Case Study Sickle Cell Disease

1. Sickle cell disease is a group of disorders that affects hemoglobin, the molecule in red blood cells that delivers oxygen to cells throughout the body. People with this disorder have atypical hemoglobin molecules called hemoglobin S, which can distort red blood cells into a sickle, or crescent, shape. SCD affects millions of people worldwide, particularly those with African, Spanish, Mediterranean, and Indian ancestry.Some 120,000 infants are born with SCD every year worldwide. In the United States, approximately 1 in 500 African-Americans and 1 in 1,200 Hispanic Americans are born with SCD. Some 2 million Americans including about 10 percent of the African-American population carry one gene for SCD, the â€Å"sickle cell trait.† 2. People without a spleen or those who have a spleen that is nonfunctioning are at an increased risk for developing infections, these infections can be fatal if not treated immediately.3. Anemia resulting from a failure in blood cellAnemia associa ted with an excessive destruction of red cells4. SCD can be very painful and to help control the pain the physican would need to know how much pain the client is in and if he is in pain did he want something to help control the pain.5. Yes V.M. is be adequately oxygenated.6. V.M. low Hgb could be causing the S.O.B. usually shortness of breath with anemia is caused upon exertion so I think there are some other underlying conditions causing his SOB.7. Increased pulse, crackles in the lungs, increased B/P, increased respirations/respiration pattern.8. I would expect the MD to do a chest xray, place client on strict I&O, give him lasix, admit for observation, order teds, place on low sodium diet.9. Normal NA 137 K 4.9 WBC 4.3 Platelets 208High Bun 27Creatinine 2.7- problem with the kidneys or kidney function Phospate 4.7- controlled by kidneys, evidence of a kidney problem Cl 110- can be caused by certain kidney diseaseLowCO2 16 Changes in your CO2 level may suggest that you are losing or retaining fluid, which causes an imbalance in your body's electrolytes.CO2 levels in the blood are influenced by kidney and lung function. The kidneys are mainly responsible for maintaining the normal bicarbonate levels. Ca 8.2- kidney decease can cause a decrease in CaHBG 7.8 can be caused by Kidney problems, SCA, bleeding etc Hct 20.9 can be cause by anemia, destruction of red blood cells and over hydration10. Furosemide – Furosemide is a loop diuretic (water pill) that prevents your body from absorbing too much salt, allowing the salt to instead be passed in your urine. Furosemide treats fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder such as nephrotic syndrome. This medication is also used to treat high blood pressure (hypertension). Methylprednisolone – is used to treat conditions such as arthritis, blood disorders, severe allergic reactions, certain cancers, eye conditions, skin/kidney/intestinal/lung diseas es, and immune system disorders. It decreases your immune system's response to various diseases to reduce symptoms such as swelling, pain, and allergic-type reactions. This medication is a corticosteroid hormone.Ceftriaxone is an antibiotic used to treat a wide variety of bacterial infections. This  medication is known as a cephalosporin antibiotic. It works by stopping the growth of bacteria. 11. Sickle Cell Disease clients often receive blood transfusions on an ongoing basis, making it more important for the them to receive the best match for their bodies. When they receive blood that is not the best match, their bodies may begin to slowly reject the blood.If they cannot receive blood safely, they may die. It is important that the labs knows it is a sickle cell patient, follow all facility protocols ( monitoring Bp, temp, pulse, as recommended), monitor the patient closely for signs and symptoms of rejection. 12. Often SCD patients are looked at as drug seekers and are not provi ded with the pain relief that they need. It’s important to remember not to stereotype patients and believe what they tell you their pain level is.13. Have him follow up with a cardiologist about his heart murmur, incourge hime to work on his B/P control with diet and exercises. Education on what can trigger Sickle cell crisis temp, smoking etc. Encourage a low sodium diet, weigh daily if more than a 2 lbs gain in a day notify his physician, Teach causes of fluid volume excess and/or excess intake to patient or caregiver. Provide information as needed regarding the individual's medical diagnosis (e.g., congestive heart failure [CHF], renal failure). Explain or reinforce rationale and intended effect of treatment program. Identify signs and symptoms of fluid volume excess. Explain importance of maintaining proper nutrition and hydration, and diet modifications. Identify symptoms to be reported.

