Condi Rice Essay Example

Condi Rice Essay Example Condi Rice Essay Condi Rice Essay Lindsey Humphries Mrs. McCaucly Speaking before Audience Febuarary 17 20089 Introduction Speech Outline: Condoleezza Rice Specific Purpose:I will introduce former Secretary of State Condoleezza Rice to the class. Central Idea: Condoleezza Rice is a woman of color who has strengthened our nation, by overcoming obstacles and by breaking down barriers. Thesis: Today I will tell you just who Condoleezza Rice is and how she became one of the most influential women in the United States, by explaining how she got there from her early childhood days, to her academic career, and finally, to her career as a diplomat. INTRODUCTION I. (Attention Getter)Former British Prime Minister Margaret Thatcher, once said, â€Å" I do not know anyone who has got to the top without hard work. That is the recipe. It will not always get you to the top, but should get you pretty near. † That quote brilliantly defines the recipe of the person that I am going to introduce to you guys today. II. (Reveal Topic) â€Å"Today I am going to introduce to you former Secretary of State, to former President George H. Walker Bush, Condoleezza Rice III. Credibility Statement) As a young college woman who has a distinct interest in politics and is interested in hopefully becoming, a Public Servant, by one day becoming a Civil Lawyer, I often look to powerful self-made female politicians in the United States as a role model and Condoleezza is one of them. IV. (Preview/Thesis) Briefly reveal your topic and state what your main points will be. For example: â€Å"Today, I will tell you just who Condoleezza Rice is and how she became one of the most influential women in the United States, by explaining her A. her childhood days† B. â€Å"her academic career† C. â€Å"and finally to her career as a politician and a diplomat for the United States. † TRANSITION: Let me start by telling you a little information about when she was a little girl. BODY : I. (MAIN POINT 1) Condoleezza Rice claims that her childhood taught her determination against adversity and to value education. A. (SUBPOINT) Born on November 14, 1954 in Birmingham, Alabama, Condoleezza Rice grew up in the South during the time of the civil rights movement. B. 1. a. Sub-sub-subpoint) Further examples and information to support your subpoint. You can use abbreviations for the labelExample = (SSSP). â€Å"Having two younger brothers to care for gave Jack a great deal of responsibility at an early age. † b. (SSSP) If you have an ‘a. ’ you must have a ‘b. ’ â€Å"Every chance he could he helped his Mother around the house. † 2. (SSP) More of the above. If you have a ‘1. ’ you must have a ‘2. ’ â€Å" B. (SP) You Must have a ‘B. ’ You must include at least 2 subpoints for each Main Point 1. SSP) Sub-Sub-Points and SSSPs are optional, however, you will most likely have both in your speech to support your subpoints and main points. a. (SSSP) Further examples and information to support your subpoint. b. (SSSP) If you have an ‘a. ’ you need a ‘b. ’ 2. (SSP) C. (SUBPOINToptional) 1. (SSP) 2. (SSP) TRANSITION: A transition is used to go smoothly from the 1st Main Point to the 2nd Main Point. (Include the exact wording of your transition) For example: â€Å"Now you know a little bit about Jack’s background let me tell you about his educational. II. (MP 2) Your second MAIN POINT goes here. Follow the same format that you used for the first main point. â€Å"Jack has some specific educational goals. † A. (SUBPOINT) You should have at least two subpoints under each main point. This could be one complete sentence. You cannot have an A without a B. 1. (SUB-SUBPOINT) This is where the specific examples from your research are included to support your main points. You can use quotes, examples, stories. Be sure to cite all sources. If you have a ‘1. ’ you must have a ‘2.. ’ . (Sub-sub-subpoint) Further examples and information to support your subpoint. b. (SSSP) If you have an ‘a. ’ you need a ‘b. ’ 2. (SSP) More of the above. B. (SP) 1. (SSP) a. (SSSP) Further examples and information to support your subpoint. b. (SSSP) If you have an ‘a. ’ you need a ‘b. ’ 2. (SSP) C. (SUBPOINToptional) 1. (SSP) 2. (SSP) TRANSITION: A transition is used to go smoothly from the 2nd Main Point to the 3rd Main Point. (Include the exact wording of your transition) III. (MP 3) Your third MAIN POINT goes here. The total number of main points is optional, however, three main points seems to be the number easiest to manage as a speaker, and the easiest to remember for your audience. ) â€Å"Jack enjoys life every chance he gets. † A. (SUBPOINT) You should have at least two subpoints under each main point. This could be one complete sentence. You cannot have an A without a B. 1. (SUB-SUBPOINT) This is where the specific examples from your research are included to support your main points. You can use quotes, examples, stories. Be sure to cite all sources. If you have a ‘1. ’ you must have a ‘2.. ’ a. (Sub-sub-subpoint) Further examples and information to support your subpoint. b. (SSSP) If you have an ‘a. ’ you need a ‘b. ’ 2. (SSP) More of the above. B. (SP) 1. (SSP) a. (SSSP) Further examples and information to support your subpoint. b. (SSSP) If you have an ‘a. ’ you need a ‘b. ’ 2. (SSP) C. (SUBPOINToptional) 1. (SSP) 2. (SSP) TRANSITION:A Transition is used to transition smoothly from the body of your