Angina Pectoris Care Plan - Free Essay Example

Sample details Pages: 3 Words: 875 Downloads: 8 Date added: 2017/09/12 Category Advertising Essay Did you like this example? Care Plan For Angina Pectoris Angina Pectoris Chief Complaint: Patient complains of having tightness and pain in his chest that seems to move down the left arm. Patient describes the pain as being sharp and can be sometimes a mild pain or an immobilizing pain. Medical Diagnosis: Coronary Artery Disease Pathophysiology of: Angina Pectoris Angina Pectoris develops when coronary blood flow becomes inadequate to meet myocardial oxygen demand. This causes myocardial cells to switch from aerobic to anaerobic metabolism, with a progressive impairment of metabolic, mechanical, and electrical functions. Angina pectoris is the most common clinical manifestation of myocardial ischemia. It is caused by chemical and mechanical stimulation of sensory afferent nerve endings in the coronary vessels and myocardium. These nerve fibers extend from the first to fourth thoracic spinal nerves, ascending via the spinal cord to the thalamus, and from there to the cerebral cortex. (https://emedicine. medscape. com/article/150215-overview, 6/15/10 12:30 pm) Medical Interventions: Diagnostic Tests: 1. Coronary intravascular ultrasonography Don’t waste time! Our writers will create an original "Angina Pectoris Care Plan" essay for you Create order A coronary intravascular ultasonography is an invasive ultrasound performed from a transducer within the lumen of the coronary arteries. (Laboratory test and diagnostic procedures, By: Cynthia Chernicky, 5th Edition 2008). 2. Electrocardiography Electrocardiography is a noninvasive acoustic imaging procedure that determines the size, shape, position, thickness and movements of the heart valves, walls, and chambers during each cardiac cycle. (Laboratory test and diagnostic procedures, By: Cynthia Chernicky, 5th Edition 2008). 3. Lipid Profile; Blood Lipid profile; blood is a test to check the units of each of the following: A. Total lipids, B. Triglycerides C. HDL Cholesterol D. LDL Cholesterol E. Total HDL Cholesterol ratio. 4. Stress Exercise Test Stress exercise test measures the efficiency of the heart during a period of physical stress on a treadmill or on a stationary bicycle. Medications: 1. Nitroglycerin Tablets: Classification: Vasodilator, antihypertensive. Action: Reduces preload and afterload, decreasing myocardial workload and oxygen demand. Uses: To prevent or treat angina pectoris, hypertension, and heart failure. Contraindications: Acute Myocardial Infarction, angle- closure glaucoma, cerebral hemorrhage, concurrent use of phosphodiesterase inhibitors, constrictive pericarditis. Route and Dosage: Adults: PO 1 mg. tablet every 5 hours while awake. (Buccal) 0. 1To 0. 8 mg. /hr. worn 12 to 14 hours at a time. (Transdermal Patch) Adverse Reactions: Some side effects of this drug that should be reported to a healthcare provider if they become severe are as follows: †¢headaches †¢dizziness †¢flushing lightheadedness Side effects with potentially serious effects are called adverse effects and need to be reported to a healthcare provider immediately. The adverse effects of nitroglycerin are: †¢ Nausea †¢ vomiting †¢ Weakness †¢ blurred vision †¢ fainting spell †¢ abdominal pain †¢ sweating †¢ chest pain †¢ pale skin †¢ rashes †¢ peeling of the skin †¢ blisters on the skin †¢ hives †¢ itching †¢ difficulty breathing Surgery: 1Transluminal coronary angioplasty Your heart’s arteries can become clogged from a buildup of cholesterol, cells or other substances. This can reduce blood flow to your heart and cause chest discomfort. Sometimes a blood clot can suddenly form or get worse and completely block blood flow, leading to a heart attack. Angioplasty opens blocked arteries and restores normal blood flow to your heart muscle. Angioplasty, a type of percutaneous coronary intervention (PCI), is not major surgery. It is done through a small puncture in a leg or arm artery and opens a clogged heart artery by inflating a tiny balloon in it. Assessment: Subjective: Patient is a 68 year old male with a history of coronary artery disease, and hypertension. Vital Signs as follows: T: 98. 6 R: 25 P: 102 B/P: 148/98 Objective: Patient seemed to be crying and in severe pain. Skin was flushed, and clammy. Right hand was over left shoulder as if he were trying to relieve the pressure of the pain. Nursing Diagnosis: 1 Physical: 1. Acute pain related to decreased oxygen supply to the myocardium. Nursing Intervention: 1. Patient will remain on oxygen as ordered for the next 12 hours. 2. Give Nitroglycerin Tablets sublingually every 5 minutes for the next 15 minutes. 3. Patient will sleep for at least 30 minutes every 2 hours for the next 8 hour shift. Nursing Evaluation/Outcome: 1. Patient was able to be taken off of oxygen after the first 12 hours. 2. Patients pain had stopped after 15 minutes of administration of the nitroglycerin tablets. 3. Patient was able to sleep for 30 minutes every 2 hours with no interruptions in the last 8 hour shift. Nursing Diagnosis: 2 Psychosocial: 1. Anxiety related to change in lifestyle. Nursing Interventions: 1. Patient will be informed of the importance of taking the nitroglycerin at first sign of pain within an 8 hour shift. 2. Patient will learn how to decrease personal activities within 30 days. 3. Patient will join a stress management course within the next month. Nursing Evaluation/Outcome: 1. Patient was able to better understand the use of the nitroglycerin tablets after an 8 hour shift. 2. Patient was able to decrease physical activities in the last 30 days. 3. Patient was able to join a stress management course in last month. Nursing Diagnosis: 3 Potential/ Risk: 1. Defiecient Knowledge related to coronary artery disease. Nursing Interventions: 1. Patient will learn the causes of angina pectoris within an 8 hour shift. 2. Patient will learn the importance of side effects to medications within 8 hours. 3. Patient will make sure to get all information of medications before leaving the hospital. Nursing Evaluation/Outcome: 1. Patient was better able to understand what caused the angina pectori by the time he left the hospital. References 1. Laboratory test and diagnostic procedures, By: Cynthia Chernicky, 5th Edition 2008. 2. https://emedicine. medscape. com/article/150215-overview, 6/15/10 12:30 pm

