Graduation Speech High School - 895 Words

The normal teenager or even preteen goes through a phase in their life when their parents become annoying and desperately want to be grown and on their own. They feel like their parents just nag and fuss for the heck of it. Though I use to think my mom was just nagging for no reason very often, I now realize that everything she told me was beneficial and that I would need it later in life. It was the end of the nine weeks to my sucky so called â€Å"junior year† of high school, and I knew that I would be bringing home a C on my report card. Although my mom was a very sweet, loving person I knew she would be furious because she was a very work-oriented person. She always pushed for good grades for as long as I can remember. She would always say, Jori, have you done your homework? or Jori, are you ready for that test? I d always say, Of course mom, because I wanted to see her happy. When I got home from school I carried the mail in the house as I did every day, and I saw that my report card came. I thought about hiding it so my mom wouldn t know about it. I anxiously waited for her to get home from work. When she came in, she asked about my day, and we had our normal conversation about one another’s day. I desperately wanted to get this report card dilemma out of the way. I wondered what was so wrong with a C? I told her my report card came in. A big smile came across her face as I handed her the envelope. After she opened it, my heart instantly dropped. I could tell thatShow MoreRelatedGraduation Speech : High School934 Words   |  4 Pageslife would be graduation. For many people, graduating from high school is an objective. It takes a lot of time, effort, and determination to accomplish that goal. For others graduation is the end of high school, and the beginning of a new chapter in life. When graduated people feel as if adulthood has begun. In the long run, graduating opens a lot of opportunities for people to thrive. I can almost reminisce the day as if it was yesterday. I was sitting in bed like any other school day. It seemedRead MoreGraduation Speech : High School852 Words   |  4 PagesAccording to a report from Thomas Nelson Community College website, 15.7 percent is the graduation rate in 2010. 84 percent of students failed to receive their degree. That’s beyond sad. College can be difficulty especially with everyday life is getting harder to main family life work and financials. Because college is challenging, I know that I have issues that I must overcome. I told myself the more patient s I have the better success I will have. Although college will be difficult my goal isRead MoreGraduation Speech : High School Essay2254 Words   |  10 Pages The day I graduated from high school The High school graduation day is a life full of journeys for everyone, high school life is a memorable time for most people, for me as well. High school can be filled with lots of good memories for some people and it could be filled with bad memories, for me it was both I had good times and I had bad times. The High school Graduation day should definitely be the best day of your life because that means no more high school, no more having to wake up at 6Read MoreGraduation Speech : High School Graduation854 Words   |  4 Pagesfail High School graduation can be an exciting time in a student’s life. It is a time in their lives where they begin to experience the kind of freedom that comes along with growing up. This freedom allows students to choose the type of college or University they would like to attend. It is necessary that they understand how responsible they need to be with the freedom that is being offered to them. When choosing what college or university to attend it may be tempting to want to go to a school thatRead MoreGraduation Speech : High School Graduation1507 Words   |  7 PagesForest English 1010 9/9/2014 Graduation During our lives, most of us have hated getting up early. Whether we as humans enjoy mornings or not, we’re always looking forward to that unforgettable day. That special is high school graduation for me. Graduation is a ceremony that recognizes students that have excelled through school. Graduation was one of the best days of my life, perhaps even better than the day that I started college. There is no other day like graduation where there comes this feelingRead MoreGraduation Speech : High School Graduation933 Words   |  4 PagesHigh School Graduation With regards to high school graduation, Balfanz, Herzog, and Iver (2007) followed 12,972 Philadelphia students enrolled in traditional middle schools from six grade (1996-1997) until 1 year beyond their expected graduation from high school (2003-2004) in order to understand what indicators would affect their projected graduation date. Unlike many of the early K-8 schools, the population Balfanz et al followed consisted of 64% African American, 19% White, 12% Hispanic,Read MoreGraduation Speech On High School Graduation851 Words   |  4 PagesThere Is No Success Without The Opportunity to Fail High School graduation can be an exciting time in a student’s life. It is a time when they begin to experience the kind of freedom that comes along with growing up. This freedom allows students to choose the type of college or University they would like to attend. It is necessary that they understand how responsible they need to be with the freedom that is being offered to them. When choosing what college or university they would like toRead MoreGraduation Speech : High School997 Words   |  4 Pagesup, I loved going to school and dreamed of one day attending college. Attending school every day and receiving good grades had become my top priority from K-12. I excelled from K-8th grade, but entering into high school was completely different than primary school. The atmosphere and environment was new to me, I was free to roam the halls or walk back out the door without any repercussions. This began my downward spiral in high school. My freshman year was by far the best school year for me becauseRead MoreGraduation Speech : High School897 Words   |  4 PagesHigh school was one of the most challenging moments in my life. Not only did I have to deal with the academic pressures and social issues from my peers I had external factors that were heavily impacting me as well. During my junior year my mom separated from her husband and me and my three little brothe rs ended up staying house to house with close relatives. Shortly after that time at the beginning of my senior year, my mom was sent to prison. In the midst of dealing with all of the demands thatRead MoreGraduation Speech : High School Essay1434 Words   |  6 PagesWhen I was in high school I had one goal, I would graduate top of my class and go to the University of Florida for pre-medicine, then onto their medical school. I never considered that I would want anything else, so I went to a specialty high school that would allow me to specialize in Biomedical sciences(STEM) and never even thought about the possibility of a life other than the one I had so precisely planned out for myself. When my nephews were born my sophomore year all of my priorities changed

Rfeh free essay sample

