Going to College Essay Example for Free

Going to College Essay Going to college really does open a new chapter in everyone life, the beginning of new friendships, opportunities and growth. As a college student, a new student will be introduced to new areas of interest, broaden his vision of possibilities, establish and accomplish goals, develop lifelong friendships and define him or her in ways that he can imagine. Anyone on Earth already asked, or will ask himself where he would be in 10, 20 or even 30 years down the road. It is hard enough imagining what his life is going to be like in a year or two. Questions like â€Å"Where do you want to be today, tomorrow and in the future? † might be hard ones for young teenagers, who just graduated from high school. Attending college will help anyone answer those questions, develop a realistic plan for accomplishing his goals, and equip him with the knowledge and skills he will needs to see his goals through to the end. We usually assume that a college degree is necessary when it is not actually. We can also noticed that, because we place so much emphasis on degrees, people who have not attended college think of themselves badly, and this lack of self-confidence can really impede their success. There are some people for whom the college is actually not the best way to learn. However, a college education is an opportunity for everyone to learn what he loves. A new student can actually take the time to enjoy learning what he is truly passionate about. If he is interested in a variety of things and he is not sure where to focus, he can take his time to try them all. Nobody should look at college as a long-term contract that he is not going to be able to get out of once he starts. Anyone should feel like he needs to decide on a major area of study before starting college. College is a time for everyone to test himself, explore his interests, see what the possibilities are, and to see what he can achieve. Most other students attending college are going to be in the exact same boat. There are also a variety of resources, provided by most universities, to help anyone through college, including academic advisors, professors accessible on campus, tutoring academic support, full-time counseling staff and more. While the prospect of attending college may seem a bit daunting and even suffocating, a graduated high school teenager should not forget that he will still get to live his life. He will be able to participate in a variety of extracurricular activities, social groups, maintain a job, or even pursue a career while completing his studies. He may even find that college ends up being much more enjoyable and fulfilling than he ever expected. There are additional reasons as to why it is important to go to college. When students experience a post-secondary education, they have the opportunity to read books and listen to the lectures of top experts in their fields. This stimulation encourages students to think, ask questions, and explore new ideas. So, â€Å"why should you go to college? † The reasoning does not begin and end with the job aspect. A good education is beneficial from many different viewpoints. If any teenager is still asking himself why he should go to college, it is important to remember the significant amount of opportunity available for college graduates. The global economy is becoming increasingly more competitive, and in order to give him the best chance for a well-paying job, he must first understand the importance of college education. Attending college provides students with the knowledge and experience they are unable to receive from a secondary education, and finding a way to fund a higher education now can pay off in a huge way in the years to come.

Benefits of Cross Border Mergers and Acquisitions

Benefits of Cross Border Mergers and Acquisitions In the process of businesses creating or building shareholder value, they the management are motivated to undertake cross border mergers and acquisitions in other to expand their operations which will then generate greater profits or potential for owners (shareholder) value creation than that of internal growth. Cross-border mergers and acquisitions (MA) internationally have played a key part in this issue of globalisation or global activity of growth and expansion. When firms and companies otherwise known as enterprises continually increase in size, they tend to look for more funding or capital from outside their territory (locality) or country of operation which may not be readily available in their home country of operation to further advance their growth and expansion drive. And this particularly involves transnational firms such as HSBC, British Petroleum (BP), Vodafone and Shell for example taking over companies or businesses in other countries by parting away with huge sums of money. According to Krekel et al.(1969) mergers usually involve businesses or corporations of same or equal size, whilst the acquiring firm in the case of acquisitions tends to be bigger or larger. According to recent trends in cross border mergers and acquisitions (MA), most of these Multinational Enterprises (MNEs) move to emerging markets in order to take charge or buy controlling interest in those markets. The creation of the European Union (EU) internal market on 31 December 1992 (which seeks to remove trade barriers among member nations) brought about influx of US, Japanese and EU companies holding market positions in EU. And thus the late nineties witnessed more MA involving both local and International partners, with mega mergers between multinationals like DaimlerChrysler and Exxon-Mobil, which transformed global market competition. During this period many businesses in emerging markets were privatised thus creating growth opportunities for MNEs to gain access to previously closed markets of enormous potential. The United Nations Conference on Trade and Development (UNCTAD, 1998) unfold the driving forces behind cross border MA as per current globalisation. Practitioners of cross border MA deals encourage deregulation or diversification and liberation of the local and state owned businesses or enterprises, thus affording foreign enterprises or businesses in advanced economies to invest directly, joint venture ship or partnership or even outright take over (UNCTAD, 1999) This paper will try to address the significant benefits and also some pitfalls of cross border, mergers and acquisitions as pertaining to global market growth and expansion of Multinational Enterprises (MNEs) or businesses. UNCTAD, 1999 reports that the transition host nation in a greenfield investment or mergers and acquisition stands to benefit in resources or technology. For instance the flow of foreign direct investment to a transition host nation will boost its foreign reserves (Gross domestic product). A clear example is the take over of Cadbury UK plc by Kraft Company which undervalued these shares (Cadbury) but yet invested in excess of Nineteen billion pounds (Â £19) into the UK economy in the midst of the global economic crunch. According to Razin et al (1998), low level of taxes or incentives in some European Union (EU) countries, prompted Investors within UK, to move their production wing of their firms from the UK to E U countries in order for these firms to enjoy stron ger market positions. Investors usually consider tax issues before deciding on where to invest or move their investments to. Many a times, investors favour or decide on nations where the tax laws and policies are relaxed thus favouring their cause in terms of releasing their investment back with maximum gain. Hitt et al (2001 a,b) described acquisition as the process by which controlling stake in a