speech into the conclusion. Include in your transitional statement your exact wording) â€Å"We can see that Jack enjoys life – let us review what makes Jack who he is today. † CONCLUSION I. (Summary Statement) Summarize your main points. Be specific and concise. Give an example from each main point. â€Å"Jack has overcome many losses and difficulties in his life. He has helped raise his two younger brothers. Wh ile helping raise his siblings he decided that he would like to pursue a career as a Teacher. Jack is not all work and no play- Jack enjoys surfing and he loves working with children. Jack has combined his two passions by teaching surfing to children in the Maui Youth Program. † II. (Memorable Closing Statement) Leave your audience with something to think about. A memorable close that refers back to the attention getter creates psychological unity for your audience. â€Å"At one time or another you may have thought to yourself that You Don’t Know Jack, however, now you do. Jack has found nothing but opportunities in the difficulties he has faced – I encourage you to take the opportunity to get to know Jack- it won’t be difficult. Let’s welcome him to our class. †

Leukemia Case Study Essays

Leukemia Case Study Essays Leukemia Case Study Essay Leukemia Case Study Essay Leukemia are cancers of the blood- forming tissues. White blood cells may be produced in excessive amounts and are unable to work properly which weakens the immune system. The patient is a 68 year old male admitted on 02/07/201 S with chief complaint of weakness and shortness of breath. Patient was admitted to the medical- surgical unit with pneumonia. Description of Condition First of all, What is Leukemia? In healthy person, white blood cells are produced in the bone marrow and then it transfer to the blood in a continuous basis. Bone marrow is the spoon). Tissue inside the bone where blood cells are made. They are produced by stem cells in the long bones. According to Assignations and Workman (201 3), Leukemia accounts for 2% of all new cases of cancers and 4 % of all deaths from cancer (as cited in American Cancer Society, 2011). In a person with ML the same process occurs, except the white blood cells production proceeds to an excessive uncontrollable rate of immature white bloo d cells. In acute leukemia, the leukemia or blast cells function abnormally and accumulate in the peripheral blood, the bone marrow, and central nervous system. At an uncontrollable rate leukemia cells dont stop diving when should. Most patients with acute leukemia will only live few months if left untreated. Body then is deprived of essential components for its immune system. Leukocytes(white blood cells) protect our bodies from infections and cancer development. Furthermore, it presents with pare skin, patchier, bleeding from minor cuts, lack of energy , and mild fever and aches in the joints or bones(Leukemia and Lymphoma Society, 2011). There are may types of leukemia, but the four most common forms are derived from only two types of cells, lymphocytes, and employees. There are subtypes of these diseases, which are classified depending on pacific cell type involved or degree of maturity. The estimates for leukemia in the United States for 2014 are about 1 8,860 new cases of Acute Myeloid Leukemia. Most will be in adults. (American Cancer Society, 2014). Etiology and Risk factors The exact cause of leukemia is unknown. There are many different origins and risk factors for the four main kinds of leukemia and while some may be directly linked, there are others that show small linkage to anything at all. Environmental and genetic factor are involved in the development of leukemia. Risk factors to the development of leukemia include environmental actors, immunologic factors, genetic factors, reduced production of blood cells in the bone marrow, exposure to chemical and drugs, viral infections, and ionizing radiation. ML has no main risk factors, but does have a few potential risk factors like excessive exposure to benzene, a chemical found in cigarette smoke and work places (Leukemia and Lymphoma Society, 2011). Smoking is a risk factor for many diseases such as lung cancer, heart disease, kidney disease among others but what most people fail to realize, It is a risk factor for leukemia. Leukemia can be acute, with sudden onset and short oration, or chronic, with slow onset and persistent symptoms for years. According to Assignations and Workman (201 3), With Leukemia, cancer most Often Occurs in the Stem cells or early precursor leukocyte cells, causing excessive growth or a specific type of immature leukocyte (p. 880). Also, the cells accumulate in the blood and in certain organs, forcing out healthy cells and interfering with the function offbeat organ. ML is caused by abnormalities of our DNA that controls the development in your bone marrow. These abnormal cells build up and replace healthy cells. Sign and Symptoms The patient with acute leukemia has abnormal labs like decrease hemoglobin and homoerotic levels, low platelet count and abnormal white blood cells counts. There are some changes associated with acute leukemia due to these abnormal labs. The blood circulate through the body thus affecting all organ systems. There are may symptoms of ML, in the early stages, the symptoms of ML may resemble the flu. Symptoms of leukemia are linked with the blood function because the initial pathogenesis