Prerequisites: Mathematics through differential equations, freshman biology sequence, first year of physics, thermodynamics (physical chemistry). Course Objectives: At the end of this course the students should be able to do the following: ; Describe the fundamental conservation principles and constitutive laws that govern heat, mass and momentum transport processes. ; Develop the fundamental engineering skills that enable effective expertise for addressing novel biomedical applications including the design of systems that interface with or analyze living systems. Develop the fundamental engineering skills o enable the modeling or analysis of transport processes in living organisms. Required Textbooks: 1 . Fundamentals of Heat and Mass Transfer, 6th Edition, by Incorporate, DeWitt, Bergman and Levine. 2. Fundamentals of Fluid Mechanics, any Edition, by Munson, Young and Cockish. Other Useful Textbooks: Bootstrap: Principles and Applications, 1st Edition, Robert Rosella and Ken Dilled. Transport Phenomena, 2nd Edition, Bird, Stewart and Lightproof. ABET Program Outcomes Achieved: 1.Apply knowledge of biological and physical sciences, mathematics, and engineering to solve problems at the interface of engineering and biology. We will write a custom essay sample on Rfeh or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page 2. Identify, formulate and solve biomedical engineering problems that address contemporary issues within a global societal and economic context. 3. Recognize the need to pursue continuing educational opportunities in biomedical engineering and have the ability to do so. Attendance: Required for all class periods. The course is designed for much of the learning experience to occur during the class period.Student Feedback: take teaching very seriously and want to provide you with information in the most accessible and applicable format. Therefore, in addition to the end of term class evaluations, we will have two other feedback rivers during the term on Blackboard. These will give you an opportunity to raise any concerns and give me a chance to implement some of your suggests. Academic Honesty: I expect you to uphold the highest standards of academic honesty. The class will be highly interactive, and hopefully a lot of fun. However, any kind of academic dishonesty will not be tolerated and severe disciplinary action will be taken. Class Etiquette: am a big fan of technology and collect the latest gadgets; however, there is a place for everything. Any kind of cell phone use will not be tolerated in class. This includes talking on the phone, receiving phone calls, SMS text messaging or even checking voice mall. I am expecting that all of us will keep our phones OFF, putting them on vibrate is not sufficient. Grading Format Homework Exam 1 Exam 2 20% If anal Exam 25% project 25% My Policies 1. Ill post the homework online the day they are assigned and collect them in-class one week later. 2. If all the homework assignments for the course are completed, the lowest homework score will be dropped from the final grade. 3. You are encouraged to study together and to discuss information and concepts covered in lecture and the sections with other students. You can vive consulting help to or receive consulting help from such students. However, this permissible cooperation should never involve one student having possession of a copy of all or part of work done by someone else. . Late homework/final projects will not be accepted. 5. Attendance to these sessions is required. UT Policies An engineering student must have the Deans approval to add or drop a course after the fourth class day of the semester. Adds and drops are not approved after the fourth class day except for good cause. Good cause is interpreted to be documented evidence of an extenuating nonacademic resistance (such as health or personal problems) that did not exist on or before the fourth class day.

Hesi Hypertension free essay sample

Mr. Dunns blood pressure reading is 189/110. His LDL cholesterol reading is 200 mg/dl. He asks the student nurse if he should be concerned about his blood pressure. 1. How should the student respond? A) Your blood pressure is very high. You need to see your healthcare provider today. INCORRECT Mr. Dunns blood pressure is high. The student nurse needs to assess for other symptoms before making the determination that the healthcare provider must see him that day. B) You have hypertension. You need to start making some lifestyle changes. INCORRECT The diagnosis of hypertension is not made until the client has an elevated blood pressure on two different occasions. C) Please sit here quietly for a few minutes. We will write a custom essay sample on Hesi Hypertension or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page I need to recheck your blood pressure. CORRECT Mr. Dunns blood pressure is high, but may be temporarily elevated due to activity or stress. The blood pressure should be rechecked after the client rests for a few minutes. D) I need you to remain seated. I am going to call for the emergency squad. INCORRECT Based on the information currently available to the student nurse, there is no need to call the EMS. The student nurse asks Mr. Dunn about his health history. He is 6 feet tall and his weight is 190 lbs. Mr. Dunn states that he has lost a lot of weight recently. He also reports experiencing a lot of stress at work and that he often goes out with the crew after work to have several beers. He reports that his mother, who had diabetes mellitus, has passed away. He believes that she also had hypertension. He smokes 1? packs of cigarettes a day and drinks 4 to 5 cups of coffee a day. 2. What significant risk factor for hypertension does the student nurse identify for Mr. Dunn according to this health history? A) Family history of diabetes. INCORRECT If Mr. Dunn had diabetes, this would be a significant risk factor but the presence of diabetes in his family is not. B) Recent weight loss. INCORRECT Weight loss is not a risk factor for hypertension. C) Caffeine intake. INCORRECT There is no current indication that caffeine intake is a risk factor for hypertension. D) Alcohol consumption. CORRECT Excessive alcohol intake is strongly associated with hypertension. Client Teaching The student nurse rechecks Mr. Dunns blood pressure now that he has been sitting quietly for a few minutes. His blood pressure is 180/106. 3. According to the assessment of this client, what recommendation is most important for the student nurse to provide Mr. Dunn? A) See his healthcare provider within the next week for a BP recheck. CORRECT His blood pressure is significantly elevated. Since these BP readings were obtained on the same day, Mr. Dunn needs to see his healthcare provider soon for a second BP measurement so that a diagnosis can be determined and treatment initiated. B) Limit his salt intake and start a weight loss program. INCORRECT Both of these actions may help decrease the clients blood pressure, but another intervention is more important at this time. C) Attend a stress reduction seminar offered in his community. INCORRECT While this may be useful, another intervention is more important at this time. D) Learn about high fiber foods and add more fiber to his diet. INCORRECT Increasing fiber in the diet promotes over-all health by helping cholesterol levels, but it does not affect blood pressure. The student nurse continues to talk with Mr. Dunn about hypertension. Mr. Dunn states he feels great physically and does not see why he needs to see his healthcare provider. 