Individuals with Behavioural Difficulties Essay

When working in the care industry whether that is with the elderly, mental health or children it becomes apparent that you as an individual become empowered by virtue of being primary care for that specific individual hence being an influential figure in any individual’s life recovery and rehabilitation. Due to this factor we have had many horrific incidents which have involved individuals in a position of power and whom have abused this trust and disregarded legislation, policy and procedure to continually systematically abuse service users in a vulnerable position. It is no secret that this has happened and still continues today within places of care. This is the purpose of the new legislative law updated and reviewed to combat and eliminate such barbaric behaviours displayed by so called supportive staff members in supposedly places of secure safe environments. Look more:  emotion focused coping definition essay The purpose of legislative law is to filter new and reform existing legislation through to the relevant policies and procedures within specific places of work. So to summarise the purpose of legislation in terms of managing difficult behaviours is that it functions to safe guard the vulnerability of service users in places of care which predominantly gets feed down through governing bodies to the policies and procedures file within the office within your place of work. It can be looked upon as a code of good practice with regards how to deal with vulnerable adults whom display challenging behaviours within places of care. When working within such an environment it is almost expected to receive challenging behaviour due to the different backgrounds and diagnosis the service users have so it would not be acceptable to react within such a way as you would when away from the unit due to the very essence of the clientele we deal with. This is not to say we are not in a vulnerable position to so we are legally permitted to utilise restraint techniques which is in the form of an in depth restraint course which covers  floor, escorting and seated restraints for the safety of the service user, other service users and also the safety of your fellow support staff within the workplace. This form of restraint is always the last line of defence it is paramount to utilise the different approaches available to return the service user to his baseline without putting hands on a client. 1 (1.2) The reason for such care institutions is specifically to rehabilitate and educate service users in the acquisition of knowledge regarding them to facilitate them to utilise coping strategies in the effort of recovery and rehabilitation rather than punitive based techniques. There are a massive variety of different approaches and methods when attempting to change an individual’s behaviour. We will target only a specific few that are more prevalent within today’s industry. The methods and approaches will include motivational interviewing, cognitive behavioural therapy, solution-focused therapy and adult learning methods these will be the approaches and methods that I will expand upon throughout the chapter. CBT is a form of talking therapy that combines cognitive therapy and behaviour therapy. It focuses on how you think about the things going on in your life, your thoughts, images, beliefs and attitudes (your cognitive processes), and how this impacts on the way you beha ve and deal with emotional problems. It then looks at how you can change any negative patterns of thinking or behaviour that may be causing you difficulties. In turn, this can change the way you feel. CBT tends to be short, taking six weeks to six months. You will usually attend a session once a week, each session lasting either 50 minutes or an hour. Together with the therapist you will explore what your problems are and develop a plan for tackling them. You will learn a set of principles that you can apply whenever you need to. You may find them useful long after you have left therapy. CBT may focus on what is going on in the present rather than the past. However, the therapy may also look at your past and how your past experiences impact on how you interpret the world now. The concept of motivational interviewing evolved from experience in the treatment of problem drinkers, and was first described by Miller (1983) in an article published in Behavioral Psychotherapy. These fundamental concepts and  approaches were later elaborated by Miller and Rollnick (1991) in a more detailed description of clinical procedures. Motivational interviewing is a semi-directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. Compared with non-directive counseling, it’s more focused and goal-directed. Motivational Interviewing is a method that works on facilitating and engaging intrinsic motivation within the client in order to change behavior. The examination and resolution of ambivalence is a central purpose, and the counselor is intentionally directive in pursuing this goal. Motivational interviewing recognizes and accepts the fact that clients who need to make changes in their lives approach counseling at different levels of readiness to change their behavior. During counseling, some patient may have thought about it but not taken steps to change it while some especially those volunt arily seeking counseling, may be actively trying to change their behavior and may have been doing so unsuccessfully for years. In order for a therapist to be successful at motivational interviewing, four basic skills should first be established. These skills include: the ability to ask open ended questions, the ability to provide affirmations, the capacity for reflective listening, and the ability to periodically provide summary statements to the client. Motivational interviewing is non-judgmental, non-confrontational and non-adversarial. The approach attempts to increase the client’s awareness of the potential problems caused, consequences experienced, and risks faced as a result of the behavior in question. Alternately, therapists help clients envision a better future, and become increasingly motivated to achieve it. Either way, the strategy seeks to help clients think differently about their behavior and ultimately to consider what might be gained through change. Motivational interviewing focuses on the present, and entails working with a client to access motivation to change a particular behavior, that is not consistent with a client’s personal value or goal. Warmth, genuine empathy, and unconditional positive regard are necessary to foster therapeutic gain (Rogers, 1961) within motivational interviewing. Another central concept is that ambivalence about decisions is resolved by conscious or unconscious weighing of