To what extent was the American Civil War a conflict about...

To what extent was the American Civil War a conflict about the rights and wrongs of slavery The American Civil War was an intense, violent war fought within one of the most powerful countries in the world. The reasons for the outbreak of this war are varied. From the formation of America to 1860, the people in this country were divided. This division was a result of location and personal sentiments. Peace could not continue in a country filled with quarrels that affected the common American. There is a common misconception that the American Civil War was fought only over slavery, when in fact there were several other reasons for why the War Between the States was fought. One cannot deny that issues over the rights and wrongs of slavery†¦show more content†¦Lincoln believed slavery was wrong but necessary. During the Lincoln-Douglas debates he stated, I am not, nor ever have been, in favour of bringing about in any way the social and political equality of the white and black races. I am not, nor have ever been, in favour of making voters or jurors of Negroes, nor of qualifying them to hold office, nor to intermarry with white people; and I will say in addition to this that there is a physical difference between the white and black races which I believe will forever forbid the two races living together on terms of social and political equality. And inasmuch as they cannot so live, he added, while they do remain together there must be the position of superior and inferior and I as much as any other man is in favour of having the superior position assigned to the white race. Before the War Between the States Lincoln left the option open for the South to return and just as he had stated in the elections he told the South he would not free any slaves. Lincoln later said that he would do whatever it takes to win the war. In a letter dated August 22, 1862, he wrote, My paramount object in this struggle is to save the Union, and is not either to save or to destroy slavery. If I could save the Union without freeing any slave, I would do it. To him this included breaking the Constitution for wartime benefit which left many unhappy and felt that they could not trust Lincoln. Again,Show MoreRelatedThe Civil War Was Fought Over African American Freedom1331 Words   |  6 Pagesquestioned what was the cause of the civil war. Till this day there has not been a straightforward answer, but many people still have different views and beliefs on what caused it. Many people believe that political issues or even taxation was the cause of the civil war. However, it was rea lly over slavery. This essay will go over the civil war and explain why slavery caused the southerners and northerners to fight in the civil war. To what extent was the Civil War fought over African American freedomRead MoreSlavery And The Civil War1641 Words   |  7 PagesThe American civil war was in no doubt the most crucial event in history. No other war compares or even comes close to the casualties suffered. It helped conserve and maintain the Union, drastically changed the relationship between the federal and states government, and led to slavery’s abolition. This war has also stirred up many conflicts until this day about the conflicts and causes. Among the countless and even undiscovered questions comes the most common as being why the Southern states wereRead MoreThe Fate of Their Country Essay1081 Words   |  5 Pagesthe most direct causes of the American Civil War, he contends in the preface, one must look at the actions of governmental officeholders in the decades before that horrific conflict. Professor Michael F Holt needs no introduction among historians. 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The civil war was inevitable, only however, after one key event; the cotton gin made the civil war inevitable. The invention of the cotton gin in 1793 was the key element which enabled the south to have sufficient vested interest in their traditional lifestyle in order to feel the need to defend it at all costs even from their Northern countrymen. The core argument of this essay centres around the evidence which clearly defines their being in existence twoRead MoreThe Battle Of The Civil War1840 Words   |  8 PagesThe American civil war was fought from April 1861 through to May 1865 to determine the existence of the Union or freedom for the Confederacy. January 1861, 7 of the southern slave states declared their withdrawal from the U.S and began to form their own allied states of America. The South from then on produced and included in total 11 states, however, the north did not declare secession and stayed â€Å"loyal† to the US. Who really was to blame for the 1861 American civil war? It’s hard to find a clearRead MoreEssay On Cause Of Civil War2356 Words   |  10 Pagesï » ¿Ã¢â‚¬Å"Slavery cause the Civil War† Jeffrey W. Crawford Instructor: Dr. Peter Skirbunt Course: History 1301 College: Central Texas College Did slavery cause the Civil War? While slavery was not the only cause for the South to secede and take up arms against the United States, it was the central motivation for the Civil War. While