4. How should the student nurse respond? A) Your blood pressure is dangerously elevated. You could have a heart attack or stroke at any time. INCORRECT Threatening the client with a major problem is not the best way to motivate a client to get care. B) While often there are no symptoms, high blood pressure does cause damage to many organs. CORRECT Often clients with hypertension have no symptoms and organ damage may occur before the client becomes symptomatic. C) Hypertension is called the silent killer. Im sure that you dont want to die at your young age. INCORRECT While this answer may scare the client, it does not help the client understand the disease process. D) It is always better to treat high blood pressure before you start having symptoms. INCORRECT This is true, but does not provide the client with the best information needed at this time. A week later, Mr. Dunn has an appointment with his healthcare provider. After the exam, the healthcare provider explains to Mr. Dunn that he has stage 2, primary (essential) hypertension. 5. What information obtained during the assessment supports this diagnosis? A) Blood pressure of 184/98. CORRECT Stage 2 hypertension is described as a Systolic blood pressure of greater than or equal to 160 mm Hg or a Diastolic blood pressure of greater than, or equal to, 100 mm Hg. B) Family history of hypertension. INCORRECT This is a risk factor not a symptom of primary hypertension. C) Irregular pulse rate of 110. INCORRECT Pulse rate and rhythm do not affect blood pressure classification. D) An auscultated heart murmur. INCORRECT A heart murmur does not directly support the diagnosis of stage 2 hypertension. However, a heart murmur may be a reflection of a problem that caused the clients hypertension. If a cause for the hypertension is found, the client would then be diagnosed with secondary hypertension. The healthcare provider informs Mr. Dunn that he needs to be on a low salt diet, stop smoking, limit his alcohol intake, decrease his stress level, and start taking chlorothiazide (Diuril) and atenolol (Tenormin). The nurse enters the room to give Mr. Dunn his prescriptions and spend some time teaching him about his care. Mr. Dunn asks the nurse to please call him Mark. In speaking with the nurse, Mark expresses concern that the healthcare provider did not prescribe any additional tests. He asks, Shouldnt the healthcare provider find out why I have hypertension? 6. How should the nurse respond to Marks question? A) Your healthcare provider does not think we need to determine the cause now. Further tests may be done once your blood pressure is in the normal range. INCORRECT If there were indicators suggesting that there was a cause, it would be important to correct them, thereby helping bring the blood pressure down. B) 90-95% of all cases of hypertension are without an identified cause, so unless there is some indicator in your health history, the healthcare provider does not look for one. CORRECT Primary (essential) hypertension has no identifiable cause, even though there are several known contributing factors. C) If there is a cause for your hypertension, it will become evident very soon. You will see the healthcare provider frequently until the cause is determined. INCORRECT If the hypertension did have a cause, clinical findings such as an abdominal bruit, variable pressures with a history of tachycardia, sweating, or a family history of renal disease may well already be present. D) Dont worry. Stress causes your blood pressure to go up even more. Your healthcare provider does know what tests to order and when they should be done. INCORRECT This response avoids the clients question, rather than helping him understand the disease process. Mark also asks the nurse about his medications, chlorothiazide (Diuril) and atenolol (Tenormin). The nurse reviews the medications, side effects, and the importance of taking them on a daily basis. 7. In evaluating Marks understanding, which statement indicates that Mark understands the nurses instructions about his medications? A) I will be taking these medications for the rest of my life. INCORRECT These medications are the beginning regimen for Mark. He may need to switch to other medications or, with life-style modifications, he may not need both medications or any medications at all. B) I can expect my heart rate to increase as my blood pressure goes down. INCORRECT The pulse rate should not increase unless the client experiences significant hypotension. In addition, atenolol (Tenormin) is a beta blocker, which may cause a decrease in heart rate. C) I may experience impotence with this drug regimen. CORRECT This is a common side effect of many antihypertensive medications, including atenolol (Tenormin), which is a beta blocker. D) An irritating cough often develops, but will subside in a few days. INCORRECT This is a common side effect of ACE inhibitors. Atenolol (Tenormin) is a beta blocker, not an ACE inhibitor, so the client should not experience this side effect. Evaluation The nurse shares with Mr. Dunn that there are several things he can do besides taking the medication to improve his health. Mark says, I know, the doctor told me that I need to quit smoking, change my eating habits, decrease the stress in my life, and stop drinking so much alcohol. There is no way I can make all of those changes. There would be nothing left in life to enjoy! 8. In discussing these lifestyle modifications with Mark, what information is most important for the nurse to share with him? A) Use of tobacco products is linked with increased risk for cardiovascular disease. CORRECT Discontinuation of tobacco use decreases blood pressure and has cardiovascular benefits within the first year of quitting. B) Drinking 24 ounces of beer a day or less is acceptable for clients with hypertension. INCORRECT This is a true statement, but another issue has a higher priority for the client to know. C) Clients with hypertension respond differently to sodium restricted diets. INCORRECT Sodium restriction has been shown to be more effective in the African American population and in the elderly. Since Mr. Dunn is not a member of either of these groups, the nurse should focus on the lifestyle modification that would be the most beneficial to this client. D) There is evidence that stress only elevates blood pressure for a short time. INCORRECT This a true statement, but Mr. Dunn does work in a field where he is constantly under stress. Relaxation therapy or guided imagery may be helpful in decreasing his blood pressure, especially during periods of high stress; however, another response is of greater priority. Mr. Dunn expresses interest in learning more about how to reduce his stress level. He states that he has seen episodes on television about biofeedback and guided imagery, but he cant imagine either of those techniques fitting into his lifestyle. 