pros and cons of change vs. not changing (Ajzen, 1980). It is critical to meet patients/clients where they are (Prochaska, 1983), and to not force a client towards change when they have not expressed a desire to  do so. Motivational interviewing is considered to be both client-centered and semi-directive. It departs from traditional Rogerian client-centered therapy through this use of direction, in which therapists attempt to influence clients to consider making changes, rather than non-directively explore themselves. Solution focused brief therapy (SFBT), often referred to as simply ‘solution focused therapy’ or ‘brief therapy’, is a type of talking therapy that is based upon social constructionist philosophy. It focuses on what clients want to achieve through therapy rather than on the problems that made them seek help. The approach does not focus on the past, but instead, focuses on the present and future. The therapist or counselor uses respectful curiosity to invite the client to envision their preferred future and then therapist and client start attending to any moves towards it whether these are small increments or large changes. To support this, questions are asked about the client’s story, strengths and resources, and about exceptions to the problem. Solution focused therapists believe that change is constant. By helping people identify the things that they wish to have changed in their life and also to attend to those things that are currently happening t hat they wish to continue to have happen, SFBT therapists help their clients to construct a concrete vision of a preferred future for themselves. The SFBT therapist then helps the client to identify times in their current life that are closer to this future, and examines what is different on these occasions. By bringing these small successes to their awareness, and helping them to repeat these successful things they do when the problem is not there or less severe, the therapists helps the client move towards the preferred future they have identified. Adult learning theory is part of being an effective educator involves understanding how adults learn best. Andragogy (adult learning) is a theory that holds a set of assumptions about how adults learn. Andragogy emphasises the value of the process of learning. It uses approaches to learning that are problem-based and collaborative rather than didactic, and also emphasises more equality between the teacher and learner. Andragogy as a study of adult learning originated in Europe in 1950’s and was then pioneered as a theory and model of adult learning from the 1970’s by Malcolm Knowles an American practitioner and theorist of adult education, who defined andragogy as â€Å"the art and science of helping adults learn†. Knowles  identified the six principles of adult learning outlined below. Adults are internally motivated and self-directed Adults bring life experiences and knowledge to learning experiences Adults are goal oriented Adults are relevancy oriented Adults are practical Adult learners like to be respected 2 (2.1) When we discuss behaviours it is imperative to understand why these behaviours are being displayed and it is often something which appears very minor to care staff but it can be interpreted as a big dilemma to the individual in question. When understanding the reasons for behaviours there can be many reasons for them but here is a few more common examples, culture, gender, beliefs, personality, illness, medication side effects, family, personal occasions etc. These are all contributing factors as to why individuals will display certain behaviours. Within the unit it has been noticed that a specific factor i.e. family contact can have a huge effect on a certain individual in our care. Due to the fact that this individual has very minimal contact with his family (personal choice) when this individual does eventually get to speak with his close family it can conjure up many different feelings within and can cause indirect behaviours within the unit. Feelings such as abandonment, not loved, singled out, why? These contributing factors will mix together and inevitably have to be released e.g. become withdrawn, aggressive, depressed (low). Now the staff team have highlighted this concern and a concise care plan has been put into place and agreed by the individual it can be monitored and dealt with more effectively in the requisition for this individual to eventually become more comfortable when discussing and contact the family. 2 (2.2) When we discuss the influence of the environment and behaviour of other individuals we are basically referring to the place in which these individuals reside e.g. the psychiatric hospital or the community home etc. These environments can play an enormously important role in the behaviours of individuals whom are observing they can be easily influenced by others  actions and will tend to mimic or act up to the situation or incident. It depends on the individuals in question but what can happen in a unit which is occupied by more than one service user is that individuals will observe (audience effect) and will either react in three different ways. The individual will either adopt and mimic the behaviour being displayed thus causing a major incident or the individual will remove themselves or will confront that individual or group of individuals having an incident thus again causing problems for the unit. 3 (3.1) When working in an area such as mental health it is imperative from the beginning to ensure you adopt a professional relationship and maintain this as long as you remain in the care system. It has been said to me that a good rule to follow is that of firm, fair but fun but not forgetting that there are constant boundaries that should be followed throughout your working career and not to be crossed. The working relationship is so important within mental health due to the fact specific clients will have blurred boundaries or have no boundaries at all so it is imperative as support staff the clearly and quickly introduce clear concise boundaries for service users. The working relationship has to remain purely professional for a number of reasons but mainly for the safety of the service users and that they do not miss interpret signals given by support staff and un intentionally cross the boundaries. If the professional working relationship is followed it can create a healthy relationship between support staff and service user and the avoidance of blurred boundaries. This is not to say that service users will not try and test the boundaries of specific staff members as this is commonplace within the area of mental health but as professional support worker it needs to meet with a firm approach and dealt with in a professional manner.