business enterprise or venture is purchased by another larger firm via an open market or on an exchange. Acquisition which is otherwise known as Takeover occurs when majority shares or stake in an organisation is purchased by another bigger firm. By this, the bigger firm take control or charge of the assets as well as the liabilities of this target business which now becomes its subsidiary. Hitt et al (2000) further saw merger as the situation where two or more smaller corporations decide to pull their resources together in order to become a giant leader in their industry or market. When this happens, a new corporate identity will adopted thus both companies will drop their old or individual identities and put on the new one after an agreement has been reached amongst the parties involved. A clear example will be the ongoing merger agreement being entered into by British Airways and Iberial Air lines which aftermath will birth a new corporate identity and image as agreed upon by the parties involved. Another example is that of GlaxoSmithKline which involved synergy between two pharmaceutical firms namely Glaxowellcome and Smithkline Becham that merged to form the second largest pharmaceutical company in Europe. It is worthy to note that synergy will provide more gain since the two companies stands to produce more when they are together through sharing of ideas and technical know how than being on their own as individual. Thus the equation of one plus one equalling three came to being (synergy theory) through merger and acquisition as beneficial to the two firms that came together as one entity or under one umbrella. Again these large companies or businesses with global repute or stature enjoy tremendous benefits in the area reduction in prices, increasing control of market and economies of scale. According to Fatemi et al (1988), even though introducing cross border MA in a near perfect market situation, the owners of the business may not enjoy dividends as per from local operation and this varied valuations for local and international mergers will seek to uncover the imperfect capital market dealings. Pringle (1991) stressed that market accessibility is the main rationale for foreign direct investment. To add to this Harris et al (1991) further elude to the fact that giant or larger companies or firms join with other firms in other nations simply to access their foreign market share. In other words it aids in its saturation into new areas or segments of other markets with no restrictions whatsoever and in addition access credit facilities whilst enjoying tax rebates reserved for local businesses. HOW CROSS BORDER MERGERS AND ACQUISITIONS ARE DETERMINED Investors are always drawn to or interested in investing in high flying corporations who are consistent and increasingly growing and engaging in expansion drive of their various businesses or business units. Growth and expansion performance of businesses may be as a result of good corporate governance practices and policies adopted by or from the side of Management of that firm in line with that of the growing target market. In the words of Cheng et al (1989) and that of Moore (1996), overseas business owners or investors enjoyed high returns on their investments after being encouraged to put or invest their wealth in financial institutions (bank), outside the United States for the simple reason of their good financial health thus, favourable growth rates and high turnover in assets and expansion drive. Among other factors that positively influence cross border dealings in emerging economies like that of Africa, Eastern Europe and South America is profitability and efficiency that st ands out as the number one reason. Financiers and investors from both the United States of America and United Kingdom channel their wealth to some financial institutions (banks) and other businesses in these regions via direct investments or mergers. Hannan et al (2007), Vander (2007) and Pasiouras et al (2007) all consented that investors from the United States will shy away from investing their wealth in those financial institutions that constantly make a deficit after they (investors) have critically scrutinised and reviewed the said financial data, profitability and investor ratios before choosing the right venture to invest in, in order to maximise their wealth. In the words of Hannan et al (2007) a lot of mergers and cross border acquisition happen due to the challenges businesses go through in sourcing for more funds or capital to expand their businesses. Hannan et al (2007) again said many of the larger financial institution (banks) and companies exploit the option of target ing emerging markets in terms of investing their resources when considering expanding their corporations. The results from this movement by the larger companies will better advance the economies of these target countries where the small firms are located for which takeover occurred since the cost involved in business transaction will be drastically reduced due to the size and capital base of these larger firms. Among other things, cross border mergers and acquisition can occur where there is concentration of similar businesses such as banks in a catchment area or region. Businesses like banks and stores according to Hannan et al (2007) would always want to take their services and operations to the door steps of the clients, thus concentrating on high streets and other prime locations to better meet their clients need as can be attested in the United Kingdom (UK). Another point worth considering in this determinant of cross border acquisition and merger is Taxation. As with most countries, local companies enjoy tax reliefs or exemptions for awhile whilst foreign companies are made to pay income tax on their local business enterprise as well as foreign income tax. In the words of Scholes et al. (1990), Servaes et al. (1994) and Desai et al. (2002), investors within advanced economies or markets who pay higher taxes tend to invest overseas where they avoid tax and enjoy exemption from foreign or overseas income. For this reason several indices were created by La porta et al. (1998), useful for eper this larger created affiliation. In these indices there is also rule of law and efficient judiciary process thus ensuring that the rights of individuals are respected by all and sundry. In the same vein, Johnson et al. (2000) agreed with the above statement with emphasis on minority shareholders whilst the rights of creditors should be enforced when f irms default in their payments after notices are served. And last but not the least, there must be fair treatment within the confines of the laws or regulations with respect to company directors (Executive and non executive directors). LIMITATIONS It is important to note that cross-border acquisitions and mergers are not, however, without pitfalls. Irrespective of acquisition being domestic or cross-border, investors experience problem of over paying thus suffering excessive financing costs (Eiteman et al., 2004 pg. 590). Merging corporate cultures between a local firm and an overseas one becomes a problem since regulations for example like governance practices might differ from country to country. Managing the aftermath of cross-border merger and acquisition process is normally characterised by retrenchment to achieve economies of scale and scope in overhead duties or functions. The outcome of this is unproductiveness among employees of the target company who fear of losing their jobs or been laid off. For example the take over of Ghana Telecom by Vodafone in January 2009 saw more than thousand workers being laid off. And their new Chief Executive Kyle Whitehill indicates that