9. How should the nurse respond? A) Biofeedback is really simple and fits into everyones lifestyle. INCORRECT This response does not acknowledge the clients feelings or his thoughts about this stress management technique. B) Of course you can use guided imagery, it works well for me. INCORRECT The nurse needs to focus on the client, rather than on the nurses personal experiences. C) You could try music therapy. What kind of music do you like? INCORRECT Music therapy does help many people reduce their stress level, but there is a better answer. D) Many methods can help reduce stress. Tell me about your work day. CORRECT With this response, the nurse helps Mark identify strategies that might fit into his lifestyle. This response empowers the client to be engaged in the process of determining which strategy will be most effective for him. Mark admits that he has tried to quit smoking several times in his life by using nicotine gum. 10. What is the most effective nursing intervention to help Mark be successful this time? A) Encourage Mark to make a quit plan. CORRECT A quit plan, which includes the quit date, notifying friends and relatives of the plan to quit, anticipating withdrawal symptoms, and throwing away all tobacco products on the quit date is an excellent method to quit smoking. Using more than one method helps ensure success. Marks use of the nicotine gum, along with a quit plan may increase the potential for success. B) Give Mark free samples of nicotine gum. INCORRECT Mark has tried using nicotine gum as the method to quit smoking in the past without success. C) Talk with Marks wife about how she can help him quit. INCORRECT Support and encouragement are important, but there is a better answer. D) Review with Mark all of the negative effects of cigarette smoking. INCORRECT Mark may already understand all of the harmful effects of smoking. Mark is looking for a way to help him stop. This response does not answer his request. Mark expresses concern about the problems that can arise if he doesnt get his blood pressure under control. The nurse explains that hypertension can damage the kidneys, heart, lungs, and blood vessels. Mark states that he had an uncle and a grandfather who both died from an aortic aneurysm. He asks the nurse if high blood pressure causes this problem. 11. How should the nurse respond to Marks concern? A) Reassure him that there is no cause for concern since aortic aneurysms only occur in about 5-7% of people over the age of 60. INCORRECT The statistics given in this answer are correct, but telling the client not to worry does not address his concern. B) Advise him that, due to his family history, his healthcare provider may want to do further testing. CORRECT Studies have shown a strong genetic predisposition in the development of abdominal aortic aneurysms. This response provides immediate feedback that addresses the clients concern. C) Instruct him that the symptom of an abdominal aortic aneurysm is a pulsating mass in the abdomen. INCORRECT A pulsating mass in the abdomen is usually only noted in thin clients. Often, abdominal aortic aneurysms are asymptomatic. D) Encourage him to share his concern with his healthcare provider during his next scheduled office visit. INCORRECT Mark has shared this concern now. It should be addressed during this visit. Abdominal Aortic Aneurysm During the initial office visit, Mark is also scheduled for an abdominal ultrasound to determine the presence of an aneurysm. The nurse notes that the healthcare provider has asked Mark to return for a follow-up visit in 1 month. 12. Considering the overall plan of care, what is the primary reason for the nurse to encourage Mark to keep his next appointment? A) Discussion of the results of the ultrasound. INCORRECT If the ultrasound does indicate the presence of an abdominal aortic aneurysm, Mark would be called immediately and called in for a follow-up appointment at that time. B) Evaluation of the effectiveness of Marks lifestyle changes. INCORRECT Mark does need to be evaluated in how he is doing with smoking cessation, stress management, and decreased alcohol consumption, but these changes will make a difference over time. A month later is too soon to determine the effectiveness of these changes. C) Follow-up measurement of his blood pressure. CORRECT Mark has just been started on antihypertensive medications. The effectiveness of this treatment needs to be assessed. Many people who are on antihypertensive medications are still hypertensive. Follow-up evaluation is essential. D) Scheduling for further diagnostic testing. INCORRECT The nurse does not know if any further testing will be needed. Since Mark has been diagnosed with primary hypertension, further tests are not needed to find the cause of the hypertension. Mark returns to the office in 1 month with his wife. The ultrasound exam showed the presence of a 3 cm Fusiform aneurysm on the abdominal aorta. 13. In teaching Mark about the aneurysm, what information should the nurse include? A) This type of aneurysm is a weakness in the wall of the aorta causing an outpouching. INCORRECT A weakness in the wall of the aorta causing an outpouching is a saccular aneurysm. B) Immediate surgery to repair the aneurysm is the recommended treatment. INCORRECT Surgical repair is the treatment of choice for aneurysms 5 cm and larger. C) Further testing is needed immediately to determine if it is enlarging. INCORRECT There are no signs or symptoms present at this time indicating that the aneurysm may be enlarging. D) Maintaining a normal blood pressure can effectively treat this size of aneurysm. CORRECT For aneurysms less than 5 cm in size, the treatment of choice is to keep the clients blood pressure under control and to monitor the size of the aneurysm every 6 months. Marks vital signs are T 98. 4Â ° F, P 78, R 20, and BP 148/90. Mark states he has been feeling fine except that he seems to be more tired than he usually is and has had some trouble sleeping. When asked, Mark replies that he has cut down to only 1 pack of cigarettes a week and he has signed up to take a class on reducing stress next month. 14. Which assessment finding is of most concern to the nurse? A) Current blood pressure reading of 148/90. CORRECT Marks blood pressure is still hypertensive. With the presence of an abdominal aortic aneurysm (AAA), attaining and maintaining a normal blood pressure is essential. B) Commitment to a stress reduction class. INCORRECT While it would be beneficial for Mark to take a stress reduction class, there is another assessment finding that is of greater concern. C) Has reduced smoking, but continues to smoke. INCORRECT Mark has made strides in decreasing the number of cigarettes he smokes a day. There is another assessment finding that is of greater concern. D) Fatigue and difficulty sleeping. INCORRECT Both of these are expected side effects of his medications. The nurse asks Mark if he is limiting his salt intake. He states that his wife fixes all the meals. 15. Which statement by his wife shows she understands a 2 gm sodium diet? A) The main change I made was to remove the salt shaker from our dining table. INCORRECT While not adding salt to the food after preparation is important, that change alone will not establish a 2 gram sodium diet. B) I am preparing a variety of fresh vegetables and avoiding processed foods. CORRECT Processed foods are a major source of sodium. Replacing processed foods with fresh is a key to maintaining a low sodium diet. C) I measure out 2 teaspoons of salt each morning and that is all I use that day for cooking. INCORRECT One teaspoon of salt is over 2 grams of sodium. D) We quit cooking with salt. Instead we are using condiments to season our meals. INCORRECT Many condiments such as ketchup, steak sauce, and soy sauce are high in sodium content. 