of the disease in on the bone marrow . The following are the common manifestations of leukemia : anemia , bleeding or bruising bone and joint ins , recurrent infections due to an increase in immature white blood cells, swollen lymph nodes abdominal distress , and breathing difficulty. Anemia due to a low ROB count. Because red blood cells carry oxygen throughout the body . The anemia occurs due to the incapacity of the bone marrow to produce red blood cells in association with the overcrowding Of the bone marrow with the proliferating cancerous cells . Manifestations of this symptom include the tiredness of the patient, faster breathing , and paleness, fatigue and short of breath. Patient is unable to do simple this like bathing because there is no energy. Also, skin becomes pale and cool to touch as a result of reduced tissue perfusion. Leukemia which is a low WEB count or decrease in production of mature, healthy, functional white blood cells. Leukocytes, which in turn weaken the body immune response; thus, the patient is vulnerable and prone to recurrent infections. Recurrent infections that can be viral or bacterial and occurs over the past weeks are brought about by the disrupted capacity of the immune system to mount an immune response due to the presence of immature white blood cells . Thermodynamic a low blood platelet count. The platelets are the load cells responsible for blood clotting. A shortage of blood platelets may lead to easy bruising or bleeding. The multitudes of cells present in the bone marrow results to pain in joint and bone . Abdominal distress is an outcome of the pooling of leukemia cells in the liver spleen , and kidney which causes the swelling of these organs. Because of enlarged liver or spleen or surrounding organs due to the build up Of abnormal cells spleen and liver may cause feeling of fullness (loss of appetite). This leads to weight loss, anorexia, nausea. Blood clotting times and factors are abnormal. Clotting time is prolonged as well. Patient History and Medication Reconciliation Patient is a 68 year old male. He was admitted on 02/07/2015 with chief complaint of weakness and shortness of breath. Patient has a past history of coronary artery disease status post MI, trial fibrillation status post pacemaker, leukemia, in remission, Hyperglycemia, Hypertension, anomic brain injuries after cardiac arrest, who has been complaining of weakness over the last 2 weeks. The patients family were concerned for pneumonia and they call EMUS. He was found to have pneumonia by chest x-ray in the Emergency Room. Patient diagnostic test in the ERE include White blood cell 3. , Hemoglobin 11 . 1, platelets 90, sodium 129, potassium 4, chloride 92, vicars 27, BUN 19, creating 0. 2, glucose 137, EKE is sinus rhythm at 72 beats per minute, wide SIRS, nonspecific inter ventricular block, SST-T abnormality, dioxin 0. 7, trooping less than 0. 01, BAN 5081. The patient past us racial history include CAB, material valve replacement with mechanical valve, Hernia repair, pacemaker in place. Patient is allergic to codeine. Patient had itch skin as stated by wife. Patient has a history of smoking long time ago. Smoked 1 pack daily for 20 years. The patient uses alcohol rarely. Patient lives at home with his wife. Patient home medication include Emendation 200 MGM once daily, transportation 20 MGM once daily, dioxin O. 25 MGM once daily, hydrazine 25 MGM ;ice dally, shorebird 20 MGM twice daily, lowercase 1 MGM Q. H. S PR. , meteorology MGM once daily, proton 40 MGM once daily, superannuation 25 MGM once daily, soma 0. 4 MGM once daily, Commanding 1 MGM once daily. Patient was admitted to the medical-surgical floor with pneumonia patient will be put on elevating and given ethylene as needed for fever. Patient is positive for dizziness, positive for shot-term memory loss, positive for dry cough, positive for shortness of breath. No chest pain, no nausea or vomiting. No abdominal pain, no diarrhea, no constipation Positive for fever. Nursing Assessment, Medications, and Labs Patient noted to be sleeping on arrival. Patient breathing normally with occasional cough. Patient recent Vitals (0)38. 2-76-18 on 2. 5 L 1 19/54. Patient had no pain at this time. Patient is on fall precautions. Patient noted to be confused and respond to voice only. Patient physical exam reveals him to be alert and oriented to person, place, and time. He communicates, though not readily. His speech and vision are intact but only to voice. Patient spends to voice commands only, and when looking at him in the eye. He has an equal grip bilaterally and can move all extremities, though he is slightly weak and needs assistance with nursing activities such as with reposition. Patient is on telemetry monitor. His apical pulse 78. Capillary refill is less than 2 s. No Jugular vein distention noted. His peripheral pulses are weak and equal. No B/L peripheral edema noted. Patient had flowstone in place. No shortness of breath noted. No nasal flaring. Chest expansion symmetrical. His left lung is clear on auscultation, but right upper lobe of the Eng rancho was heard on auscultation, his respiratory rate is 18, and his oxygen saturation is 98% on 2. L of oxygen via nasal canal. Patient is able to turn, cough and deep breath. Patients wife assisted him with the use of incentive speedometer at 1200. Patient noted to have a pacemaker on right chest wall. Also, on the left