further restructuring is necessary to ensure that the company is able to deliver prudent returns Source: Joy Business/Myjoyonline.com/Ghana (July 29, 2010). Even for some top executives, for fear losing their jobs become uncooperative when it comes to merger and takeover talks. United Kingdoms example is the aftermath of takeover of Cadbury UK by Kraft plc from United States which saw the downsizing of over four hundred of its employees after the production plant or unit in UK was relocated in Poland to reduce labour and operative costs. In the words of Hadlock et al (1999), company bosses or executives, for fear of losing their jobs after the takeover will conceal some vital information or be reluctant to provide important data that will aid the investors to properly come to a decision as to whether to invest or not in a target business. Globally, additional problems occur from the part of host countries where their government intervene in price discrimination, financing, employment guarantees, segmentation and general nationalism and favouritism which includes capital flight and corrupt practises by foreign investors with the help of personnel in state departments from target nation (see Eiteman et al., 2004 pg. 590). An example is the Quality Grain Scandal in Ghana where some ministers connived with foreign investors to cause financial loss to the state is seen as the most corrupt deal in the country (Source: newsinghana.com). Also the preparation of final accounts might differ from country to country thus it is advised that there must be consistency in its preparation among subsidiaries of that holding company for easy comprehension. For some countries among emerging economies, the host government creates its own standards which differs from that of developed economies for example United States where private sectors and the Government set up GAAP with other principals and standards. Radebaugh et al (1997), Choi et al (1991) and Land et al (2000) all confirmed the differences in the way financial statements are prepared in US, UK and other European countries with makes it difficult for entrepreneurs to understand and compare with similar statements (profit and loss) within sector. According to Ali et al (2000) and Ball et al (2000), Germany lacks in the preparation of returns such that investors or entrepreneurs request for more insight to facts from host nations outside that of the financial report. Anoth er area worth considering is disclosure policy pertaining to corporate governance. Unlike the US and UK where disclosure in corporate governance is held in high esteem, that of emerging countries is very low. For instance some public companies and their private counterparts in these emerging refuse to practise international accounting standards been accepted globally and for that reason are reluctant to fully disclose information freely to prospective investors or other third parties (see UNCTAD 2000). In fact, the ability to successfully complete cross-border acquisition may itself be a test of competency of the MNE in the twenty first century (see Eiteman et al. (2004) pg. 590). SIGNIFICANT ADVANTAGES OF CROSS-BORDER MERGER AND ACQUISITION CONCLUSION Finally, managers tend to take uneconomical plans of takeovers. Sometimes, the motives for takeover decisions by managers may be attributed to availability of free cash flow or for no just cause. The number and dollar value of cross border mergers and acquisitions has grown rapidly in recent years but the growth and magnitude of activity is taking place in the developed countries, not the developing countries. As opposed to the fighting and scraping for market share and profits in traditional domestic markets, a MNE can expect greater growth potential in the global marketplace. There are a variety of paths by which the MNE can enter foreign markets, including Greenfield investment and acquisition. The drivers of MA activity are both macro (the global competitive environment) and micro in scope (the variety of industry and firm-level forces and actions driving individual firm value). The primary forces of change in the global competitive environment technological change, regulatory change, and capital market change create new business opportunities for MNEs, which they pursue aggressively.

Patients With Neurologic Dysfunction Health And Social Care Essay

Patients With Neurologic Dysfunction Health And Social Care Essay Keshin Himura is a 42-year-old patient diagnosed with pituitary prolactinoma, a benign tumor that arises from the pituitary gland, resulting in a decrease in libido and impotence and increased milk production of the breast. The patient also has complaints of headache and drowsiness and the presence of visual field changes and papilledema preoperatively. What postoperative care should the nurse provide the patient? The nurse should provide the following postoperative care to the patient: Evaluate gag reflex and ability to swallow Offer semisoft diet Perform neurologic checks Monitor vital signs Maintain neurologic flow chart Reorient patient when necessary to person, time and place If with seizures, carefully monitor and and protect from injury Check motor function at intervals Assess for sensory disturbances Evaluate speech The patients family asks the nurse how will they know that the problems the patient had before surgery have stopped; what is the nurses best response? Through observation, conducting series of test that will be provided by the physician (e.g. MRI, CT scans) to check if the tumors are already diminished, because presence of tumor will still inhibit the signs and symptoms of the disorder. The primary objective of the surgical intervention is to remove or destroy the entire tumor without increasing the neurologic deficit and to relieve symptoms by decompression. And if there is no evidence of tumor, the normal levels of hormone would return in usual, the patient will no longer experience the symptoms of the disease. What management strategies should the nurse anticipate will be ordered to care for diabetes insipidus if it occurs? The objective of the therapy is: To replace ADH To ensure adequate fluid replacement To correct the underlying intracranial problem (pituitary prolactinoma) A fluid deprivation test is ordered by the physician to confirm for the diagnosis of diabetes insipidus by: withholding fluids by 8 to 12 hours Patient is weighed frequently during the test Plasma and urine osmolality studies are performed at the beginning and end of the test. The inability to increase the specific gravity and osmolality of the urine is an indication of Diabetes insipidus Pharmacologic Therapy Administer Desmopressin (DDAVP) intranasally, BID as ordered Nursing Management Establish baseline data ( weight, BP, I/O patter), Monitor BP and weight frequently throughout therapy and report sudden changes to physician Monitor I/O and specific gravity and serum osmolality as ordered If patient has Coronary artery disease, use this drug with caution as this drug causes vasoconstriction Avoid concentrated fluids as this increase urine volume What discharge instructions should the nurse provide the patient and family? Most patients will spend at least one night in the intensive care unit (ICU) and then typically 2 or 3 additional nights on a regular (non-ICU) ward after surgery The patient will likely have some incisional pain and mild to moderate headache for which he will be given pain medication. A CT scan or MRI will be ordered before discharge Ask patient to return 2-3weeks after surgery Inform patient to return 2-3months after 1st check-up Inform family to watch out for signs of DI (intense thirst, frequent urination). Refer immediately Management of