16. Based on the data the nurse has obtained, which nursing diagnosis should be included in the plan of care? A) Ineffective health maintenance. CORRECT Mark remains hypertensive. His treatment regimen needs to be re-evaluated in order for Mark to become normotensive. B) Anxiety related to lifestyle changes. INCORRECT Nothing that Mark or his wife has shared indicates that anxiety is a problem at this time. C) Disturbed body image. INCORRECT To determine if this is a problem, the nurse needs to complete additional assessment. D) Self neglect. INCORRECT No data obtained by the nurse so far supports this problem. Mark is continuing to work and take care of his self care needs. Antihypertensive Therapy The healthcare provider adds nifedipine (Procardia) to Marks other prescriptions. 17. What instruction related to this medication is essential for the nurse to provide Mark? A) Do not take any non-steroidal antiinflammatory drugs (NSAIDs). INCORRECT The effectiveness of angiotensin-converting enzyme inhibitors (ACE inhibitors) is reduced by NSAIDs. Nifedipine is not an ACE inhibitor. B) Discontinue the medication if he is lightheaded when he gets up suddenly. INCORRECT Postural hypotension is an expected side effect when starting an antihypertensive. The client should be instructed to change positions slowly at first. This side effect usually resolves with time. C) Notify the healthcare provider if he has any urinary retention. INCORRECT Urinary retention is not a side effect of the antihypertensive medications. Instead, some alpha adrenergic blockers such as doxazosin (Cardura) and prazosin (Minipress) can help with urinary retention due to benign prostatic hypertrophy. D) Avoid eating fresh grapefruit or grapefruit juice. CORRECT Grapefruit decreases the effectiveness of nifedipine (Procardia), a calcium channel blocker. 18. What statement by Mark indicates to the nurse that he understands his current plan of care? A) I should take my blood pressure at home frequently. If it is low, I can quit taking my medications. INCORRECT It is important for the client to monitor his blood pressure, but stopping his blood pressure medication suddenly may cause rebound hypertension. B) If I quit smoking, eat a low sodium diet, decrease my alcohol intake, and get my stress level down, I can quit taking these medications. INCORRECT Rebound hypertension can occur with sudden discontinuation of many antihypertensives. Discontinuation of these medications should be done under the direction of his healthcare provider. C) If my blood pressure is in the normal range on my next visit, I will probably continue on these medications for at least 1 year. CORRECT Step-down therapy is not started until after 1 year of good blood pressure control. D) This combination of medications is used frequently. I do not need to worry about drug interactions. INCORRECT Each individual must be assessed for possible drug interactions. Mark and his wife leave the office feeling comfortable with their knowledge about hypertension and the life style modifications they need to make. A Complication Occurs Six months later, Marks wife takes an overdose of diazepam (Valium) and alcohol. She is brought to the Emergency Department by the EMS. Mark arrives a little while later from work. He is obviously upset and very angry. As Mark is giving information to the registration clerk, he becomes pale and complains of the sudden onset of severe back pain. Mark is taken to the triage nurse. 19. What assessment data obtained during the triage assessment alerts the nurse that Mark needs immediate medical evaluation? A) History of hypertension and blood pressure of 175/90. INCORRECT Marks blood pressure is high, but he has a history of hypertension and has had this problem for awhile. While he may need to be seen by the healthcare provider, this assessment alone does not warrant immediate care. B) Respiratory rate of 26 and pulse rate of 96. INCORRECT These values are within normal parameters. Although slightly elevated and warrant further assessment, by themselves they are less significant than another finding. C) Headache on and off for last week with nausea. INCORRECT Headache and nausea are not symptoms of a major medical emergency. D) History of 3 cm aortic aneurysm and sudden onset of back pain. CORRECT The sudden onset of back pain in the client with a history of an aneurysm is a sign that the aneurysm may be dissecting or may have ruptured. After examining Mark, the healthcare provider writes several prescriptions. 20. Which prescription should the nurse complete first? A) Stat 12 lead electrocardiogram (EKG). INCORRECT While the healthcare team will need a baseline EKG, other actions are more critical to keeping Mark alive. B) Computed tomography scan (CT) of abdomen. INCORRECT A CT of the abdomen is needed to confirm the diagnosis, but another action is of greater priority. C) IV of 0. 9% Normal Saline with large bore angiocath. CORRECT When a dissecting or ruptured aneurysm occurs, the client requires large amounts of fluid replacement to maintain the blood pressure. It is essential that an IV be started before Marks blood pressure starts to fall. D) Type and cross match for 4 units packed red blood cells (PRBC). INCORRECT Mark will need blood replacement, and will need more than 4 units. However, another nursing action needs to be completed first. When Mark returns from radiology where the abdominal CT was performed, the diagnosis of dissecting aortic aneurysm is made. Mark is informed that he needs immediate surgery. Unfortunately, his wife is intubated and nonresponsive. 21. Which nursing action should take priority? A) Call report to the operating room staff. INCORRECT It is important to call report, but other nursing actions take priority in this life and death situation. B) Get the surgical consent form signed. INCORRECT The surgeon does need to inform the client about the procedure and the risks involved, but actually getting the consent form signed is not the highest immediate priority for the nurse. C) Notify Marks children and family. CORRECT A significant number of clients who have surgery to repair a dissecting abdominal aortic do not live through the surgery. Mark and his family need time to connect before the surgery. D) Consult a social worker. INCORRECT A social worker will need to be involved to help deal with the familys psychosocial issues, but there is another action that should take priority. Delegation Several things need to be done before Mark goes to surgery. 