chest patient has an infusorians that hasnt been access. In the middle of the chest patient has an old scar form CAB. He has positive bo wel sounds in all quadrants on auscultation , and his abdomen is soft, round, and non tender. He had a small loose brownish bowel moment this morning. Patient is passing flatus. He is on a regular diet, but his appetite has been poor for the past few weeks his wife stated. Wife stated that patient did not have anything to eat for breakfast except for a few sips of juice. For lunch, wife fed patient about 25% and 120 ml of milk. Patient takes pills whole. Patient has his own teeth, and does not wear glasses. No bladder distention noted. No burning on urination. Client is incontinent of urine. This morning nursing student put a new condom catheter. Client is voiding appropriately and his urine is clear and yellow. No foul odor or cloudy. He appears pale and is unkempt. His skin is warm, dry, and intact. NO ash noted. Oral cavity dry. He appears somber and is slow to comply with nursing instructions. Patient has a saline lock on left arm on the thumb side. No pain, rather, edema noted. At 1 100, 0. 9% INS IV fluids 50 ran_/hrs. Patient is on bed rest. He is out of bed with assistance of 2. And transfer with assistance of 2. He needs assistance to set up meal tray. Patient was wash this morning, though he was tired. He was turn at 1200, 1400. Patient ID band was in place. Call bell in reach. Patient demonstrated ability to push button on call bell. Partial side rails up, fall risk identified, fall alert sigh in place. Patient is a DON/DIN. When talking with wife, she stated that she is the primary caregiver at home. Her husband sleep in a regular bed. Case manager was in this morning discussing with the wife of the patient about possible discharge to a nursing home. Patient current medication list include for angina therapy, Shorebird Monetarist to be given 20 MGM orally 2 times per day, Mentality agents; Lowercase 1 MGM orally every day at bed time, Antichrists; moderation administer consistently in regards to food/meals 200 MGM orally everyday. Anticoagulants; warring 2 MGM orally every day, patient currently not on medication. Interdisciplinary; transition 20 MGM orally every day. Interventions therapy engage; hydrazine 25 MGM orally 2 times per day. Beta adrenaline blocker; meteorology ERE 150 MGM orally every day. Cardiac Interlopes; Dioxin 127 meg orally every day. Diuretics; superannuation 17. 5 orally every day. Peptic ulcer therapy; proton 40 MGM orally every morning. Prismatic Hypertrophy agent; Tomlinson ERE 0. 4 MGM orally everyday. Patient is on Sodium Chloride 0. 9 IV 50 ml/hrs continuous. Levitation in DEW MGM IV every 24 hrs. Opprobrium-alabaster 0. OMG-3 MGM inhalation every 6 hrs. Bonaparte 200 MGM orally three times a day as needed for cough. Suffering 600 MGM oral every 12 hours to reduce viscosity of secretions. Chlorinating 25 MGM orally. Patient lab include: on 02/07/15 CB with Dif include Interruption 14. 6, Lymphocyte 21. 0, Monocots 64. 1, Censorship 0. 2. On 02/10/15, WEB count 1. 9, Hemoglobin 9. 6, Homoerotic 28. 9, Platelets 62, BUN 34, creature 0. 70, sodium 133, potassium 4. 3, Albumin 2. 8, promote 35. 5. On 02/12/15, WEB count was 0. 8, ROB count 2. 75, Hemoglobin 9. 0, Homoerotic 26. 8, Platelets 42, Interruption 4. 9, Lymphocytes 85. , Monocots 9. 7, Promote 35. 5, INNER 3. 23. On 2/9/15 patient had an cardiograms which show iterate left ventricular dilation, Hyperkinetic inferior wall. Severely reduced FEE estimated at 20-30%. Normally function mechanical valve. Diagnostic procedure and Treatment Diagnosing acute myeloid leukemia (ML) and ML subtype usually involves a series of tests including complete blood count and bone marrow aspiration and biopsy (Leukemia and Lymphoma Society, 201 1). The gold standard for diagnosing leukemia is an examination of cells obtained from bone marrow aspiration and biopsy. The bone marrow full immature cells. This cells have tags( antigen) on the surface of cell. The specific antigens can alp diagnose the type of leukemia. Due to accelerated research and advances in oncology medicine in recent years, there are several forms of treatment available for the patient with leukemia. The main types of treatment selected for most patients with leukemia today are chemotherapy, radiation, and stem cell transplantation also know as homeopathic stem cell transplantation(HOST) (Assignations Workman, 201 3, p. 883-889). The type of treatment selected by the patient and doctor is based on many factors including the type of leukemia, the age of the patient, and other health issues or problems the patient may have. There are a few efferent treatments recommended for ML depending on the severity and the individual patient. A combination of chemotherapy drugs is the most popular initial treatment. Antibiotics may also be recommended to prevent infection which is very common in this disease. Drug therapy for patient with ML is divided in three distinctive phases: Induction, consolidation, and maintenance (Assignations Workman, 2013, p. 83) Chemotherapy is the use of anticancer drugs design to slow or stop the growth of rapidly diving immature cells in the body. While chemotherapy targets cancer cells, it can also damage health cells and cause unpleasant side effects. ML treatment is generally done in two phases: induction therapy, consolidation therapy; thus,Len