many still debate the ultimate causes of the Civil War, Pulitzer Prize-winning author James McPherson writes that, The Civil War started because of uncompromising differencesRead MoreIs Hate A Crime?1322 Words   |  6 Pagestheir helmets and football uniforms. The James F. Byrnes High School Rebels is what we are called since its founding in 1955. I have studied history ever since elementary school and have read much about the civil war, rebel soldiers, confederate flags, and slavery. However, that is all it was to me, history. Now I sit at my desk by the window and see over 40 clansmen in white sheets waiving the Confederate flag and the American flag and marching up and down the street in front of my school. Looks likeRead MoreThe Battle Of The Confederacy3672 Words   |  15 Pagesthan it was in the 1860s. Arguments over its symbols, its flags, its leaders, its memorials, and its legacy have been almost constant over the past several years. These battles are always about one thing, the meaning of the confederacy. This usually devolves into an â€Å"it’s about slavery, it’s about states’ rights† argument with neither side listening to the other, each side convinced that it is right. Nevertheless, the question remains: what did it mean to be a confederate during the Civil War? TheRead MoreViews of American Culture in The Adventures of Huckleberry Finn1899 Words   |  8 PagesHuckleberry Finn, written in 1885, is a literary satire written by Mark Twain. The setting of the novel takes place prior to the Civil War along the Mississippi River. This novel presents moral and ethical problems that southern culture placed on individuals during the time period it was written. Twain wrote his Realist period novel to criticize what he believe d was wrong with the society of his time. Twain presented his novel through the eyes and speech of the twelve year-old Huckleberry Finn to

Evaluation of Competitor Restaurant

Question: Discuss about the Evaluation of Competitor Restaurant. Answer: Criterion 1: The most significant part of any restaurant is its food. While evaluating the Sole, too, the main concern for any reviewer will be the quality of food. The quality of food at the restaurant was impeccable. It was served fresh. The food items that were ordered were a Sole sushi combo platter with a side of spinach and garlic and a Shogun sushi platter. The total cost of the food items were $28. The quality of the fish was of a very high quality. The other food items too were supremely delicious and of a high quality. Although the price range of this restaurant is a little high, the quality of the food that it serves is fresh and is very delicious. Criterion 2 The atmosphere of the restaurant was also good and there were great drinks at decent prices. The atmosphere and ambience of a restaurant plays an important role in the customer experience and satisfaction. The atmosphere of the restaurant, the Sole, was very nice and enjoyable. There were options for having meal in a sit down setting as well as having dinner at the bar. There were selections from the raw and sushi bar, which could be ordered only after 10 p.m. This restriction of time was a little disappointing. The specialty drink, the Sole Bowl is great and is worth the money spent. Criterion 3 The most disappointing aspect of the restaurant during that night was the service of the restaurant during that particular night. During other days, the restaurant has quite a reputation for its service, which is very efficient and responsive. One of the parameters for evaluating the quality of a restaurant is the quality and efficiency of the service and behavior of the staff of the restaurant. The factor, which led to an addition in the negative point for the restaurant, was that the wait for getting a table and ordering were far too long. However, the waiters and the waitresses and the manager were very apologetic and sorry for the scenario. They explained that it was a very busy night and thus they were helpless in providing a quicker service. However, they finally made up for their slow pace of service and for the inconvenience caused by serving a complimentary dessert with the meal. The Sole, thus, has a polite but a little slow service. Another factor, which adds to the list of negative points for the restaurant, is the price range of the restaurant. The price range of the food items and the drinks are a little high. The total price of the food items that were ordered was $28, which is a little steep for many customers in that area. Summary: The restaurant, the Sole is a competition to Oz Diner. The analysis and the evaluation helped to find and indicate the loopholes and the drawbacks that exist within the business structure and organization of Oz Diner. The criteria or the parameters set for the evaluation were the quality of food, the ambience and the service. Therefore, it can be said that the Sole is a restaurant with a strong and efficient operation, serving quality foods. Thus, it can be said that the competitor to Oz Diner is stronger and there are many areas where Oz Diner can improve. The only part where the Sole lags a little behind is its price range of the food items.