22. Which action can be safely delegated to the unlicensed assistive personnel (UAP)? A) Observe Mark sign the surgical consent form. INCORRECT The surgeon is responsible for informing the client about the surgery. The nurse, after assessing that the client has been informed, may get the consent signed. B) Obtain a full set of vital signs along with a neurologic check. INCORRECT While the UAP may take the clients vital signs, a nurse must perform all assessments. Neurological checks are an important assessment parameter. C) Call a report of the clients condition to the surgery staff. INCORRECT Calling report is the responsibility of the nurse who has the knowledge and expertise to provide the correct information. D) Document a list of Marks personal belongings. CORRECT This is the only action listed that does not require the expertise of the nurse. After these tasks are completed, the nurse asks the UAP to obtain a second set of vital signs on Mark. 23. What result indicates that this task was successfully delegated? A) The vital signs were obtained by an experienced UAP. INCORRECT This only reflects that the right person was assigned to the task, the first step in the delegation process. B) A complete set of vital signs are documented on the chart. INCORRECT This only indicates that the UAP did get a set of vital signs. C) The UAP reports the current vital signs to the nurse. CORRECT For delegation to be complete, not only must the right task be assigned to the right person and completed, but the results must be reviewed by the nurse. D) The UAP obtains an accurate set of vital signs. INCORRECT An accurate set of vital signs indicates the right task was performed, but the last step in the delegation process needs to be completed. Communication The first unit of packed red blood cells is available before Mark goes to the operating room. While the nurse is hanging the first unit of blood, Mark asks if he is going to die. Mark states that he has never been around anyone who was dying and he is scared of what happens after death. 24. What is the best response by the nurse? A) No one knows if you will live or die. Right now you need to focus on being strong for your children when they arrive. INCORRECT The nurse is negating the patients feelings with this response. B) This is a frightening experience. Is there someone with whom you would like to talk about your fears? CORRECT The nurse acknowledges Marks feelings and addresses the issue. C) There is a real chance you may die from this. Many people do die from a dissecting aneurysm. INCORRECT This is a true statement, but not the best response. The nurse closes the conversation with this statement without offering support. D) Your healthcare provider is the best person to answer your questions about whether or not you will live through the surgery. INCORRECT This response does not address Marks fears about what happens after death and also closes the conversation. Legal-Ethical Issues Marks children arrive in the Emergency Department and spend a few minutes with him before he goes to surgery. After a short period of time, the surgeon reports to the family that the aneurysm repair was unsuccessful and Mark died in surgery. One of Marks sons returns to the ER and starts yelling at the nurse. 25. What is the nurses best initial response? A) Call security to handle the situation. INCORRECT The nurse may need to call security to assist in the situation, but this does not help the son address his feelings and is not the best initial response. The presence of a security guard may aggravate the sons anger further. B) Explain that the nursing staff did everything possible. INCORRECT Justifying the nurses actions is not the priority concern in this situation. C) Acknowledge the sons anger. CORRECT Understanding that the sons anger is not directed personally at the nurse will help the nurse respond to the son in an effective, caring manner. D) Redirect the sons hostility. INCORRECT Redirecting the sons anger is not the best initial response to this situation. 26. In addition to talking with Marks children and preparing the body for transport to the morgue, what other action must the surgical nurse perform? A) Call the organ procurement agency for the region. CORRECT Federal law requires the nurse to notify the organ procurement agency for their region with all hospital deaths. B) Notify the hospitals sentinel event committee. INCORRECT Sentinel events are occurrences where a mistake made results in harm to a client. There is no indication at this time that a mistake was made by the healthcare team. C) Assist the family in deciding which funeral home to use. INCORRECT Deciding on a funeral home is the responsibility of the family and their support network. D) Bring the children into surgery to say goodbye to Mark. INCORRECT Bringing the family into the operating room to see Mark may be a task that the nurse does perform, but it is not mandatory. Marks wife has been taken to the intensive care unit (ICU). The next day, she becomes alert and responsive. The children tell the ICU nurse that they do not want their mother told of her husbands death. 27. How should the nurse respond? A) Honor their wishes, recognizing that the children know what is best for their mother. INCORRECT One of the ethical principles guiding nursing practice is veracity. The nurse caring for Mrs. Dunn needs to respond to her questions with honesty. B) Tell the children that legally the nurse must inform their mother. INCORRECT This is not a legal issue. C) Call pastoral care to consult with the family. INCORRECT Calling pastoral care to become involved may be an appropriate nursing action eventually, but another action takes precedence. D) Talk further with the children and explore options with them. CORRECT The nurse needs to do a further assessment and allow the children to communicate their concerns. The children are adamant that the nurse not tell their mother of their fathers death. Meanwhile, Marks wife continues to ask the nursing staff where her husband is. 28. What resource is most valuable for the nurse to use to resolve this situation? A) The hospital ethics committee. CORRECT The nurse needs to have others involved in this decision. Consulting the ethics committee is the appropriate channel to take to resolve this ethical dilemma. B) Policy and procedure manual. INCORRECT This situation cannot be resolved using a policy and procedure manual. C) The unit case manager. INCORRECT The case manager is not the best resource to resolve this conflict. D) Mental health services. INCORRECT Mental health services may need to be consulted at some point, but another resource is more useful to resolve the immediate situation. Case Outcome Marks children, accompanied by their pastor, tell Mrs. Dunn about Marks death. After signing a contract with the counselor stating she will not attempt to commit suicide, Mrs. Dunn is released from the hospital. A funeral service for Mark is held. Mrs. Dunn does continue with outpatient counseling sessions. References: BaHammam, Ahmed, et al. Prevalence and predictors of arrhythmia in patients with obstructive sleep apnea (OSA). European Respiratory Journal 38.Suppl 55 (2011): p1742. Cicardo, V. H., and J. C. Garcia. Neurogenic arterial hypertension by the cortical-spinal pathway. Archives internationales de physiologie et de biochimie 66.3 (1958): 309-317. Hanes, Donna S., Matthew R. Weir, and James R. Sowers. Gender considerations in hypertension pathophysiology and treatment. The American journal of medicine 101.3 (1996): 10S-21S. Xu, Shaoping, and Rhian M. Touyz. Reactive oxygen species and vascular remodelling in hypertension: still alive. Canadian Journal of Cardiology 22.11 (2006): 947-951.