Patients with Neurologic Dysfunction  Ã‚   Case Study 2 Hiehachi Nishima, a 22-year-old patient who weighs 150 pounds, presents to the emergency department (ED) after being thrown from his horse and passing out for a few minutes; he regained consciousness. The friend who was also riding a horse called the squad. The patient presented with a GCS of 15, and the neuro exam was within normal limits (WNL). The ED physician wrote the orders for a CT scan without contrast of the head, CBC, renal and metabolic profile, PT, PTT, and INR. The nurse sent the labs and had the IV of NS at keep-open rate per ED protocol hanging. The nurse was awaiting radiology to call for the patient to go for the CT when the patient had an epileptic cry, became unconscious, stiffened his entire body, and then had violent muscle contractions. The respirations are very shallow, and the lips and nail bed became blue. The patient lost control of bladder and bowel. The patient bit his tongue and blood is coming from the mouth. The radiology department calls and is ready f or the patient. List in the correct order the actions that should be taken by the nurse. Before and during a seizure, the patient is assessed and the following items are documented: The circumstances before the seizure The occurrence of aura The first thing the patient does in the seizure where movements or stiffness begins, conjugate gaze position, position of head The type of movements in the part of the body involved The areas of the body involved The size of the pupils and whether the eyes are open Whether the eyes or the head are turned to one side The presence or absence of automatisms Incontinence of urine or stool Unconsciousness and its duration Any obvious paralysis or weakness of arms or legs after the seizure Inability to speak after the seizure Movements at the end of the seizure Whether or not the patient sleeps or not afterwards Cognitive status after the seizure In addition to providing data about the seizure, nursing care is directed at preventing injury and supporting the patient not only physically but also psychologically. Consequences such as anxiety, embarrassment, fatigue, and depression can be devastating to the patient. After the patient has a seizure, the nurses role is to document the events leading to and occurring during and after the seizure to prevent complications. Explain what type of seizure the patient is having, and describe the three phases of the patients seizure and the specific nursing care for each stage. The patient had a tonic-clonic (gran mal) seizure. There are three phases namely the aura, the tonic and the clonic phase. In the aura phase is the forewarning of an epileptic attack. It characterized by episodes of Dà ©jà   vu or Jamais vu. The client may also have auditory, olfactory, or even visual hallucinations, abnormal tastes, and tingling sensations. Physical symptoms include dizziness, headache, lightheadedness, nausea, numbness. Though in this case, the client did not show signs of the aura phase. *Nsg Mgt: Provide privacy and protect the patient from curious onlookers Patients who have an aura may have time to seek a safe, private place Ease the patient to the floor, if possible Loosen constrictive clothing Push aside any furniture that may injure the patient during a seizure If an aura precedes the seizure, insert an oral airway to reduce the possibility of the patients biting the tongue The next is the tonic phase. It is usually the shortest part of the seizure, lasting not more than only a few seconds. In this case, it is when the patient had an epileptic cry, became unconscious and stiffened his entire body. *Nsg Mgt: Protect the head with a pad to prevent injury from striking a hard surface If the patient is in bed, remove pillows and raise side rails The last is the clonic phase. It is when the client had violent muscle contractions, very shallow respirations, the lips and nail beds became blue, lost control of bladder and bowel and bit his tongue. *Nsg Mgt: Do not attempt to pry open jaws that are clenched in a spasm or to insert anything. Broken teeth and injury to the lips and tongue may result from such an action. No attempt should be made to restrain the patient during the seizure because muscular contractions are strong and restraint can cause injury If possible, place the patient on one side with head flexed forward, which allows the tongue to fall forward and facilitates drainage of saliva and mucus. If suction is available, use if necessary to clear secretions. The ED physician orders the following: Valium (diazepam) 10 mg every 10 to 15 minutes prn for seizures (maximum dose of 30 mg). Once seizures stop, administer Dilantin (phenytoin) 10 mg/kg IVPB. ECG monitoring continuously, VS, GCS, neuro checks every 30 minutes. Explain what meds the nurse should provide, in what order, and how they should be administered. The nurse should provide Valium injection (diazepam) 10 mg IM PRN every 10 to 15 mins. (max 30mg) for his seizure to relief the muscle spasm. For the long term relief, administer Dilantin (phenytoin) 10 mg/kg IVPB loading dose STAT, once the seizures stop. Dilantin (phenytoin) is an anti-seizure medication (anticonvulsant), especially to prevent tonic-clonic (grand mal) seizures and complex partial seizures (psychomotor seizures).We use piggyback to administer different IV drugs at different times. Dilantin can cause irritability to the veins and can cause serious tissue and/or nerve damage if it infiltrates. So we should administer it with normal saline. Draw up the drugs in a syringe and attach it to the piggyback port on the IV tubing cassette, which is run concurrently with the primary IV fluid (normal saline). Run it slowly and keep an eye on the ECG monitor. This ECG monitoring should be done continuously to help identify irregular heartbeats. For the vital signs, Glasgow coma scale and neuro V/S, it should be check every 30 minutes to provide reliable, objective way of recording the conscious state of a person for initial as well as subsequent assessment. Group Assignments Have each member address nursing management related to caring for an unconscious patient. Preventing Urinary Retention Palpate bladder at intervals to determine whether urinary retention is present If patient is not voiding, an indwelling catheter is inserted and connected to a closed drainage system as ordered Observe for fever and cloudy urine for infection Observe the area around the urethral orifice for any drainage As soon as consciousness is regained, a bladder-training program initiated Promote Bowel Function Assess abdomen for distention by listening for bowel sounds (irregular gurgling sounds should be heard every 5-20sec) Measuring the girth of the abdomen with a tape measure. Monitor for the number and consistency of bowel movements Perform rectal examination for signs of fecal impaction as ordered. Stool softeners may be prescribed and can be administered with tube feedings Glycerin suppository may be indicated to facilitate bowel emptying May require enema every other day to empty lower colon Maintain Skin and Joint Integrity Monitor pressure areas for possible ulcerations Establish a regular schedule of turning to avoid pressure, which can cause breakdown and necrosis of the skin This provides kinesthetic, proprioceptive and vestibular stimulation Avoid dragging and pulling the patient up in the bed, because this creates a shearing force and friction on the skin surface Maintain correct body position Passive exercise of the extremities is important to prevent contractures Splints or foam boots may be used to prevent foot drop and pressure of bedding on the toes Trochanter rolls may be used to support the hip joints and keep the legs