Apa citation genorator
Tuesday, August 25, 2020
Pepsi vs coca in india case Essay Example | Topics and Well Written Essays - 250 words
Pepsi versus coca in india case - Essay Example Coca-Cola reappeared India in the mid 1990s when the Indian government embraced the arrangement of advancement, privatization and globalization. At that point, PepsiCo had just procured 26 percent of the cola fragment. Coca-Cola couldn't eat into the piece of the pie of existing players as the drink advertise was in the development stage. PepsiCo has been effectively reinforcing its non-cola portfolio in India. The organization has enhanced into the lemon and orange section of carbonated beverages and has likewise propelled its image of juices. PepsiCo earns one-fourth of its income from the non-cola fragment and is all around ready to profit by the customers changing tastes and inclinations. One the other hand, Coca-Colaââ¬â¢s lead brands; Coke and Thums Up are cola drinks. PepsiCo has likewise propelled its Aquafina image of packaged mineral water in India. The organization has caught a huge piece of the overall industry in the filtered water advertise which is relied upon to develop consistently later on. The immense item exhibit of PepsiCo likewise incorporates Gatorade, an entrenched global games drink brand. The developing wellbeing awareness among Indian customers is probably going to help Gatorade increase further footing in the Indian market. The development of sports and activities in the every day routine of Indian customers looks good for PepsiCo. PepsiCo utilizes fitting publicizing and deals advancement strategies remembering the Indian culture. Sponsorship of cricket and football competitions and big name supports has hit the correct harmony with PepsiCoââ¬â¢s target advertise in
Saturday, August 22, 2020
Strategic management Essay Example | Topics and Well Written Essays - 11000 words - 1
Key administration - Essay Example Corporate culture portrays and oversees the reasoning, feeling and activities of proprietors of organizations and representatives. It doesn't make a difference whether corporate culture is composed as a statement of purpose or simply comprehended by authoritative publics. Corporate culture might be established on the convictions explained in the statement of purpose or be comprised in the piece of a corporate image. For instance, Appleââ¬â¢s corporate culture is reflected in its rainbow-shaded apple. Contemporary chiefs are consistently enthused about the corporate culture of their associations. As per Johnson, Whittington, Scholes, Angwin and Regneì r (2014), corporate culture has a basic task to carry out most definitely. On a very basic level, how well a business performs is dependent upon the routes through which individuals act in associations. Practices, as battled by Mintzberg, Ahlstrand and Lampel (2009), involve the activities that lead to creation of results. Corporate culture is a subset of these activities; this is the reason corporate culture is straightforwardly corresponding to the presentation of a business. Capon (2008) accepted that all associations have a created series of expectations, understandings, and verifiable principles that administer the every day practices in the work environment. All organizations have their own societies that decide the connections among them and outside partners. Corporate culture isn't consistent and fixed inside an association. Volberda (2011) set that all parts of associations should highlight adaptability so as to upgrade flexibility across time, spot, and conditions. On the off chance that an organization isn't content with the current corporate culture, the administration can start searching for methods of transforming it into what they need. The administration can discover elective image, accepts, perspectives and even qualities that can alter the course of conduct. The administration, for this situation, ought to guarantee
Sunday, August 9, 2020
Listen to Admissions Holly on applications, art, and action team
Listen to Admissions Holly on applications, art, and action team Earlier this summer I sent out an email to the office asking if anyone who doesnt blog would like to be interviewed for the blogs. A few minutes later, my friend Holly responded and said that, duh, of course she would. Even if you dont know Holly, you may have received something that shes made in the mail. Holly is a Senior Counselor for Communications, and she basically makes all of our print publications, as well as being the token #millenial on our social media. One reason I love working with Holly is because shes always down to try anything new and creative just because its new or creative. Last week Holly and I finally got to sit down and talk about ourselves. The transcript from that interview ran almost 11 pages, which seemed downright cruel to blog. So instead, we decided to post the audio to Soundcloud, so you can listen to it whenever and however you like. I listen to a lot of podcasts and radio shows, and used to run one for my college newspaper, so it seemed like a nice way to try and bring the form to the blogs. I embedded the interview below: This is the first time weve tried anything like this, so please, let us know what you thought, and what other sounds of admissions you might like to hear! opening music: Dear by blogger alum Joe B. 18 *** update 11/14/2015: by popular demand in the comments below, here is Hollys list of scams (TM): Living rooms Dr. Oz Ski valet U.S. Food Pyramid For-profit universities Groundhog Day LinkedIn Fat free foods Nespresso The terms âtouch baseâ and âbest regards 1 like = 1 prayer Life coaches Home phones Personality tests If someone calls themselves a âguruâ Hard Rock Cafes