Louis XVI Essay Example | Topics and Well Written Essays - 2500 words

Louis XVI - Essay Example Even during his life, when his subjects generally liked him and exempted him from their harsh and bitter sarcasms, Louis XVI did not know how to sell himself to his people" (Padover, 1939, p. viii) The nation cried for a king, and it was given an image of a stout man too shy to play to the galleries. Louis XVI built no bridges between himself and his subjects, and the wonder is that he retained their affections as long as he did. Almost to the very end, Frenchmen were attached to the monarchy, but they demanded something more of the monarch than ritualised inertia. In no way, except intentions, did Louis meet the expectations of his people. This interplay of forces, as expressed by what an aroused nation wanted and a slow moving ruler did not offer. One of the curious ironies in the career of Louis XVI is that his death came to be perhaps more important than his life. From the point of view of the Revolutionary reforms, the king's death was unnecessary because it took place after the Revolution had achieved its program; and from the point of view of French history, the decapitation of Louis XVI was a national tragedy because it tore the country from its traditional moorings and cast it into a sea of violence. One of the major difficulties Louis XVI faced at succession was that he was a young boy devoid of any social contacts. Initially he was frightened at such a responsibility that he was not expecting. Louis XVI as a bewildered boy had never before had to make decisions or take action on his own. Always there had been somebody mastering him father, mother, brother, or wife but now he was king and absolute lord of the realm, and the entire world expected him to rule and command. Yet he did not have the remotest idea of his specific functions, or any knowledge of finance and legislation, or any awareness of the complex problems that waited solution. He knew how to sign papers submitted by ministers and was of course conscious that his signature implied sanction and compelled obedience. But his distrust of all his grandfather's ministers and functionaries was too deep to allow them to remain in office. At court there was no one in whom he had confidence. Yet it was essential that he find one man to whom he could entrust himself and the destinies of the state; such a man could serve as prime minister, as royal tutor, and even as a sort of parent-substitute. But where was the king to find such a mentor He had virtually no contact with prominent men, and some of the persons recommended in his father's list 'Maurepas', for example had not been at court in Louis' lifetime. Immensely worried, Louis consulted the one woman he trusted, his clever and haughty Aunt Adelaide, who was his father's sister and who knew everybody. Together they scanned the late dauphin's list of recommendations until by a process of elimination there remained only Machault and Maurepas, both of them past their allotted span of years. But Madame Adelaide was a pious woman, and when her nephew asked her what she thought of Machault, she replied that the former minister of finance, although honest enough, was a Jan senist and therefore a heretic. Louis, accordingly, decided against him. Thus only Maurepas, equally ancient and presumably equally wise, was left in the field. In this way the king chose a minister who was to shape