in proper alignment Providing Mouth Care Inspect mouth for dryness, inflammation, and crusting Cleanse and rinse mouth carefully to remove secretions and crusts and to keep the mucous membranes moist Administer petrolatum on the lips to prevent drying, cracking and encrustations. If patient has an endotracheal tube, the tube should be moved to the opposite side of the mouth and lips Perform routine tooth brushing every 8hrs to decrease ventilator-associated pneumonia Maintaining the Airway Elevate the head of bed to 30 degrees to prevent aspiration. Place the client in lateral position to allow the jaw and tongue to fall forward to promote drainage of secretions. Suction for secretions as needed Maintain oral hygiene Chest physiotherapy and postural drainage to promote pulmonary hygiene Auscultate the patients chest every 8 hours to assess for any deviated breath sounds. If the patient has a mechanical ventilator, maintain the patency of the endotracheal tube or tracheostomy, provide oral care, monitor arterial blood gas measurements and maintaining ventilator settings. Protecting the Patient Raise side rails up as always to prevent injury Ensure the patients dignity during altered LOC, speaking to the client during nursing care activities. Maintaining Fluid Balance and Managing Nutritional Needs Assess skin turgor and mucous membrane for dryness Monitor for intake and output and determine the needs for catheterization Preserving Corneal Integrity Patients eyes may be cleansed with cotton balls moistened with sterile normal saline to remove any discharge. For artificial tears (prescription by the physician), may introduce every 2 hours. Maintaining Body Temperature The environment can be adjusted (depending on the patients condition) to promote normal body temperature. If body temperature is elevated, a minimum amount of bedding is used. For geriatric patients and doesnt have any elevated temperature, a warmer environment is needed. Providing Sensory Stimulation Communicate with patient, and encourage the family members to do it so. Orient the patient to time, date, and place once for every 8 hours. Have each group member develop a nursing diagnosis related to a patient with an altered level of consciousness. Identify potential problems and complications related to the nursing diagnosis. Nursing Diagnosis Potential Problems and Complications 1. Ineffective airway clearance related to altered level of consciousness Aspiration 2. Risk for impaired skin integrity related to prolonged immobility Bed sore Pressure ulceration 3. Impaired Urinary elimination: retention related to impairment in neurologic sensing and control Bladder distention Infection Formation of stones 4. Impaired tissue integrity of cornea related to diminished or absent corneal reflex Periorbital edema Ulcerations Corneal abrasions 5. Deficient fluid volume related to inability to take fluids by mouth Dehydration Cerebral edema 6. Interrupted family processes related to changes in the cognitive and physical status of their loved one Crisis Severe anxiety, denial, anger, remorse, grief, and reconciliation 7. Risk for injury related to decreased LOC Falls 8. Ineffective thermoregulation related to damage to hypothalamic center Hyperthermia 9. Impaired oral mucous membrane related to mouth breathing , absence of pharyngeal reflex and altered fluid intake Dryness Inflammation Crusting 10. Bowel incontinence related to impairment neurologic sensing and control Abdominal distention Diarrhea Frequent loose stools As a group, identify potential complications that may arise in the postoperative phase of cranial surgery. Increased ICP Monro-Kellie hypothesis states that, because of the limited space for expansion within the skull, an increase in any one of the components causes a change in the volume of the others.because brain tissue has limited space to expand, compensation typically is accomplished by displacing or shifting CSF, increasing the absorption or diminishing the production of CSF, or decreasing cerebral volume resulting to an increase ICP. Bleeding and hypovolemic shock An accumulation of blood under the bone flap (extradural, subdural, or intracerebral hematoma) may pose a threat to life. A clot must be suspected in any patient who does not awaken as expected or whose conditions deteriorates. Fluid and electrolyte disturbances IV solutions and blood component therapy for patients with intracranial conditions must be administered slowly. If they are administered too rapidly, they can increase ICP. The quantity of fluids administered may be restricted to minimize the possibility of cerebral edema. Infection The risk of infection is great when ICP is monitored with an intraventricular catheter and increases with the duration of the monitoring. Seizures Underlying cause is an electrical disturbance in the nerve cells in one section of the brain. An abnormal motor, sensory, autonomic, or physical activity that result from sudden excessive discharge from cerebral neurons. Have each group member identify a type of seizure. Describe clinical manifestations, diagnosis, and treatment of each. Generalized Seizures: This are seizures that mainly involves electrical charges in the whole brain, its clinical manifestations includes loss of consciousness for a short or long period of time. Types of Seizure Clinical Manifestation Grand Mal or Generalized tonic-clonic Unconsciousness Convulsions Muscle rigidity Absence Short loss of unconsciousness Myoclonic Irregular jerky movements Clonic Repetitive jerky movements Tonic Muscle stiffness and rigidity Atonic Loss of muscle tone Diagnosis: Physical examination particularly neurologic examination EEG For temporary and reversible causes of seizures: Blood chemistry Blood sugar Complete Blood Count Cerebrospinal fluid analysis Kidney function test Liver function tests Test to determine the cause and location: EEG (electroencephalograph) to measure the electrical activity in the brain Head CT or MRI scan Lumbar puncture-spinal tap Treatment: When a seizure occurs, protect the person from injury, make the environment safe for you and the patient. Protect the patients head Loosen tight clothing Place the patient into a side-lying position if vomiting occurs Stay with patient until she or he is fully recovered Monitor the patients vital signs Medications such as anticonvulsants may be given as ordered to reduce the number of future seizures. The DONTs During Seizures: Dont restrain the patient Dont place anything between the patients teeth during a seizure Dont move the patient unless he or she is in danger or near something hazardous Dont try to stop the patient from convulsing. Partial Seizures: This are seizures that mainly involves electrical charges in one part of the brain, its clinical manifestations includes abnormal muscle movements, automatisms, abnormal sensations, hallucinations, nausea, sweating, dilated pupils, rapid heart rate and pulse rate, changes in vision. Types of Seizure Clinical Manifestation Simple (consciousness is intact) Jerky movements Muscle rigidity, spasm Unusual sensation Memory and emotional disturbance Complex (consciousness is impaired) Automatisms: lip smacking, chewing, walking and repetitive involuntary and coordinated movements Diagnosis: CT scan MRI EEG EEG-video recordings Treatment: Vagus Nerve Stimulation in which a small battery is implanted in the chest wall which will program to deliver short bursts of energy to the brain. Corpus Callosotomy is a type of surgical intervention that will cut the connections between the two sides of the brain that will prevent drop attacks.. Multiple sub-pial transection which is a surgical technique that will cut a certain connection between nerve cells.