Goal

Goal relationships and competition for resources affect healthy relationship, which exist among people. This makes the people have sour relationship among them, which makes a person fail to experience peace of heart and peace of mind. A person also pursues to have peace of heart and peace of mind by reference to divine intervention. Religion acts as a reference to many people as they strive to attain peace of heart and peace of mind. Religion acts as a source of aspiration to many people. Persons own religious beliefs are a source of inspiration. When a person is faced with conflict, he, or she may try to seek divine intervention to have peace. Religious believes have their own ways in which they inspire peace to the believers. The religious beliefs have some spiritual inspirations, which they put to people so that they can be healed of any problem they may be faced by at different circumstances. Spiritual nourishment acts as a source of peace to many people both in their minds and in the heart. This is because many religious teaching offers hope to a person that tomorrow is always a better day. Therefore, they give hope to many people who may have no hope. This makes a person to turn to religion when striving to attain this goal of peace of mind and peace of heart. However, there is always opposition when a person tries to attain peace of heart and peace of mind by use of religious intervention. There are many times when the religious intervention fails to provide this peace. This especially happens if a person needs instant peace or the person has so many conflicts. This is because for one to attain peace through religious interventions one needs to have strong faith. If one does not have this faith then, person may not attain peace by use of religious intervention. Therefore, as can be seen from the essay peace of mind and peace of heart is a basic need if a person has to attain full human development. Every person would enjoy life in one has this peace. However as we have seen there are opposition that come on the way, so it becomes important for a person to be able to face the opposition and strive more to attain this goal of having peace of mind and peace of heart in his or her life.

Think of one character from hamlet who makes either a good decision or Essay

Think of one character from hamlet who makes either a good decision or a bad decision. Identufy that decisiom, tell us how it a - Essay Example This essay considers Hamlet’s decision to delay killing Claudius, examines how it affects Hamlet, indicates why Hamlet made that decision, and indicates that Hamlet made the wrong decision. Hamlet’s decision to delay killing Claudius represents the worst decision of the play and the decision to which nearly all negative narrative elements emerge from. One of the primary reasons for the negative aspects of this decision is the problems it creates with Hamlet’s relationships. During the beginning scenes of the play the reader comes to grasps Hamlet’s growing anger at Claudius. Referring to Claudius who asks Hamlet a question, Hamlet responds, â€Å"A little more than kin, a little less than kind† (Act I, scene ii, 267). Here Hamlet is indicating the nature of his relationship with Claudius in a negative way; more than kin means Claudius is now more than merely his uncle, and less than kind means Hamlet is angered about this occurrence. While this stat ement doesn’t overtly indicate Hamlet’s psychic dysfunction, it does give an early indication of his growing negative demeanor that would come to affect not only him, but all the other characters in the play. As this act advances and Hamlet interacts with his mother, his general spite and hatred becomes evident. He states, â€Å"'Tis not alone my inky cloak, good mother,/ Nor customary suits of solemn black,/ Nor windy suspiration of forced breath,/ No, nor the fruitful river in the eye,/ Nor the dejected 'havior of the visage,/ Together with all forms, moods, shapes of grief,/ That can denote me truly† (Act I, scene ii, 280-285). At this point it’s clear that Hamlet has been significantly affected by his father’s death and is angered at Claudius for the action. In these regards, Hamlet’s indecision to kill Claudius and resolve the problem has both affected his relationship with his mother. Another of the central elements related to Hamletâ €™s decision to delay killing Claudius is the psychic confusion it creates within Hamlet’s own demeanor. While Hamlet’s decision not to kill Claudius at this point has affected his relationship with his mother, perhaps the more central concern of this decision is its effect it had on Hamlet himself. While earlier Hamlet had indicated his discontentment towards Claudius, he later goes to internalize his discontent. In Hamlet’s first soliloquy, the reader comes to realize the incredible psychic confusion and anger Hamlet is experiencing. Hamlet states, â€Å"Oh, that this too, too sullied flesh would melt,/ Thaw, and resolve itself into a dew,/ Or that the Everlasting had not fixed/ His canon 'gainst self-slaughter! O God, God!† (Act I, scene ii, 333-336). Here the reader discovers that Hamlet is experiencing suicidal thoughts as a result of the actions relating to Claudius. Indeed, this becomes a prominent theme throughout the play, with many of Hamlet ’s soliloquys indicating his intense passion and desire to commit suicide; this is perhaps most notably seen in ‘to be or no to be’ soliloquy. With this intensity of expression, it’s clear that Hamlet would be better off murdering Claudius and resolving his psychic confusion, rather than suffering the sling and arrows of outrageous fortune. In addition to Hamlet’s decision to delay killing Claudius affecting his demeanor and his relations with others, Shakespeare also indicates that the combining of these elements is also a treacherous element throughout the pla

The problems associated with the Blockbuster company Essay

The problems associated with the Blockbuster company - Essay Example The firm that is analyzed in the paper is Blockbuster. It was started in the year 1985 in Dallas as a single movie-renting store. With its aggressive growth strategy, the company managed to grow to nearly 7,265 stores in 24 nations around the world. Though the company remained as the world leader in movie rental during 1990s, problems emerged as new technologies developed in the area of entertainment distribution. New technologies that allowed online booking and online delivery of content developed as time passed, but the company management was adamant to give up its basic brick and mortar movie renting stores. As a result, while its competitors like Netflix effectively shifted to, and excelled in, methods like online booking, mail delivery and VOD, Blockbuster went on struggling with the already declining in-store movie renting systems and fell into debts. This resulted in a lot of issues in customer service that again made many existing customers leave the company. Firstly, the num ber of titles on offer declined dramatically, and secondly, popular items often went out-of-stock. Also, the delivery system was too slow as compared to that of its rivals. Thus, the company closed its year 2007 with a net loss of $ 85.1 million. This work looks into the various reasons behind the existing issues and tries to suggest ways for improvement in the future. A look into the performance of Blockbuster proves that once glamorous Blockbuster where everyone stopped to pick up a few movies has become a shadow of its past. There are a number of issues ranging from stiff competition, indifferent and doubtful management, lack of clear objectives, and finally, the