Saturday, May 23, 2020
Private Security/Security Plan - 1383 Words
Javier Sierra Private Security 8/3/2011 My Security Plan There are approximately 800 employees employed at The ABC Valve Plant for prevention of theft and pilferage by means of personnel screening, background investigations, procedural controls, and polygraph and psychological stress evaluator investigations will be mandatory for employment and security purposes. Once hired all employees must check in with fingerprints to clock in to work this will prevent any intruders into the premises. When the truckers come in to pick up or deliver shipment they will be ask to show identification and there purpose at ABC Valve Plant. Planning and goal setting for The ABC Valve Plant a detailed check of certain areas, their probability, and theirâ⬠¦show more contentâ⬠¦There will be lighting in each corner of the fence and one big light at the top of The ABC Valve Plant. The four lights in the corner will be motion sensor to any movement within 20 yards away the light on top will be functioning all night till morning. In my security plan I will h ave an Emergency Response Plan having these plans is good in case of a terrorist attacks and are also useful in case of natural disasters I would have an exit doors in case of emergency a fire extinguisher in every corner even in the other rooms itââ¬â¢s better to be safe than sorry. Anyone that wants to enter the premises must show identification to the security guard by the front gate and license plate number for security purposes. Since the plant already has only an Intrusion Alarm, along with that I will install Fire Alarms which warn of fire dangers in various stages of development of a fire or to respond protectively by announcing the flow of water in a sprinkler system. The sprinkler system which means the heat triggered the sprinklers. Also Special use alarms warn of dangerous temperature either too high or too slow of the presence of toxic fumes, or that a machine is running to fast. That could be a good way to prevent an injury or even death. The last alarm system I wou ld install would be an alarm sensor system this alarm is designed to respond to a certain change in conditions, such as the openingShow MoreRelatedThe Importance and Use of Disclosure1858 Words à |à 7 Pagesand more precise forecasts, implying that institutional ownership is an antecedent. Voluntary disclosure is the provision of information provided by a companys management beyond requirements such as generally accepted accounting principles and Securities and Exchange Commission rules (known as Mandatory Disclosure), where the information is believed to be relevant to the decision-making of users of the companys annual reports. There are two types of voluntary disclosure: management earnings forecastsRead MoreEssay on Public Policing Versus Private Security1451 Words à |à 6 PagesPolicing Versus Private Security Peter g. CJA/500 January 30, 2011 Patrick Cote Public Policing Versus Private Security The existence of security in the world brought happiness to mankind because men choose pleasure over pain (Ortmeier, 2008, p. 4.).However, without some measures of security man would not live in peace and the war of all against all (crime) would inundate the entire world. Public policing and private security have severalRead MorePublic Policing Versus Private Security1347 Words à |à 6 PagesPublic Policing Versus Private Security Kayla Cook CJA/500 November 8, 2009 Mrs. Jancie Graham Abstract Public policing and private security have several distinct differences. Public policing is the ability to enforce the law and maintain order in society. Private securities are paid agencies that perform the protective and loss-prevention duties not handled by police officers. Yet public policing and private security offers the same services and duties. These services and dutiesRead MoreRoles and Responsibilities of Public Policing vs. Private Security1652 Words à |à 7 PagesPublic Policing vs. Private Security ASJ-502 February 6, 2012 Abstract This paper explores the similarities and differences of public police and private security throughout history. How the criminal justice system and public police and private security are linked to each other. The essential policies that have been developed and how these police have assisted in the cooperation between police and private security. Finally, the need for a comprehensive security plan will be discussed andRead MorePublic Policing vs. Private Policing1556 Words à |à 7 PagesPublic Policing vs. Private Security AJS 502/Survey of Justice and Security Jessica Bishop June 3, 2012 Public Policing vs. Private Security Public policing stands for more in society than private security because of the funding provided. Most private security agencies have to acquire more publicRead MorePublic Policing vs Private Security Comparison Essay examples1223 Words à |à 5 Pagesinclude private security and public policing. State government, city government, and towns normally provide the community with a public police force to enforce the laws and protect the citizens. Police officers are very important within a community but sometimes a private security can come in and help