jimhf Jim as Hero in The Adventures of Huck Finn :: Adventures Huckleberry Huck Finn Essays

Jim as Hero in The Adventures of Huck Finn A hero is defined as a person noted for feats of courage or nobility of purpose. The character of Jim in Huckleberry Finn by Mark Twain certainly fits that description. He risked his life in order to free himself from slavery, and in doing so, helps Huck to realize that he has worth. Huck becomes aware of Jim's sense of love and humanity, his basic goodness, and his desire to help others. There are many illustrations of this phenomenon in Huckleberry Finn. The reader first becomes aware of Jim's sense of love and humanity when Jim discovers Pap's corpse on the houseboat: ...But it didn't budge. So I hollered again, and then Jim says: "De man ain't asleep -- he's dead. You hold still-- I'll go en see. "He went, and bent down and looked, and says: "It's a dead man. Yes, indeedy; naked, too. He's ben shot in de back. I reck'n he's ben dead two er three days. Come in, Huck, but doan' look at his face -- it's too gashly." This is an example of how Jim is a humane and loving person because he does not allow Huck to see his dead father's face once he sees and understands the position in wehich he is placed. Later, Huck wishes to speak to Jim about the dead man, but Jim will not allow it since he does not want to reveal the truth about Pap to Huck. This is a second and more direct approach that is used in the story in order to show this same point. Jim is also basically a good person. Although he is ignorant, he knows that it is a good thing for him to show Huck that he has worth so that Huck can think of him as an equal. This is a tough idea for Huck to realize because at this point in time he still thinks of Jim in terms of being a slave, and not on equal footing with him. This is shown by Jim's statement of his own self worth. "Yes; en I's rich now, come to look at it. I owns mysef, en I's wuth eight hund'd dollars. I wisht I had de money, I wouldn' want no mo'. jimhf Jim as Hero in The Adventures of Huck Finn :: Adventures Huckleberry Huck Finn Essays Jim as Hero in The Adventures of Huck Finn A hero is defined as a person noted for feats of courage or nobility of purpose. The character of Jim in Huckleberry Finn by Mark Twain certainly fits that description. He risked his life in order to free himself from slavery, and in doing so, helps Huck to realize that he has worth. Huck becomes aware of Jim's sense of love and humanity, his basic goodness, and his desire to help others. There are many illustrations of this phenomenon in Huckleberry Finn. The reader first becomes aware of Jim's sense of love and humanity when Jim discovers Pap's corpse on the houseboat: ...But it didn't budge. So I hollered again, and then Jim says: "De man ain't asleep -- he's dead. You hold still-- I'll go en see. "He went, and bent down and looked, and says: "It's a dead man. Yes, indeedy; naked, too. He's ben shot in de back. I reck'n he's ben dead two er three days. Come in, Huck, but doan' look at his face -- it's too gashly." This is an example of how Jim is a humane and loving person because he does not allow Huck to see his dead father's face once he sees and understands the position in wehich he is placed. Later, Huck wishes to speak to Jim about the dead man, but Jim will not allow it since he does not want to reveal the truth about Pap to Huck. This is a second and more direct approach that is used in the story in order to show this same point. Jim is also basically a good person. Although he is ignorant, he knows that it is a good thing for him to show Huck that he has worth so that Huck can think of him as an equal. This is a tough idea for Huck to realize because at this point in time he still thinks of Jim in terms of being a slave, and not on equal footing with him. This is shown by Jim's statement of his own self worth. "Yes; en I's rich now, come to look at it. I owns mysef, en I's wuth eight hund'd dollars. I wisht I had de money, I wouldn' want no mo'.