induction chemotherapy a combination of dr ug is used to destroy as many leukemia cells as possible and bring blood counts to normal (Leukemia and Lymphoma Society, 201 1). At this phase of treatment patient emotional, physical, social state are vulnerable. The anticancer drugs take a toll on the body, making the patient more at risk for infection. Nausea, vomiting, diarrhea, loss of hair, mouth sores, are among the many undesirable side effects patient experience while going through this phase. Prolonged hospitalizing are common while the patient is entropic (Assignations Workman, 2013, p. 884). Then, consolidation chemotherapy is used to destroy any remaining leukemia cells that cannot be seen in the blood or bone marrow. It consist of another course of either the same drugs use for induction at a different dosage or a different combination of chemotherapy drugs; HOST also may be considered, depending on the disease subtype and the patients response to induction therapy (Assignations Workman, 2013, p. 884). Not only do the body immune system is weak by the mass production f immature WEB, but chemotherapy severely suppresses the bone marrow leaving patient at an increase risk for infection. Nursing care for this patient is vital. Nurses caring for the patient with leukemia face many challenges. It is crucial that should not only understand the disease process, but treatment course as well. This enables them to educate their patient, administer treatment safely, and manage for possible side effects; but also to provide support to the patient and family. HOST is the standard treatment for the patient with leukemia who has a closely matched donor and who is in temporary remission after induction These treatments are lethal to the bone marrow, and without replacement of the stem cells by transplantation, the patient would die of infection or hemorrhage (Assignations Workman, 201 3, p. 85). Stem cells are classified by the source. HOST started with the use of allegoric is transplantation of bone mallow form a sibling or matched unrelated donor and has advanced to the use of human leukocyte antigen(HAL) There is tautologys, in which patient receives their own step cell which are collected before high-doses therapy Lastly, genetics are those that come form identical sibling (Assi gnations Workman, 201 3, p. 85). After, the frozen stem cells are thaw and given as blood transfusions by a central venous catheter or a venous access device. In order for the body to successfully take the transplanted cells a process called engagement is key to the whole transplantation process (Assignations Workman, 2013, p. 887). The period after transplantation is difficult for both the patient and family due to the patient weaken immunity. During and aftermath prevention of complications Life-threatening complications in particular can require complex physical treatment but, more significantly, may arouse complex emotional, psychological and spiritual issues for both patient and nurse. The care focuses on the patient taking chemotherapy and HOST. The most difficult task for the nursing during this processes is maintain hope through this long recovery period. Infections are a major complication in patients with acute myeloid leukemia (ML) undergoing intensive chemotherapy, these complications are still associated with severe morbidity and mortality. Meghan, T et al. (2012) emphasized, Preventing infection is a paramount goal for nurses caring for patients with leukemia. Interruption among hospitalized patients with acute leukemia puts them at a high risk of infection (p. 80). Hand hygiene is to be one of the most effective ways to prevent the transmission of infection. It is important to teach the patient about hand washing to prevent infections while this vulnerable state. Patient should be place in single rooms to prevent cross contamination. The most common infections are fungal, bacteria, and dome residual viral breakthrough (Assignations Workman, 201 3, p. 419). It is important to keep equipment used by the patient in the room, this will ensure there is no contamination. Assisted personal should be taught about washing hands often in between patients and use hand sanitized when you cant use soap and water. Avoid people with colds or the flu, thus, visiting patient should wear a mask at all times. These steps can help reduce the chances of coming into contact with someone who is sick. Patients are wipe out the majority of the time after treatment that self care is often neglected. It is imperative to teach patient, family, and assisted personal that some aspects of personal care cannot be put off for a later time. Mouth care is vital to prevent infection. Brush your teeth after meals and before bedtime, using an extra- soft toothbrush that wont hurt your gums. Inspect mouth for any sores, and report any open sores immediately. Clean your toothbrush at least weekly by either rinsing it liquid laundry bleach and then rinsing the bleach with hot running water. Skin is often the only body part protecting the patient, thus, any break can be a major potential for infection. Bathe regularly with warm water. Be careful to dry your skin completely. Use lotion to prevent cracks in your skin. Open cut and cracks may let bacteria in. Keep your skin hydrated and moisturizer. Dry, cracked skin is more likely to break and become susceptible to infections. Furthermore, squeezing