out and this frees up time for the public policing. Private security personnel generally work for a private company that handles their own dispatching, training and recruiting. Private security functionsRead MorePrivate Security and Critical Infrastructure Assets Essay932 Words à |à 4 PagesThe private security and law enforcement officer as well the FBI function and responsibilities have tightened after the 9/11 at tacked. Private security officers are undergoing more advanced training from latest technology system to protect the nation to terrorism to be prepared and ready in any event that might come along the way like the 9/11 attacked. After the disastrous event of the 9/11 attack numerous companies and group of people obligate themselves a thorough investigation and evaluationRead MoreImplementing A Company s Security Plan Essay1089 Words à |à 5 PagesAssignment- Security Jean Robert Robillard BUSN624: Principles of E-Commerce APUS Professor: Alex Lazio 11/27/16 Weekly Assignment-Security 1. Identify and describe the five main steps in establishing a companyââ¬â¢s security plan? The IT department of e-commerce firms must have a security plan to protect the technologies and assess the risks. Laudon and Traver identify five steps in establishing and assessing the companyââ¬â¢s security plan. The followings are the steps: risk assessment, security policyRead MoreInformation Classification Plan For Kingsley Media Enterprises1212 Words à |à 5 Pages ââ¬Æ' Executive Summary The report is introductory to an information classification plan related to Kingsley Media Enterprises This report explains the importance of information classification and introduces three labels that can define any information, and the countermeasure that aid to mitigate the risk and impacts of information being exposed. Proper security measures must be accompanied with information classification and practical workshops for employees to learn how to label information. Read MoreEssay on Retirement Revamping1377 Words à |à 6 Pages Social Security is a major concern in American society today. Social Security first started in 1935 under President Roosevelt when he signed the Social Security Act that provided the elderly with guaranteed retirement income. In 1939, benefits for spouses, dependent children of retirees, and survivors of workers who die before retirement were implemented by congress. In the 1950ââ¬â¢s, disabled workers were also given benefits. Now days, Social Security is under close scrutiny. Funds are depleting,
Tuesday, May 12, 2020
The Journals And Letters Of Carl Smith Essay - 1200 Words
The Journals and Letters of Carl Smith March 8, 1769 My original name is Carl Smith but my friends call me CS. Iââ¬â¢m 23 years old, Iââ¬â¢m from Virginia and during the last years I have been traveling around the 13 colonies to fight the British soldiers. The reason why I joined the American Army over 6 Months ago is because Iââ¬â¢m single, and I also was unable to get a job that I wanted was unable to receive my diploma, because I was unable to afford the stamp to be stamped on the certificate. I also joined the army because I was tired of all these decisions the British government took for us because we had no authority for example I was tired of the Kingsââ¬â¢ unacceptable taxes over some items for example the stamp act. Soldiers are not professionals in modern English, for they might well first enter a military school or buy a commission... The stamp act was a tax put it to every official document, the list included Contracts, newspapers, and playing cards. Important people to colonies had to purchase these stamps. After all the sales the colony would take a good amount of money from all the stamps they sold. This new revenue was to collect money from the different colonies in the U.S. This tariff it was supposedly used to protect the British colonies, but in reality it was used to pay the national debt that the Seven Years war left to Great Britain . In consequence I decided to join the American Army, I have participated in The Stamp Act, The Boston Massacre, The army ofShow MoreRelatedThe Perkins Act1710 Words à |à 7 PagesQUESTION #1: (2 points). The Perkins Act, now known as the Carl D. Perkins Career and Technical Education Act of 2006, is one of the most influential legislations in Career and Technical education to date. Summarize the Carl D. Perkins Career and Technical Education Act of 2006, including a brief introduction, benefits of the legislation, and the significance of the legislation. Contrary to what people might think, our education deserved some major changes in the ways technical education wasRead MoreBernie Madoff2651 Words à |à 11 Pagescaught the perpetuator will have to face prosecution and / or repayment of all money to victims and possible jail / prison time or pay restitution to the government. In some cases there are assets seized to reimburse victims and pay restitution (Smith, 2011). Madoff committed this fraud by luring and convincing his victims that he would guarantee one a double digit return. He consistently provided a return by his endless supply of victims according to Madoff at one point you were the outcastRead MoreBernard Lawrence Madoff: Con Man1630 Words à |à 6 Pagesaccount to her personal account in order to have cash just in case he needed it for his investors. Soon after that, his investors demanded a return of $7 billion. Obviously, this $15.5 million comes nowhere close to the money needed