continuously changing industry dynamics. Until the end of 1990s, Blockbuster was at the top of the rental business, and it never considered Netflix or any such other companies as consequential competitors. So the company paid little attention towards the emerging technologies and the changing customer preferences. Soon, the company found that its profits were going dramatically down. Thus, the stock price of the company fell from $29 to $2 per share. This was mainly the result of the emergence of other forms of entertainment delivery like rental by mail and video on demand. As these technologies emerged, a significant proportion of customers found them more convenient than in-store renting. It was at that juncture that the company made the most terrible mistake in its history. Instead of adapting itself to the emerging trend, the company decided to strengthen its in-store business. However, as the in-store business was destined to fail as technology allowed more convenient renting options, the effort proved futile. On the other hand, its rivals like Netflix who successfully adopted rental by mail and video on demand technologies found significant improvement in business and profit. As the company found itself in trouble, it started new strategies like kiosks, rental by mail and video on demand. How ever, each of the new strategies had its own defect too. For example, the rental by mail offered by Blockbuster was not as effective as that of Netflix. While Netflix managed to deliver the order in a single day, Blockbuster took one to three days. Also, while Netflix ensured successful delivery in more than 95% of the cases, many of the Blockbuster visitors found their favorite titles out-of-stock. Admittedly, the company has taken beneficial steps that will improve the position of the company in future. First of all, it has widened the product array in its brick and mortar stores by adding electronic appliances and video games. Secondly, it has started VOD though it has not been seriously explored. In fact, most of the problems faced by the company are associated with the lack of a specific objective. The management goes on changing its strategies in very short intervals, and hence, the customers get too puzzled to take a decision. Also, even the company representatives find it

Mexican American Journal Entry Essay Example for Free

Mexican American Journal Entry Essay It has been 11 years since we have arrived to Los Angeles, California. I can still remember the feeling of when my father had said to us that he we would be moving to a far place to try to find better jobs for my mother and him because with the two jobs my father had and the washing and ironing of other peoples clothes my mom did was not bringing enough money to support my sisters and me and did they wanted to provide a better life for my sisters and me. Mexico was such a poor country that my parents could not see themselves make enough money to support my sisters and me, let alone see us get a better education. So my parents decide to migrate to the United States with one of my mother’s brother. We arrived in Los Angeles, California on July 16, 1931, with my Aunt Julia and Uncle Fernando. My family and I were so happy to finally arrive to the U. S. to live the â€Å"American Dream. † Soon we would find out that our dreams would come crushing down fast. After settling down, my mother decided it was time to enroll my sisters and me into school. My mother asked my Aunt Julia and Uncle Fernando what my sisters and I need to enroll into school but since my aunt and uncle did not have any children, they were unable to tell my parents the information we would need. As my mother, my sisters and I walked into the school we could notice all the â€Å"gringos† looking at us in a weird way (looking at us like we did not belong there). My mother can right away tell that there was something wrong that we would not be accepted into that school. My mom was correct, as we entered the office the school secretary told my mother that we were not welcomed there and that if she wanted to enroll us into school it needed to be in a segregated Mexican school. Walking out of the school with confusion on her face, my mother saw an elderly Mexican American woman who spoke Spanish and asked her if she knew the reason we were not accepted into the school. The woman proceeded to explain to my mother that in the past few years many Mexicans were migrating to the U. S forced by the economic and political disorder produced by the Mexican Revolution and were tempted by jobs in U. S. agribusiness and industry that many Americans feared losing their jobs to underpaid illegal immigrants. Americans could not deal with losing the jobs they had especially during this time of the Great Depression. The elderly woman proceeded to explain to my mother that Mexicans were not welcomed to California or other parts of the country, that Mexicans were discriminated against and that we only had to go to schools that were for Mexicans only, that the only language we could speak in the schools regardless if they were for Mexicans only was English. She read my mother some signs that said, â€Å"NO MEXICANS ALLOWED. † She continued to tell my mother which neighborhoods we could not enter and which we could. If we saw signs like the ones she read for us, then we should be aware that we were not wanted there. After finding an all Mexican school for my sisters and me, my parents thought the hard part was over. I would here them talking in their bed room that as long as they did not bother the â€Å"gringos† or got in there way we would not have anything to worry about but they were wrong. Shortly after being able to find jobs for themselves, I began to see my parents worried and listening to their radios all the time. They had just found out that Mexicans were being deported back to Mexico regardless of their legal status. The news stated that tens of thousands of Mexican families were arrested and sent to jail for 10 days before they were sent to Mexico by train, because of an anti-immigrant campaign that the Americans had done. Those families were not given a chance to proof if any family members were U. S citizens. Families were not given the chance to take anything with them. The news also began announcing free trains rides back to Mexico for Mexican American and Mexicans who wished to voluntarily be taken back to Mexico. I can remember seeing my mother cry because she said she did not want to return to Mexico and live in the horrible conditions we were living in before. She begged my father to do something so we did not have to return to Mexico. One day my father came home telling my mother that he had heard of migrant work camps established by the U. S. Farm Security Administration, or FSA and that they had a possibility of getting jobs there to stay in the U. S. The camps provided housing, food, and medicine for immigrant families as well as safety from any criminal elements that can take advantage of defenseless immigrants. We had the possibility of staying we were extremely happy!! Little by little more Mexicans have extended their stay as well as the places were we live at. The most popular places where Mexicans live at now are Chicago, California, and New York. We stayed in the U. S. , my sisters and I are receiving a great education and compared to Mexico, I think we are now living the American Dream!!!! Reference: Depression and the Struggle for Survival. (2005, April 20). Immigration. Retrieved August 10, 2008, from The Library of Congress. Koch, W. (2006, April 4). 1930s Deportees Await Apology. USA TODAY. Retrieved from http:www. usatoday. com.