Cultural theory and the meanings of money :: Business and Management Studies

Cultural theory and the meanings of money Couples and their money: theory and practice in personal finances Four perspectives draw on: * Economics and rational choice theory * Social structural approaches * Psychological approaches * Cultural theory and the meanings of money. According to classical economic theory money has four main functions: †¢it is a medium of exchange, †¢a store of value, †¢a unit of account, †¢a standard of deferred payment. Perspectives within economic theory relevant to personal finances: †¢fungibility This notion is standard in classical economic theory and means that money is considered to be neutral and interchangeable, so that any unit of wealth is substitutable for any other (McCloskey, 1987). †¢rational choice theory This assumes that people make reasoned choices in order to maximise their overall welfare or utility. Rational choice theory lays stress on the importance of information in facilitating the efficient working of markets and of consumer choice. Daniel: I have a high interest account with First Direct as well. And then I have another savings account which is slightly lower interest. The high interest savings account has a penalty on withdrawals, so I keep a sum of money in there stable which I don’t draw on. If I have extra spending, or I need to top up my current account in case I’m going overdrawn, that comes from the third, lower interest account which I keep for small amounts. When I have a surplus at the end of the month in my current account I transfer across to the high interest account as much as I can. Daniel’s economic rationality extended to credit cards and Air Miles. He explained about his American Express Gold Card: I use that for my purchases because I get Air Miles on that, so all my purchases I get Air Miles and I transfer that to my various Air Miles accounts. I originally got a Gold Card because they did a special offer, had one free for a year, and so I gave up after a year. Said ‘No thank you. I don’t want to pay for a card’. Oh well, another card arrives free for a year, so I said, ‘Fine’. Pahl, J. (2001) ‘Couples and their money: theory and practice in personal finances’, in R. Sykes, C.Bochel and N. R. Ellison, Social Policy Review 13, Policy Press Bristol. Rosie: If I’ve got to have dealings with them for money, I like to know that it’s only a certain number of hours†¦ I like restrictions of banking hours; I do quite like that. I’m old fashioned, completely opposite to Daniel. If he sees that something is wrong with one of

Is Jaws a Horror Movie? Essay example -- Film Review

Is Jaws a Horror Movie? First, I will intend to take you on a brief journey through the horror genre and the conventions that have been associated. Second I will show you how these conventions are used in the film Jaws. Let’s take a closer look at the history of the horror genre. To get started we are going to start with the first era or as it’s called the silent era. This era was based on monsters such as Frankenstein (1910), Dracula (1912) and The Hunchback of Notre Dame (1923). The horror was all about the make up and the clever use of lighting, to add thrills. The first conventions were that we see are the ‘revealing of the monsters’ and the use of ‘isolated houses’ where the monsters are based. This left audiences feeling panicky. These films had to rely on the music, yet they still lack the big horror genre fear factor. Through the talkies little changed, they still had the monsters, the same monsters, the same storylines, but the Atomic Phase of the 1950s soon had a impact. Sci-fi and hammer movies took centre stage, Godzilla (1954) and The Blob (1958) box office hits. From here we moved on to the witchcraft and the undead such Peeping Tom (1960) and The Night of Dead () . New films brought with them new conventions. Zombie films trapped the audience, claustrophobic attack scenes when the zombies came closer towards the camera. Horror finally became horror with the slasher movie era. They became realistic but also they became more stylised. Based on a real life tragic such as, Texas Chainsaw Massacre (1974), Halloween (1978) and Nightmare on Elm Street (1984) screens where awash with blood. This is where we see male psycho, the unwilling hero and teenage trouble. There are also soul survivors that carry the seque... ...horror so it is a bit of both but compared to the horrors that we have now with all the blood and gore special effects that make it better and the 3d its nothing like the horror’s today. Compared to the final destination 3D jaws is not even scary because of the 3D it makes it better with the way that if someone has an axe or something chucked at them it comes out of the screen at you and it comes towards you therefore you think it’s going to hit you which makes you get scared and it makes the film more jumpy so there for I don’t think jaws is a horror even if it was in its time compared to now day films I say it is a thriller. My opinion is that Spielberg is still in his twenties when he made this film, this shows his talent for creating suspense, delivering shocks and defusing situations through humour and this shows he is building up to a great climax.

Introduction Internet Protocol Suite Essay

The Internet protocol suite is the set of communications protocols used for the Internet and similar networks, and generally the most popularprotocol stack for wide area networks. It is commonly known as TCP/IP, because of its most important protocols: Transmission Control Protocol(TCP) and Internet Protocol (IP), which were the first networking protocols defined in this standard. It is occasionally known as the DoD model due to the foundational influence of the ARPANET in the 1970s (operated by DARPA, an agency of the United States Department of Defense). TCP/IP provides end-to-end connectivity specifying how data should be formatted, addressed, transmitted, routed and received at the destination. It has four abstraction layers, each with its own protocols. From lowest to highest, the layers are: The link layer (commonly Ethernet) contains communication technologies for a local network. The internet layer (IP) connects local networks, thus establishing internetworking. The transport layer (TCP) handles host-to-host communication. See more: introduction paragraph example The application layer (for example HTTP) contains all protocols for specific data communications services on a process-to-process level (for example how a web browser communicates with a web server). The TCP/IP model and related protocols are maintained by the Internet Engineering Task Force (IETF). SRI First Internetworked Connection diagram Layers in the Internet protocol suite Two Internet hosts connected via two routers and the corresponding layers used at each hop. The application on each host executes read and write operations as if the processes were directly connected to each other by some kind of data pipe. Every other detail of the communication is hidden from each process. The underlying mechanisms that transmit data between the host computers are located in the lower protocol layers. Encapsulation of application data descending through the layers described in RFC 1122 The Internet protocol suite uses encapsulation to provide abstraction of protocols and services. Encapsulation is usually aligned with the division of the protocol suite into layers of general functionality. In general, an application (the highest level of the model) uses a set of protocols to send its data down the layers, being further encapsulated at each level. The â€Å"layers† of the protocol suite near the top are logically closer to the user application, while those near the bottom are logically closer to the physical transmission of the data. Viewing layers as providing or consuming a service is a method ofabstraction to isolate upper layer protocols from the nitty-gritty detail of transmitting bits over, for example, Ethernet and collision detection, while the lower layers avoid having to know the details of each and every application and its protocol. Even when the layers are examined, the assorted architectural documents—there is no single architectural model such as ISO 7498, the Open Systems Interconnection (OSI) model—have fewer and less rigidly defined layers than the OSI model, and thus provide an easier fit for real-world protocols. In point of fact, one frequently referenced document, RFC 1958, does not contain a stack of layers. The lack of emphasis on layering is a strong difference between the IETF and OSI approaches. It only refers to the existence of the â€Å"internetworking layer† and generally to â€Å"upper layers†; this document was intended as a 1996 â€Å"snapshot† of the architecture: â€Å"The Internet and its architecture have grown in evolutionary fashion from modest beginnings, rather than from a Grand Plan. While