for his investors. Carl Shaprio, one of Madoffââ¬â¢s loyal investors, invested $250 million to try to bail out Madoffââ¬â¢s firm. It still wasnââ¬â¢t enough. Madoff was out of ideas and decided to confess his entire crime to his two sons, Mark and Andy Madoff. They went straight to theirRead MoreStyles and Themes of Samuel Richardson3736 Words à |à 15 PagesStyles and Themes of Samuel Richardson Samuel Richardson wrote his novels using the epistolary novel style, in which all the books are made up of letters. These letters are meant to be written during the time that the stories take place by the main character. They either described a scene or dialogue within the scene (Brophy 245). The stories used the themes of female dominance over the emotions of a man, and male dominance over the physicality of a woman. Also, many women in his stories areRead MoreRestructuring at Marvel8331 Words à |à 34 Pagesinvesting $365 million in exchange for 427 million newly issued shares. Perelman would then own 80% of the reorganized companyââ¬â¢s equity while public debtholders would receive 15% of the equity in exchange for debt with a face value of $894 million. Carl Icahn, one of the many ââ¬Å"vulture investorsâ⬠who had purchased deeply discounted Marvel bonds with the hope of profiting on the reorganization, considered Perelmanââ¬â¢s plan an ââ¬Å"unconscionable att empt to maintain control of Marvel at all costsâ⬠and wasRead MoreBernie Madoff Case Study4737 Words à |à 19 Pagesrelationshipâ⬠with Madoff. The Ponzi scheme was named after Charles Ponzi who in the early 20th Century, saw a way to profit from international reply coupons. International reply coupons were a guarantee of return postage in response to an international letter. Charles Ponzi determined that he could make money, legally, by swapping out these coupons for more expensive postage stamps in countries where the stamps were of higher value. While making a significant profit with this system, Ponzi got the ideaRead MoreEssay on Jungian Psychology and Joseph Conradââ¬â¢s Heart of Darkness6193 Words à |à 25 Pagesthe horrors of its savage embrace had, in 1890, lured Conrad himself into adventure that turned him from sailor to writer (Smith, 25) and severely effected his health for the rest of his life (Conrad,v). As the voyage up the Congo proved fateful f or the development of Conradââ¬â¢s narrator, Marlow, it was equally fateful for Conradââ¬â¢s individuation, as he reflects in his letters ââ¬Å"Before the Congo I was just a mere animal.â⬠(Jean-Aubrey, 141) Hillman, in ââ¬Å"Notes on White Supremacyâ⬠reminds us that,Read MoreEssay about The Roanoke Colony3826 Words à |à 16 Pagesgo beyond; the next day they departed. They left Roanoke Island and started inhabiting in the Chesapeake Bay. They built rafts or a boat of some sort using resources tattered apart from their homes. Close to twenty years had passed before John Smith and his assembly started the well-known colony of Jamestown (where the popular story of Pocahontas takes place). This colony was close to the Chesapeake Bay. Some evidence in this is that the leader of the natives did certainly confess to killing theRead MoreLiterature And Literature : The Novel One Of The Most Interesting And Significant Expression Of Humanity 1854 Words à |à 8 Pagessignificant expression of Humanity - Literatureâ⬠Literature is the art of written work that is produced by the writers. It reflects about us and our society. The term Literature is derived from Latin - Literatura which means that a writing formed with letters. Literature is a term indicated all books and writing. . . Literature has many genres such as Poem, Drama, Novel, and short story.The novel is one of the genres of fiction. The term Novel is derived from Italian word ââ¬Å"Novellaâ⬠. The novella was aRead MoreGeorge Washington4952 Words à |à 20 PagesWaging War with Honorâ⬠, American History, Vol 44 Issue 6, (February 2010): 30-35, 6 pp. 16. Raphael, ââ¬Å"George Washingtonââ¬â¢s Five Rules for Waging War with Honorâ⬠, page 35. 17. Raphael, page 35. 18. Carl LaVO, ââ¬Å"Showdown on the Delawareâ⬠, Naval History 23, no. 6 (December 2009): 66. 19. Carl LaVO, ââ¬Å"Showdown on the Delawareâ⬠, 66. 20. Cunliffe, page 93. 21. John R. Alden, A History of the American Revolution (Alfred A. Knopf: New York, 1969), pp 457-76. 22. Alden, A History of the
Wednesday, May 6, 2020
Love vs. Infatuation Free Essays
Do you remember the first time you gave any serious thought to the meaning of love? As a youngster you may have carved entwined hearts on a tree or scrawled them on a notebook. For many of you, the words ââ¬Å"I love youâ⬠flowed easily during high school dating experiences, but for others the sentiment was unspoken or virtually unknown. We can remember as teenagers talking about love with our peers and wondering how we would know when it happened. We will write a custom essay sample on Love vs. Infatuation or any similar topic only for you Order Now At times we felt certain that what we were feeling was loveââ¬âonly to decided, in light of the broken romance, that it was just ââ¬Å"infatuation.â⬠Occasional discussion with adults elicited a series of homilies about not letting the heart rule the head. A married cousin, perhaps speaking from experience, advised, ââ¬Å"Never date anyone you wouldnââ¬â¢t consider marrying.â⬠The point was clear: one might fall in love with someone with whom marriage was inappropriate. Parental words of wisdom ranged from ââ¬Å"Itââ¬â¢s as easy to fall in love with a rich person as a poor oneâ⬠to ââ¬Å"Donââ¬â¢t worry about it. When love hits, youââ¬â¢ll know it.