Movie Review - Dr Strangelove Essay Example | Topics and Well Written Essays - 1250 words

Movie Review - Dr Strangelove - Essay Example General Jack D. Ripper, played by Sterling Hayden for instance, ordered attack on Soviet Union because he believed USSR was contaminating their foods and drinks through fluoridation, claiming to be the most monstrous conceived and dangerous communist plot. When asked about when he had the idea starting, he admits that he had it during sexual acts where he noticed something wrong with his fluids which was really amusing because his basis as a man with rank, was simply based on his personal experience without evidence that other people are suffering from such condition or if the process is actually happening and not just a rumor. Since the film was made in 1964, just two years after the Cuban Missile Crisis where Soviet Union and the United States held meetings regarding the bases in Cuba which were believed to house a number of nuclear weapons aimed in destroying most of the United States, communications made between the two nations in the attempt to maintain peace, are evident in the movie. With the cold war going on, Soviet Union made its bases in Cuba while the United States allied with Italy and Turkey for similar purposes. However, in the end, they both dismantled their bases with the understanding that each should mutually ensure the safety of the other. This condition is portrayed in the film on another angle with the creation of the doomsday machine which could ensure the safety of Soviet Union from any attack. Making a machine that is automatically triggered when an attack is made on the Soviet nations, they can be sure that they never lost the attack because of the doomsday machine that will cost the lives of all the people on the earth, with it having the impossibility of being untriggered. This then gives a sense of security to Soviet Union because then, their enemies would not dare bring close a single missile near the country. However, the

PROJECT MANAGEMENT Assignment Example | Topics and Well Written Essays - 2500 words

PROJECT MANAGEMENT - Assignment Example The goal is to present this information in the ten minute time allotted. Benefits and methods of the proposed project are to improve on-line fire prevention information for businesses. In order to complete that task there are preliminary document checklists that should be completed in order to ensure that the project management proposal is accepted and utilized for the target deadline date. The Learning Outcomes in this Assignment prepared us to present a Project Initiation Document Checklist which describes 1. What is the project all about? 2. Why should this project go ahead? 3. Who will work on the project? 4. How and when will the project be delivered? ASSESSMENT CRITERIA 1. Choose type of leadership 2. Use practical project management 3. Understand your responsibilities as a leader for the group are 4. Understand your responsibilities as a manager for each individual are 5. Implement the Project Initiation Document Checklist 6. Team is ready to proceed with Project Management Ta sk Transformational  Leadership What Is Transformational Leadership? Transformational leadership is a type of leadership style that leads to positive changes in those who follow. Transformational leaders are generally energetic, enthusiastic and passionate. Not only are these leaders concerned and involved in the process; they are also focused on helping every member of the group succeed as well. Leading and Developing Others Personal Qualities Leading the Organization Showing genuine concern Being honest and consistent Networking and achieving Enabling Acting with integrity Focuses effort Being accessible Being decisive Building shared vision Encouraging change Inspiring others Supporting a developmental culture Resolving complex problems Facilitating change sensitively Practical Project Management: The most important thing to know about project management is that first and foremost it’s a way of thinking about projects 1. Focus on the objective – A written statemen t of a project designed to achieve one or more goals 2. Starting to Plan – work through the planning process, uncover questions, problems and issues 3. Laying out the project – gather task data and prepare a rough sequence process 4. Analyzing Your Tasks – sequence first analyze tasks second and integrate the two steps 5. Managing Time and Cost – By Utilizing the PERT The Program Evaluation and Review Technique 6. How to Make and Use a Gantt Chart – Don’t reinvent the wheel save time use templates 7. Using PERT and CPM Charts – Critical Path Method to determine time, budget, and performance 8. Budgeting for Projects – determine fixed, variable costs, equipment, rentals, outside contracts 9. Managing the Project – committed teamwork, SMART Goals, communication 10. Monitor and Adjust – Utilize a project control chart to tract progress of time budget & data 11. How to wrap up the project - Determine the three Estimat es: Historical Data, Research, and Publish Data & Scenarios. Source: Practical Project Management (Dobson 1996) Project Initiation Document Checklist PID Item Check When Complete Section 1: What is the project all about?    Project title    Background    Purpose    Objectives (and how they will be measured)    Project scope    Exclusions from scope    Deliverables (including dates of completion)    Constraints    Assumptions    Section 2:Why should this project go ahead?