this process of evolution is one of the main reasons for the technology’s success, it nevertheless seems useful to record a snapshot of the current principles of the Internet architecture. RFC 1122, entitled Host Requirements, is structured in paragraphs referring to layers, but the document refers to many other architectural principles not emphasizing layering. It loosely defines a four-layer model, with the layers having names, not numbers, as follows: †¢Application layer (process-to-process): This is the scope within which applications create user data and communicate this data to other processes or applications on another or the same host. The communications partners are often called peers. This is where the â€Å"higher level† protocols such as SMTP, FTP, SSH, HTTP, etc. operate. †¢Transport layer (host-to-host): The transport layer constitutes the networking regime between two network hosts, either on the local network or on remote networks separated by routers. The transport layer provides a uniform networking interface that hides the actual topology (layout) of the underlying network connections. This is where flow-control, error-correction, and connection protocols exist, such as TCP. This layer deals with opening and maintaining connections between Internet hosts. Internet layer (internetworking): The internet layer has the task of exchanging datagrams across network boundaries. It is therefore also referred to as the layer that establishes internetworking, indeed, it defines and establishes the Internet. This layer defines the addressing and routing structures used for the TCP/IP protocol suite. The primary protocol in this scope is the Internet Protocol, which defines IP addresses. Its function in routing is to transport datagrams to the next IP router that has the connectivity to a network closer to the final data destination. Link layer: This layer defines the networking methods within the scope of the local network link on which hosts communicate without intervening routers. This layer describes the protocols used to describe the local network topology and the interfaces needed to effect transmission of Internet layer datagrams to next-neighbor hosts. (cf. the OSI data link layer). The Internet protocol suite and the layered protocol stack design were in use before the OSI model was established. Since then, the TCP/IP model has been compared with the OSI model in books and classrooms, which often results in confusion because the two models use different assumptions, including about the relative importance of strict layering. This abstraction also allows upper layers to provide services that the lower layers cannot, or choose not, to provide. Again, the original OSI model was extended to include connectionless services (OSIRM CL). For example, IP is not designed to be reliable and is a best effort delivery protocol. This means that all transport layer implementations must choose whether or not to provide reliability and to what degree. UDP provides data integrity (via a checksum) but does not guarantee delivery; TCP provides both data integrity and delivery guarantee (by retransmitting until the receiver acknowledges the reception of the packet). This model lacks the formalism of the OSI model and associated documents, but the IETF does not use a formal model and does not consider this a limitation, as in the comment by David D. Clark, â€Å"We reject: kings, presidents and voting. We believe in: rough consensus and running code. † Criticisms of this model, which have been made with respect to the OSI model, often do not consider ISO’s later extensions to that model. 1. For multiaccess links with their own addressing systems (e. g. Ethernet) an address mapping protocol is needed. Such protocols can be considered to be below IP but above the existing link system. While the IETF does not use the terminology, this is a subnetwork dependent convergence facility according to an extension to the OSI model, the internal organization of the network layer (IONL). . ICMP & IGMP operate on top of IP but do not transport data like UDP or TCP. Again, this functionality exists as layer management extensions to the OSI model, in its Management Framework (OSIRM MF) . 3. The SSL/TLS library operates above the transport layer (uses TCP) but below application protocols. Again, there was no intention, on the part of the designers of these protocols, to comply with OSI architecture. 4. The link is treated like a black box here. This is fine for discussing IP (since the whole point of IP is it will run over virtually anything). The IETF explicitly does not intend to discuss transmission systems, which is a less academic but practical alternative to the OSI model. The following is a description of each layer in the TCP/IP networking model starting from the lowest level. Link layer The link layer is the networking scope of the local network connection to which a host is attached. This regime is called the link in Internet literature. This is the lowest component layer of the Internet protocols, as TCP/IP is designed to be hardware independent. As a result TCP/IP is able to be implemented on top of virtually any hardware networking technology. The link layer is used to move packets between the Internet layer interfaces of two different hosts on the same link. The processes of transmitting and receiving packets on a given link can be controlled both in the software device driver for the network card, as well as on firmware or specialized chipsets. These will perform data link functions such as adding a packet header to prepare it for transmission, then actually transmit the frame over a physical medium. The TCP/IP model includes specifications of translating the network addressing methods used in the Internet Protocol to data link addressing, such as Media Access Control (MAC), however all other aspects below that level are implicitly assumed to exist in the link layer, but are not explicitly defined. This is also the layer where packets may be selected to be sent over a virtual private network or other networking tunnel. In this scenario, the link layer data may be considered application data which traverses another instantiation of the IP stack for transmission or reception over another IP connection. Such a connection, or virtual link, may be established with a transport protocol or even an application scope protocol that serves as a tunnel in the link layer of the protocol stack. Thus, the TCP/IP model does not dictate a strict hierarchical encapsulation sequence. Internet layer The internet layer has the responsibility of sending packets across potentially multiple networks. Internetworking requires sending data from the source network to the destination network. This process is called routing In the Internet protocol suite, the Internet Protocol performs two basic functions: †¢Host addressing and identification: This is accomplished with a hierarchical addressing system (see IP address). †¢Packet routing: This is the basic task of sending packets of data (datagrams) from source to destination by sending them to the next network node (router) closer to the final destination. The internet layer is not only agnostic of application data structures at the transport layer, but it also does not distinguish between operation of the various transport layer protocols. So, IP can carry data for a variety of different upper layer protocols. These protocols are each identified by a unique protocol number: for example, Internet Control Message Protocol (ICMP) and Internet Group Management Protocol (IGMP) are protocols 1 and 2, respectively. Some of the protocols carried by IP, such as ICMP (used to transmit diagnostic information about IP transmission) and IGMP (used to manage IP Multicast data) are layered on top of IP but perform internetworking functions. This illustrates the differences in the architecture of the TCP/IP stack of the Internet and the OSI model. The internet layer only provides an unreliable datagram transmission facility between hosts located on potentially different IP networks by forwarding the transport layer datagrams to an appropriate next-hop router for further relaying to its destination. With this functionality, the internet layer makes possible internetworking, the interworking of different IP networks, and it essentially establishes the Internet. The Internet Protocol is the rincipal component of the internet layer, and it defines two addressing systems to identify network hosts computers, and to locate them on the network. The original address system of the ARPANET and its successor, the Internet, is Internet Protocol version 4 (IPv4). It uses a 32-bit IP address and is therefore capable of identifying approximately four billion hosts. This limitation was eliminated by the standardization of Internet Protoc ol version 6 (IPv6) in 1998, and beginning production implementations in approximately 2006.