â⬠None of this advice seemed very helpful. Even so, we all knew that whatever love was, it was very serious (Hinkle, 2001). Popular songs, films, and novels were just as confusing. Literature classes exposed us to the peculiarities of love as experienced, for example, by Dante and Beatriceââ¬âthe love that inspired Danteââ¬â¢s Divine Comedy. As a child, Dante saw Beatrice once and never recovered from the passion he felt. He married someone else and had seven children, but in his poems he mentions only Beatrice. II. Discussion A. What is love and infatuation? How does it differ from each other? Every individual desires to have his/her own partner in life; thus, desires to be loved and to loved. This is the reason why young people and older ones indulge in courtship to seek love and find a potential partner for marriage. This motivates everyone to watch romantic movies and read novels that show two people who are head-over-heels in love with each other. But are they really experiencing the true meaning of love or is it just an infatuation? Many young people thought that it is already love when the time they feel something for the opposite sex but most often, it is just an infatuation. So how can a person know that what he/she feels is love or just an infatuation? Love is basically giving your all in all unselfishly. The best description of love can be found in the Bible on 1st Corinthians 13: 4-8): ââ¬Å"Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It à à à à à à à is not rude, it is not self-seeking, it is not easily angered, it keeps no records of à à à à wrongs. Love does not delight in evil but rejoices with the truth. It always à à à à à protects, always trusts, always hopes, always perseveres. Love never failsâ⬠¦Ã¢â¬ This would simply mean that love is not based on feelings but based on decision and commitment. Loving someone who has many flaws is a decision to make. Love is the all-purpose cure, covering all wrongs. It is worth searching for. It should be expressed openly. When you really love someone, you accept him for who he is regardless of his past. You do not only accept him because of his strengths and his personality but as a whole that includes his totality as a person.à Moreover, love is wondrous state, deep, tender and reassuring. Because of its intimate and personal nature it is regarded by some as an improper topic for experimental research (Harlow, 2003). On the other hand, infatuation is the opposite of love. The true concept of love is misinterpreted. This is usually happening to the young ones who are very emotional due to their being young. Young people are mostly motivated by emotions; thus, they make decisions very quickly without logic but by feelings alone. They thought that the excessive passion they feel for the opposite sex is already love but it is not and basically just an infatuation. Infatuation is an excessive passion for the other person. Its ground is how the person feels for the opposite sex basically does not involve logic, decision and commitment because when he discovers some flaws and weaknesses, he immediately get discourage for that person. That is why we sometimes hear the line ââ¬Å"I am falling out of loveâ⬠for those people who are just infatuated. III. Conclusion Infatuation can be viewed as a temporary, aroused sate that we cognitively labels as love. The strong affection of companionate love, which often emerges as a relationship matures, is enhanced by an equitable relationship and by intimate self-disclosure. True love sustains the marriage. No matter how life difficult is, the two people who are committed and bind with love can survive the storms of their relationship. Moreover, love is based on a decision and commitment. It accepts the flaws of otherââ¬â¢s behalf. Love can cover multitudes of wrongs and easily forgives. In establishing a relationship, love is very important and significant because if there is no love, the relationship cannot continue. While infatuation is based on feelings; thus, it fluctuates when it sees mistakes and flaws. It does not endure hardships. You can love the person now and the next day, you may not feel loving him anymore; thus, the special feelings you have for your partner is just based on ââ¬Å"emotionsâ⬠which is usually called as ââ¬Å"infatuation.â⬠Young individuals must not rush in making decisions in getting married but must think million times. Therefore, infatuation is a counterfeit of love. Reference: Harlow, Harry (2003). ââ¬Å"The nature of Love.â⬠American Psychologist 13:673-685. Hinkle, Dennis E., Sporakowski Michael J. (2001). Attitudes toward Love: A Reexamination.â⬠Journal of Marriage and the Family 37: 764-767. Love. 1st Corinthians 13: 4-8. The Student Bible. New International Version. à à How to cite Love vs. Infatuation, Essay examples
Saturday, May 2, 2020
Program Concerns with Care for Patients â⬠Myassignmenthelp.Com