or scratching pimples can rate open sores that would also place you at higher risk of infection. The same is true of biting or tearing at your cuticles. Use an electric razor instead of a blade. This may help you to avoid cuts. Patients should avoid anything raw vegetables, fruit. Cook all food thoroughly. This will help kill any potential germs that may be on raw food. Teach patient to avoid eating raw fruits and vegetables; undercooked meat, eggs, and fish, pepper, apical. The priority nursing interventions for patient with interruption are protecting him or her form infection and teaching patient and family about ways in which they can educe infection. Total patient assessment, including skin, lung, mouth, close inspection of venous access device insertion site(illustrating Workman, 201 3, p. 41 9). The patient should be monitor continuously for infection. Take temperatures according to hospital policy. Monitor the patients CB with differential. Inspect the mouth during every shift for lesions. A complete respiratory assessment should be assess for any presence of crackles, wheezes, and diminish breath sounds. Ask the patient to report any burning, painful urination, also, report any foul odor or cloudiness. It is important to maintain aseptic technique when dealing with central venous devices for dressing changes and administration of chemotherapy drugs at all times. Inspect open areas, such as C.V. every 4 hours for manifestations of infection. Change IV tubing according to hospital protocol. In addition, the patient is also vulnerable from minimal injury. Thermodynamic is defined as a decreased number of platelets in the blood, which can result in poor blood clotting. Thermodynamic is induced by chemotherapy, this poses the patient at great risk for excessive bleeding (Assignations Workman, 201 3, . 89). Patient with thermodynamic often experience include: Easy bruising, bleeding from your nose, rectum (black or bloody bowel movements), or stomach (vomiting blood or coffee-appearing material). Encourage the patient to stand unclothed in front of a mirror once a day to check for areas of bruising. Patchier, which are red spots in the skin. Economies which are larger reddish-blue patch es (bruises) on your skin. In women, periods that are heavier than normal. There are ways to manage this condition, they include: medications that stimulate the formation of platelets. One of this medication is Megan (Assignations Workman, 2013, p. 421) Patient should caution to avoid taking aspirin because it increases risk for bleeding. Patients should use electrical razors. If patient want to blow nose they should do it gently. Also, they should avoid hard food. If patient wears dentures they should fit the mouth properly. If patient want to cut nails they should do so with care. Patient should avoid becoming constipated or straining by taking a stool softener. If any bleeding does occur, instruct the patient to apply pressure to the area and seek help. The most important specs of care of this patient is to maintain a safe, hazardous free environment. Moreover, the patient also suffers from anemia. Normal production of red blood cell is limited with leukemia. Anemia is relatively common in patients who undergo chemotherapy. The goal with anemia is to conserve energy and improve red blood cell counts. Anemia depends on the extend of disease and intensity of treatment. Patients are often left feeling of tiredness which may interfere with every day activities. Fatigue is the most common sign of anemia Patient may become short of breath, dizzy. As Meghan, T et al. 012) advised, Blood transfusions are given to relieve symptoms and improve patients quality of life. (p. 81). Transfusions may be one way to alleviate patients symptoms though the correction effort is fast the duration is limited ant transient. Drug therapy include the administration of arthroscopies-stimulating agent. This agents that boost the production of red blood cells. It is important for nurses to be understanding and helpful during this time of weakness and to reassure patient that is only temporary. There are ways in which nurses can help patient cope with low energy level angina from medication to nursing activities. For example, nursing staff and assisted personnel should space out nursing activities throughout the day and perform any activity possible when the patient has the most energy. It is important to monitor respiratory status during activity to determine if the patient is able to tolerate. Also, nutrition plays a vital role and should be consider because the patient needs enough calories to meet and maintain demand of body. Lastly, malnutrition among patients with leukemia is high. It is very common problem among hospitalized patient, in general; anyway, who wants to eat when sick! It is the nurse, that need to educate abut the importance of nutrition. There are many causes of malnutrition including pain, fatigue, depression, and side effects of chemotherapy. The simple most obvious cause is loss of appetite due to alter taste. Some symptoms include sore mouth, dry mouth, pain, taste and smell changes, diarrhea, fatigue, anxiety, nausea and vomiting. When encourage patient about nutrition modifications is important to keep in mind to include the patient in decision making as much as possible giving a sense of power. Asking the patient about what are some likes and dislikes.