Art and craft Coursework Example | Topics and Well Written Essays - 500 words

Art and craft - Coursework Example At later stages, art and craft required more than just painting and drawing, but creativity, planning, design and patience. Introduction of drawing competitions among pupils acted as an extrinsic motivation to pay keen attention to the art of drawing, painting and designing while borrowing heavily from the environment. The most important thing was to communicate through various paintings and molding. A distinction was only attained through the uniqueness and application of basic arts and craft skills to attain originality in all projects of arts (Craft et al., 2007). Art and craft were taught basing on age and grade level. For instance, at lower elementary school level, pupils were tested on the ability to identify different art tools such as colours and use their psychomotor skills to create pictures as well as models according to instructions of the teacher. However, at a higher level, most art and craft lessons required use creativity, planning, accuracy and speed to come up with drawings and models that exhibited maturity and concrete expression of ideas. It was expected of the pupils to apply all the basics of arts and craft in every activity. Grading was done for pupils at the same level basing on their abilities to express their concepts through art in the most comprehensive and original manner using the available resource Art and craft goes beyond decoration of ideas and environment to imparting lifelong skill that a child will always find useful through his or her experience. Although the prime purpose of art and craft is to facilitate learning of various disciplines in school, so many benefits come along. Most of these benefits become part of the life of a child through adulthood (Craft et al., 2007). For instance, art and craft, promote life skills such as; visual-processing abilities such as pattern identification, spatial rotation and discovering of

A Reflection and Evaluation to Personal and Organizational Business Research Paper

A Reflection and Evaluation to Personal and Organizational Business Ethics - Research Paper Example Corporate organizations, or any professional organization for that matter, will always have to reach a point when improvement is needed or that the need for change should be addressed. Such scenarios happen within an organization, whether minor adjustments in policies or complete organization structure overhauls, are usually necessary so that operations or activities can progress accordingly. However, the central issue really of organizational development is all about the welfare of the individuals working within the organization, and the manner which their abilities and performance in reaching the organization’s objectives are achieved. Also taken into great consideration are the effects of the business activities to the public constituents. Many relevant issues are put into inquiry. This matter would be called as business ethics. The definition of business ethics varies greatly, but it is perhaps best described by Velazquez as â€Å"a specialized study of moral right and wrong. It concentrates on moral standards as they apply to business policies, institutions and behavior†. As changes in the economic and social environment, how should an organization’s culture and practices deal with the nature of change? If being given the mantle of leadership the head manager of a corporate organization, how would I set the standards, vision, mission and methods needed to develop a business entity that is fair, just, and balanced between profit and principles, and also maintaining integrity? This would be elaborated further on. Before everything, I must understand what are my personal ethics and standards, and try to form them as the organization’s mission and vision as well. My personal code of ethics for this company revolves around the concept care. The concept of care is usually taken into a typically altruistic point of view. The concept of care ethics tells that â€Å"we have an obligation to exercise special care toward particular persons with whom we have valuable close relationships, particularly relations of dependency† (Velazquez, 2006, p.125). Hence, my personal principle with regard to business ethics, in both the personal and organizational aspect, is that the treatment given and practiced between everyone involved in the organization is compassion and kindness. My personal mission statement encapsulates this ideal in the form of â€Å"care and share.† As a manager, I would consider developing a mission and vision statement that would encapsulate the principled ideals that I have for the company. In having a clear mission and vision, as well as having room for flexible and achievable room to adapt along the way, individuals who are part of the company will also have a clear understanding of their purpose within the organization. Mikush and Philbin (1999) point this out precisely: In effective organizations, the vision, values and mission derive from the convictions of