Question: Discuss About The Program Concerns With Care For Patients? Answer: Introducation The Monash Healthcare (Nursing and Midwifery) program concerns with care for patients to be provided under various conditions including critical care and deliver ongoing educational program. Other than these this program also concentrates on providing placement for the graduates and providing them with the best clinical experience possible during training time. The graduate nurse here can be a master of things such as clinical assessment, documentation along with the necessary training for the patients at the various level or stages of the disease. Other than the routine education program, an effort has been made for the research to include evidence based practising as well as looking into new novel aspects of nursing for the beneficiary or betterment of the mankind. (Bylund, Peterson Cameron, 2012). These programs assess the competency of nurse in critical thinking, reasoning, situation handling and decision making under emergencies for the betterment of the patient. This program t eaches the need for maintenance of standards in teaching, documentation of medication and treatment provided. It also advised the nurse of the need for the strict regime of medication for the patient and role of nurse in improving the literacy of health education both for the patient and caretaker of the patient. Being a nurse myself, I apply the principle of maintaining standards in providing holistic care for the patient and have a strong background of knowledge before analysing a situation or decision making or prioritising among more than one patient. It also looks into the factors to be considered while treating acute illness in adults in comparison to the same disease in children. Further I would like to actively participate in the research which enables me to have sound knowledge both theoretically and practically. Clinical question You are caring for a male patient who suffered a fractured shaft of femur 5 days ago. He develops chest pain and shortness of breath. What would your immediate actions be? Fat embolism syndrome (FES) is most commonly associated with the any injury or damage to skeletal system and is most common among patient with long bone fracture and pelvic fracture. Development of chest pain and shortness of breath might be due to different reasons depending on type of fracture suffered which also correlates with age, gender and other factors also. In FES, soon after injury body starts releasing free fatty acids into circulation (Cathleen, 2012). Literature sights increased risk of FES in case of multiple and closed fracture and young age. FES complications include Acute Respiratory Distress syndrome (ARDS), pulmonary dysfunction and severe hypoxemia and respiratory insufficiency. The immediate nursing intervention includes providing mechanical breathing. Record the vitals while looking for shock. Check for blood pressure and history of patient for hypertension or hypotension. This may happen due to excessive loss of blood or anaemic condition and in mean time assess haemoglobin and haematocrit values (Edwards et al., 2013). Check for infection in the wound and provide antibiotic prophylaxis to prevent wound infection occurring. (With consultation to doctor). If excessive bleeding, infection or anaemic condition is noted, record in medical history and immediately consult the doctor. Pulmonary complications also result in chest pain and reduced breathing, during the acute phase nurse has to record vital signs along with breath sounds and sputum if available. (Carpinter et al., 2014). Check for blood in sputum which is indicative pulmonary dysfunction. Increase head height of bed for patient to facilitate easy breathing. Provide mechanical breathing or mouth breathing if necessary. Hypothesis Listen for auscultation of breath sounds, assess frequency, depth of breathing and chest movement. If there is any discrepancy in rate of breathing associated with elevated body temperature hints possible infection leading to pneumonia. Give medication as prescribed by a doctor, for relaxation of smooth muscles and ease up local congestion. This helps in reducing chest pain associated with easing of breathing providing better exchange of gasses. Providing chest physiotherapy or cardiothoracic physiotherapy (includes postural drainage, chest percussion, chest vibration, turning, deep breathing exercises and coughing) will be better option for the patient to improve shortness of breath which also results in indirect removal of mucus if any (Yeo et al., 2013).Provide nutritionally balanced diet and check for electrolyte and body fluid content as diminished nutrition leads to mental shock and patient with respiratory disorders requires nutrition rich diet with proper electrolyte balance. Evaluate the level of activity tolerance and provide supplemental oxygen at standard rate to improve hypoxia condition. Observe the patient for change in nails, skin colour, and mucous membranes for cyanosis which are indicative of vasoconstriction and systemic hypoxia respectively (Votile, Hoffmann Cejna, 2015). Educate the patient and family or care taker on the need for maintaining proper nutrition-rich diet and proper electrolyte and fluid balance which helps in speedy recovery and prevents readmission to hospital for same complications or increased complication. Educate the patient and care taker on need for health literacy and in the mean time explain to them the need for cardiothoracic physiotherapy, prescribed medication and adverse effects associated with it. Prioritization; The request for the addressing will be made in the order of attending Patient 2 first then patient 1, followed by patient 4 and patient 3. The rationale for the decision has been discussed below;( I think patient 4 should be first cus of shortness of breath, then patient 1 cus she needs help with ensuit and she can use her