The First Voyage of Christopher Columbus (1492-1493)

The First Voyage of Christopher Columbus (1492-1493) How was the first voyage of Columbus to the New World undertaken, and what was its legacy? Having convinced the King and Queen of Spain to finance his voyage, Christopher Columbus departed mainland Spain on August 3, 1492. He quickly made port in the Canary Islands for a final restocking and left there on September 6. He was in command of three ships: the Pinta, the Nià ±a, and the Santa Marà ­a. Although Columbus was in overall command, the Pinta was captained by Martà ­n Alonso Pinzà ³n and the Nià ±a by Vicente Yaà ±ez Pinzà ³n. First Landfall: San Salvador On October 12, Rodrigo de Triana, a sailor aboard the Pinta, first sighted land. Columbus himself later claimed that he had seen a sort of light or aura before Triana did, allowing him to keep the reward he had promised to give to  whoever spotted land first. The land turned out to be a small island in the present-day Bahamas. Columbus named the island San Salvador, although he remarked in his journal that the natives referred to it as Guanahani. There is some debate over which island was Columbus’ first stop; most experts believe it to be San Salvador, Samana Cay, Plana Cays or Grand Turk Island. Second Landfall: Cuba Columbus had explored five islands in the modern-day Bahamas before he made it to Cuba. He reached Cuba on October 28, making landfall at Bariay, a harbor near the eastern tip of the island. Thinking he had found China, he sent two men to investigate. They were Rodrigo de Jerez and Luis de Torres, a converted Jew who spoke Hebrew, Aramaic, and Arabic in addition to Spanish. Columbus had brought him as an interpreter. The two men failed in their mission to find the Emperor of China  but did visit a native Taà ­no village. There they were the first to observe the smoking of tobacco, a habit which they promptly picked up. Third Landfall: Hispaniola Leaving Cuba, Columbus made landfall on the Island of Hispaniola on December 5. The natives called it Haità ­, but Columbus renamed it La Espaà ±ola, a name which was later changed to Hispaniola when Latin texts were written about the discovery. On December 25, the Santa Marà ­a ran aground and had to be abandoned. Columbus himself took over as captain of the Nià ±a, as the Pinta had become separated from the other two ships. Negotiating with the local chieftain Guacanagari, Columbus arranged to leave 39 of his men behind in a small settlement, named La Navidad. Return to Spain On January 6, the Pinta arrived, and the ships were reunited: they set out for Spain on January 16. The ships arrived in Lisbon, Portugal, on March 4, returning to Spain shortly after that. Historical Importance of Columbus First Voyage In retrospect, it is somewhat surprising that what is today considered one of the most important voyages in history was something of a failure at the time. Columbus had promised to find a new, quicker route to the lucrative Chinese trade markets and he failed miserably. Instead of holds full of Chinese silks and spices, he returned with some trinkets and a few bedraggled natives from Hispaniola. Some 10 more had perished on the voyage. Also, he had lost the largest of the three ships entrusted to him. Columbus actually considered the natives his greatest find. He thought that a new slave trade could make his discoveries lucrative. Columbus was hugely disappointed a few years later when Queen Isabela, after careful thought, decided not to open the New World to slave trading. Columbus never believed that he had found something new. He maintained, to his dying day, that the lands he discovered were indeed part of the known Far East. In spite of the failure of the first expedition to find spices or gold, a much larger second expedition was approved, perhaps in part due to Columbus’ skills as a salesman. Sources Herring, Hubert. A History of Latin America From the Beginnings to the Present. New York: Alfred A. Knopf, 1962 Thomas, Hugh. Rivers of Gold: The Rise of the Spanish Empire, from Columbus to Magellan. 1st edition, Random House, June 1, 2004.

Benifits and Disadvantages of Coaching PowerPoint Presentation

Benifits and Disadvantages of Coaching - PowerPoint Presentation Example Knowledge gets transferred from one individual to another through the process of coaching. It is partly different from teaching in that in coaching, the tutor essentially adopts such a behavior that makes him/her the role model for the learners whereas in the course of learning, the tutor just has more knowledge about the subject as compared to the learners. He/she may not at all be involved in the subject of discussion. All that matters is the conveyance of knowledge to the learners whereas in coaching, the coach essentially tells the followers how to do a certain task. It involves display of certain characteristics that are consistent with the demand of the subject of discussion. Therefore, a coach assumes the responsibility to behave and act professionally so that he/she may rationally decide what to deliver when, how and how much. The same professionalism is inculcated in the followers as they accede to the instructions of the coach. Coaching provides the learners with an opportu nity to identify their weaknesses and discover their strengths with the guidance of the coach. Coaching is a coherent process whose various stages are sensibly linked to each other. In the initial stage of coaching, the coach tells the followers what is expected of them once they master a certain art.

