite end of the spectrum; a perfect example of this would be Grendels mother. She is a strong and fierce monster whom Beowulf must kill. By reading about these two women in Beowulf, we can understand the different ways women are portrayed in this society. Throughout the story of Beowulf, the author sub tly supports the traditional Anglo-Saxon views of women by praising the actions of Welthow, condemning Grendels mother, and showing the need to stop feminine forces like Wyrd; however, the author also contradicts these views on a few rare occasions by sympathizing with Grendels mother, allowing Welthow to assert herself in support of her family. In the story of Beowulf, Welthow is by far the one that one would think of when they picture a typical Anglo-Saxon women in these times. The instance that best demonstrates this is after they all return to Hrothgar. Then Welthow, Hrothgars gold-ringed queen, greeted the warriors a noble woman who knew what was right, she raised a flowing cup to Hrothgar first, holding it high for the lord of the Danes to drink, wishing him joy in the feast. She thanked god for answering her prayers, for allowing her hands the happy duty of offering mead to the heros. (Raffel 28-29) This passage gives a detailed example of what is expected of women in these times. Even on into later years, Women were still expected and encouraged to serve drinks. The wife grew the grapes, harvested the grapes, made the wine, and sold the wine(Collins 26). Even though she is operating as a typical Anglo-Saxon woman she is still a queen. This is evident in her role from that of a traditional Anglo-Saxon woman to a peace maker when she gives a toast in the meadhall Celebrate his courage, rejoice and be generous while a kingdom sits in your palm, a people and power that death will stealà ¢Ã¢â€š ¬Ã‚ ¦. I know your nephews kindness; I know hell replay in kind the goodness you have shown him. (Raffel 51-52) With everyone gathered for the toast, Hrothulf would have second thoughts about betraying his family and taking the throne. In another similar way, in the poem Les Voeux de Paon, a family is quarreling and with the help of a young woman peacemaker, they put down their disagreements, Elyses, a young woman, goes to each knight asking for them to vow to discharge their obligations to arms(Murphy 6) She continues to gently persuade each of them until they all give in to laying down their weapons. However, on the other end of the spectrum we have Grendels mother. Grendels mother defies the traditional role of an Anglo-Saxon woman by being powerful and aggressive. The main difference between Welthow and Grendels mother is that Welthows influence is much more subtle and nonviolent than that of Grendels mother. Being a monster, Grendels mother possesses great warrior-strength (Raffel 57). Grendels mother attacks Herot. Shed taken Hrothgars closest friend, The man he most loved of all men on earth, The wise old kind, trembled in anger and grief, his dearest friend and adviser dead (Raffel 57). The next morning, Beowulf follows her tracks back to her underwater lair. Beowulf goes into her underwater lair and they fight. However Beowulf did not consider the enormous strength she would have. In order to defeat Grendel, Beowulf grabs one of his arms and rips off; on the other hand, Grendels mother fights with Beowulf and almost defeats him. Beowulf only wins the fight because of divine intervention, The ruler of the world, showed me, hanging shining and beautiful on a wall, a mighty old sword (Raffel 71) When later recounting his battle with Grendels mother, he says she fought with such strength that would surpass any man. Despite Beowulf being the hero and Grendels mother being portrayed as a monster, he creates sympathy for Grendels mother by accepting her motive for vengeance and suggesting a close mother-son bond. When Grendels mother is first introduced, she is depicted as a mother mourning her son and out for vengeance. It shows some reason for her attack instead of just being evil. The author continues to build sympathy for Grendels mother by presenting her as having a clear emotional bond with her son. After her attack on Herot, Grendels mother takes the arm of her slain son. Further evidence of the strong emotional attachment between the two is the fact that Beowulf finds Grendels dead body in his mothers underwater lair. The last we hear of Grendel, he is fleeing from Herot with a mortal wound. One can only assume that Grendels mother was mourning the death of her son and unable to let him go. The continued reinforcement of appropriate female roles by presenting two separate and opposing supernatural forces that strongly influence the plot of Beowulf: a masculine God and a feminine Wyrd, suggesting that feminine forces require suppression. Wyrd is a mysterious force that acts as a fate, bringing the heroes of Beowulf ever closer to agony and death; however, God protects Beowulf and helps him in battle. Wyrd works to bring disorder and doom to Beowulf, just as Grendels mother wages war on Hrothgar and his kingdom. Beowulf is able to kill Grendels mother, ending her influence, however he is unable to do anything about the Wyrd except to look to God for help. The story of Beowulf helps paint a picture of what it must have been like to be an Anglo-Saxon woman in those times. The woman who followed the traditional roles are considered good and those who dont are cast out as monsters. Raffel, Burton. Beowulf. 2nd ed. London: Signet Classic, 2008. Print. Collins, James. French Historical Studies. French Historical Studies. 16.2 Print. Murphy, Michael. English Studies. English Studies. 66.2 105. Print.

I’m Not an Imitation of Someone Else, I’m Latina :: Personal Narrative Writing

I’m Not an Imitation of Someone Else, I’m Latina As I sat at the kitchen table on those chilly winter evenings in Kenner, Louisiana, I could feel my mother staring at me from where she was. I was busy doing my homework, and she was preparing that night's supper. She would always start off by asking me what I was doing and the only thing I would ever answer was, "Oh, nothing. Just homework." Then I would turn away and sort of look in the other direction as if to tell her to leave me alone, because I had a lot to do. At the time I was only eight years old, in my second complete year of schooling in the United States. I had already fully grasped the English language, and it had been a year and a half since I had been removed from the bilingual program. In actuality, I had become Americanized quiet easily. Although this was a process that involvedgive and take, because although I did adapt to my new environment very well, I never let go of what I had already learned in my previous environment. I can recall that at the same time that I was learning to read and write in English, I was also learning to do so in my native tongue, Spanish. In school, as I sat in the small wooden house, which was the bilingual classroom, I could clearly remember wondering why it was that "Spot" was so important. For more than a month we had been learning about this brown dog and about seeing him run. This experience was very strange for me, not only because it was in a totally new language but because I never did really see spot run. I only saw him painted on an oversized illustrated notebook. After a long and confusing day at school, I would come home to do my assignments; alone. It wasn't that my mother did not want to help me, but she couldn't. She knew little about the assignment , and knew even less about the language. At first I didn't mind. The assignments were easy for me to figure out, and if it was really hard I would just tell the teacher the next day that I couldn't figure it out. Sh e would ask me why I didn't ask my mother for help, and I would have to respond to her, "because she didn't know either.