bowel, patient 2 and patient 3) Patient 2 needs medical attention first as she has to undergo analysing glucose levels before her meal. It was actually scheduled for 0600hrs but is due even at 0730. For a patient suffering the situation of patient 2 (Mrs. Walters) it isalways necessary to run on schedule with insulin scaling as it decides the amount of carbohydrate to be taken in the meal (breakfast) depending upon the blood glucose content of the body at rest(Tsujita, Sakamato Kojima, 2013). The dosage remains varied depending upon the amount of blood glucose level. As it is already 0730 and breakfast will be served by 0740 it is highly recommended to attend patient 2. Another reason to attend patient 2 is increased or decreased blood glucose severely affects body function, if not controlled may lead to coma and death. The next patient to get priority nursing facility is patient number 4, suffering from asthma. Slight coughing will help in increasing breath rate. The patient can help himself to move to take the aerosol (spacers or inhalers) and help himself to free bronchospasm. Further, the patients with asthma will be always advised have the spacers and inhalers nearby and will be given guidelines on importance of health literacy. The nurse can intervene by assessing situation with her knowledge on asthma and can help the patient by provide mechanical breathing or assist with the nebuliser with the suitable medication to increase the comfort of breathing (Vertino, 2014). This patient will be helping himself to have spacers and inhalers to ease up breathing later the nurse can intervene with the situation, analyse and can proceed further with assisting patient 4. The next immediate attention will be seek by patient 1 for Mrs Peterson is asking for help to the ensuite to use her bowels. As she has been classified as high falls risk and suffering from moderate left hemiplegia therefore attempt made by patient to move may lead to her falling from bed leading to further complications, including bone fractures (Ting et al., 2014). Patient 3 with IV infusion will be receiving last attention. The reason that Mr Young is left till last is because the infusion pump has air sensor and pressure sensor which automatically stops giving alarm indicating some error in the function. The error can be managed within stipulated period of time and there will not be complications associated with this patient. The only factor to be worried is about air embolism, but the automatic setting of the instrument for detection of air will prevent entry of air into veins creating the embolism (Sebastianet al., 2015). Professional A colleague has removed every second suture from a long wound on the lower leg. She has asked for your assistance to support the patients limb while she reapplies a dressing. A small area at the end of the suture line is moist. The wound is being dressed with MelolinTM, Combine and crepe bandage for protection and support. During the dressing your colleague drops a piece of Melolin TM on the bed and retrieves this placing it back on the dressing tray. She remarks it will be fine up the clean end of the wound. My immediate response will be to assist her to be more careful while dressing and to have sound knowledge on handling the wounds. I also suggest her to be more attentive and the mistakes she has done by not following the nursing standards and for not providing the holistic care. Firstly this represents the negligence of the nurse towards the patient and questions the holistic management and dedication by her to give the treatment to the patient. Although she has taken care to remove suture which is assisted by the another nurse (my self in this case) she forget to wash the wound with disinfectant (70% alcohol) which also assists in removing any amount of water present in and around the wound there by preventing the sepsis or further complications associated with wound healing (Craig et al., 2014) The dressing has been done with Melolin which contains strong adsorbent cotton which also assist in removal of any amount of moisture. It also helps in quick healing of the wound also. Further the nurse has taken care to provide an extra layer of dressing, protection and support with crepe bandage which is nice idea, which helps the Melolin to remain in its position intact and provide with some heat further assists in quick healing and fixing of Melolin to the wounded area (Konstantinos et al., 2012). But the nurse fails to maintain aseptic conditions and strict standards of nursing neglecting the moisture at the end of wound and dropping Melolin during the course of dressing. Although we consider that hospital premises are maintained aseptically one cannot give 100% assurance on the same as there are chances of 0.1% infection chances. Since the nurse has dropped Melolin and she thinking to apply at the end of the wound which is already having bit of moisture may further create sepsis complicating the healing of the wound. The moisture at the end acts as a good source for the growth of bacteria or bacterial activity (Langslet et al., 2014). The nurse must be more careful while applying the dressing taking proper care with use of disinfectant to remove any amount of moisture thus preventing sepsis and to be more careful while handling the bandages such as Melolin. The idea of nurse to keep the Melolin dropped back into dressing tray questions the nurse on maintaining the standards of treating and providing the h).It