Inquiry Brief Essay Example | Topics and Well Written Essays - 500 words

Inquiry Brief - Essay Example My research question is as follows: do medical advancements and biomedical progress outweigh the controversial ethical and moral acts made in stem cell research? My argument is that medical and social benefits stem cell research brings to humanity the past progress and future development of the research. For the purpose of the analysis and argument on stem cell research, three academic sources were selected. The article by L. Leydesdorff and I. Hellsten â€Å"Metaphors and Diaphors in Science Communication: Mapping the Case of Stem-Cell Reseach† in Science Communication examine the term â€Å"stem cell† and how it varies in different contexts of research, applications and policy debates. From the very beginning, authors emphasize the pressing importance of stem cell research, indicating that the United States President George W. Bush addressed the political and social issue of stem cell research, specifically, embryonic stem cell research and it was the first time an American President had gone on national television in a special broadcast on a bioethical issue (Leydesdorff & Hellsten, 71). Later in November 2001, Bush convinced Congress to ban reproductive and therapeutic cloning of stem cells (Leydesdorff & Hellsten, 71). Authors points out that these restrictive policies have greatly affected both scientific research in the United States and the public debate over stem cell research. More specifically Leydesdorff and Hellsten focus on communication of stem cell research to general public and the importance of it to the latter. From the authors’ perspective, it is evident that stem cell research will receive the fullest reception of society. In her book â€Å"Stem Cell Research† Lillian Forman provides a thorough analysis of almost every aspect around stem cell research, from its medical potential and future benefits to policy

Guy couples should be allowed to adopt children Essay

Guy couples should be allowed to adopt children - Essay Example It is high time the remaining States emulate them, take cognizance of the overwhelming arguments in favor of the practice, stop their unfair restriction and allow gay and lesbian couples to adopt children. Firstly, there are an inordinately large number of children in the country who are on the adoption waiting list. Rob Woronoff, spokesperson of Child Welfare League of America {CWLA} has gone on record to state that the child welfare system in the U.S. is mired in deep crisis because there are not enough families coming forward to adopt children. North American Council on Adoptable Children reports that nearly 520,000 children are in foster homes in the U.S. Out of these, although 120,000 are ready for adoption, only 50,000 ultimately reach permanent homes every year (Stone http://www.usatoday.com/news/nation/2006-02-20-gay-adoption-foster_x.htm). A large percentage of the children left behind are the ‘odd’ ones: older children, or children with special needs. The children left behind, especially the ‘odd’ ones, have been accepted in foster care by same sex couples, who are now desirous of adopting the children (Belge http://lesbianlife.about.com/cs/families /a/adoption.htm). Renowned actress Rosie O’Donnell {a lesbian living with her same sex partner Kelli O’Donnell and their 4 adopted children} unerringly points to the reason for same sex couples’ partiality towards adopting ‘odd’ children: â€Å"As a gay person as a child, you kind of know what it’s like to be the odd one out† (Stone http://www.usatoday.com/news/nation/2006-02-20-gay-adoption-foster_x.htm). By not allowing adoption, the authorities are not permitting the already existing loving relationship between children and same sex couples to blossom into full-fledged fruition acceptable by society. This attitude is especially unfair to the children as they are being refused the opportunity to live in safe, sound and permanent households (Belge

The UAE Essay Example | Topics and Well Written Essays - 1000 words

The UAE - Essay Example Moreover, it was recently ranked number 40 out of the 183 countries with regard to the overall ease of conducting business. This article explores the business environment of the UAE by examining its PESTL environments. The United Arabs Emirates (UEA) is a Middle East country bordering the Arabian Gulf and Oman Gulf, between Saudi Arabia and Oman. It is a federation of seven countries established in 1971with its members operating under one federal government. The country which is a monarchy is politically stable. Even though democracy sometimes is jeopardized, citizens enjoy a lot of freedom. UAE has four levels of governments: President, Federal National Council, High Council, and Local Emirs. What is evident is that most powers are vested in the hands of the Emirs. As such, no authority is allowed beyond Emirs, implying that citizens from different Emirates have absolutely no say on political issues (Kjeilen 2004). The UAE enjoys favorable diplomatic relations with several countries. It has close ties with most Arab countries including Egypt and Pakistan. The country’s main export markets include Germany and the United Kingdom even as the U.S. and France maintain security related cooperation with the country. The government has made great effort to increase spending on job creation, opening up space for private investor involvement as well as expanding its infrastructural facilities to create a favorable environment for business and investment. The government’s commitment to promote business and investment is also seen when it created a free trade zone in UAE. The zone was mainly established by the government as a way of promoting direct foreign investment in the country. This implies that there are no limits on overseas ownership within UAE. The government in this case allows foreign investors to establish fully-owned companies within the free trade zones, which currently stand at