is always preferred to wash the wound either with hot tap water and then with agents such as hydrogen peroxide and other so that excess amount of moisture or any contaminants on the wound are completely washed and provided with the highest possible hygiene for the better curing of the wound. olistic care for the patient (safe and atraumatic removal of dressing) (Langslet et al., 2014) The nurse should employ better technique and handling of wound with a thorough knowledge on dos and donts during treating a wound. It appears that the knowledge level and training for the nurse is not adequate and sufficient enough that she is going to provide a holistic and good care for the patient. The standard guideline says to use warm water, sodium chloride, antibiotics and use of hydrogen peroxide for the cleaning of the wound prior to the applying dress (how do we know she didnt wash her hands) The nurse should have a knowledge on the type of the wound she is going to handle and the priority given to type of the bandage used and the material or ointment (Hydrophobic, low adsorbent or high adsorbent) used for the curing. Although nurse seeks help of other nurse in suture and creep bandage, she fails to recognise the moisture in the wound and neglects the moisture and doesnt maintain aseptic and proper handling of the bandage which is evident by the fact that she drops the Melo lin and puts it back in the dressing tray and suggests using it for the end of wound, which is not a standard practice according to the guideline for wound caring (Yeo et al., 2013). She doesnt worry about this although it is not a standard practise and tries to convince her friendthat its not a big problem. Finally, nurses should pay attention to their work and should have a strong background of the condition being handled (Ropp, Lin White, 2015). If faced by any dilemma nurse should consult the physician or any other experienced nurse before treating it by herself otherwise she may complicate the disease further. References Brinkert, R. (2012). A literature review of conflict communication causes, costs, benefits and interventions in nursing. Journal of Nursing Management, 18, 145-156. Doi: 10.1111/j.1365-2834.2010.01061.x. Bylund, C., Peterson, E., Cameron, K. (2012). A practitioners guide to interpersonal communication theory: An overview and exploration of selected theories. Patient Education and Counseling, 87(3), 261-267. Doi: 10.1016/j.pec.2011.10.006 Carpintero, P., Ramn, J., Caeiro, Carpintero, R., Morales, A., Samuel, S., Manuel, M. (2014). Complications of hip fractures: A review. World Journal of Orthopedic, 5(4), 402-411. Cathleen, S. C.(2012). Postoperative management of hip fractures: interventions associated with improved outcomes.A review.BoneKEyReports. 1, 241. doi: 10.1038/bonekey.2012.241 Craig, C. A., Cameron, S., Jesse, O.,Matthew, K. (2014). Fat embolism syndrome after femur fracture fixation: a case report. The Iowa Orthopaedic Journal.34, 5562. Edwards, H., Gibb, M., Finlayson, K., Jensen, R. (2013). Wound dressing guide. Promoting healthy skin, champions for skin integrity Brisbane: Queensland University of Technology. ISBN 978-1-921897-79-5 Konstantinos, P., Michael, K., Zarogoulidis, P., Maria, K., Kalliopi,D., Alexandros,M., Panagiotis, B., Stamatia,B., Alkis,I., Vasilis,Z., Nikolaos,C., Nikolaos,K., Konstantinos Z. (2012). Fat embolism due to bilateral femoral fracture: a case report. International Journal of General Medicine, 5, 5963. Langslet, E., Frihagen, F., Opland, V., Madsen, J. E., Nordsletten, L.,Figved, W. (2014). Cemented versus uncementedhemiarthroplastyfor displaced femoral neck fractures: 5-year followup of arandomized trial. ClinicalOrthopedics and Related Research,472, 1291-1299. Ropp, A., Lin, C. T., White, C. S. (2015). Coronary computed tomographyangiography for the assessment of acute chest pain in the emergencydepartment: evidence, guidelines, and tips for implementation. Journal of Thoracic Imaging, 30, 169175. Sebastiaan, H., Lucia, J. K., Alberto, L. H., Ruben, L., Albert, R. (2015). Chest CT examinations in patients presenting with acute chest pain: a pictorial review. InsightsImaging, 6, 719728. Shapiro, J. (2014). Does medical education promote professional alexithymia? A call for attendance to the emotions of patients and self in medical training. Academic Medicine, 86(3), 326-332. doi: 10.1097/ACM.0b013e3182088833 Ting, B., Zurakowski, D., Herder, L., Wagner, K., Appleton, P., Rodriguez, E. K. (2014). Pre-injury ambulatory status is associated with 1-year mortality following lateral compression Type I fractures in the geriatric population older than 80 years. Journal of Trauma and Acute Care Surgery, 76(5), 1306-1309. doi: 10.1097/TA.0000000000000212. Tsujita, K., Sakamoto, K., Kojima, S. (2013) Coronary plaque component in patients with vasospastic angina: a virtual histology intravascular ultrasound study. International Journal of Cardiology, 168, 2411-2415. Vertino, K. (2014). Effective Interpersonal Communication: A Practical Guide to Improve Your Life. The Online Journal of Issues in Nursing. 19(3), doi: 10.3912/OJIN.Vol19No03Man01. Voitle, E., Hofmann, W., Cejna, M. (2015) Aortic emergencies diagnosis and treatment: a pictorial review. Insights Imaging 6, 1732. Yeo, S. H., Chang, H. W., Sohn, S. I., Cho, C. H., Bae, K. C. (2013) Pulmonary and cerebral fat embolism syndrome after total knee replacement. Journal of Clinical and Medical Research, 5, 239242.
Subscribe to:
Posts (Atom)