The 19th or 20th Century

Table of Contents Introduction Historically Accurate and Inaccurate Instances Lessons from the Specific Period A Propaganda Film Stereotyping Parallels/Conclusion Works Cited Introduction Steered by Steven Spielberg and composed by Robert Rodat, the 1998 celluloid, Saving Private Ryan, is a ‘must watch’ chef-d’oeuvre, set in the 20th century and relatable to those who claim to be devotees of the history of World Wars. Saving Private Ryan unfolds the events of 20th century, covering countries like England, France, as well as Ireland, all of which participated in World War II.Advertising We will write a custom essay sample on The 19th or 20th Century specifically for you for only $16.05 $11/page Learn More Steven, in this captivating masterpiece, takes the viewer through a historical voyage, showing the events as they really occurred during the Second World War specifically in 1944, a year before the war ended. Some characters in th e film once existed in history, for instance, Captain Miller, once lived because his tombstone still exists. The director highlights the respective contributions of these people in the making of the present ‘history of World Wars.’ He wants to show that what people call history is no more than a past real life story experienced by people. A good number of instances in the film are historically accurate. However, Steven intentionally infixes some scenarios, which contradict the reality as unfolded by history, to meet dramatic effects as well as to imprison the attention of the viewers. However, some historically inaccurate episodes arise from Steven’s sloppiness. Historically Accurate and Inaccurate Instances In Saving Private Ryan film, the way Steven pictures the intrusion of Normandy concurs with history. The movie unfolds the events as they really occurred when this French province was invaded on 6th June 1944. The actual plan was to make sure that the Ranger companies were attacked first, so that the main objective of securing Pointe-de-Hoc and some other ‘higher grounds’ may be easily achieved. As the movie unfolds, Omaha beach is stormed arousing the horrors of the battle, which agrees with history. In addition, the way the men match towards the LCPVs to storm the beach is historically accurate because the way they suffer casualties thereafter, matches the exact happening of 1944. Moreover, as Custin points out, â€Å"The scenes from the Invasion of Normandy were correct in showing the shore just as it was on June 6, 1944† (22). The image of the shore in the movie resembles the real picture as it was then. For instance, the evident blood covering the sands on the shore matches the real picture as it stood in 1944. More so, just as the dead bodies lie scattered besides the shore with the bloody waters of the ocean passes for the real scenario. The boats employed in the movie matches with the ones used then. The movi e pictures a cemetery at the Normandy province, which resembles the exact one in France, referred to as the ‘Normandy American Cemetery.’ The names of some characters and places used by Steven, match with the real names of those who fought the war. Finnigan proves the existence of Miller when he says, â€Å"†¦and I do believe Captain Miller were real people†¦there are tombstones to prove it† (Para. 7) However, as aforementioned, some scenarios in the movie are historically inaccurate.Advertising Looking for essay on history? Let's see if we can help you! Get your first paper with 15% OFF Learn More History has it that Omaha beach was swept away by the third wave but not the first as the movie insinuates. Private Ryan is no more than a fictional character that never existed in history, though he plays the role of Frederick Niland, a real person from the 101st airborne section. There is no sufficient historical information concerning this pe rson as the movie depicts. However, he was among the four men, whose three brothers died at various places during World War II, with his mother receiving the death information at ago. Historically, there lacks evidence of any attempts to search for him as Steven pictures in his film. In addition, during the last battle, the soldiers did not use the phrase, ‘Lets rock and roll’ the movie shows; the phrase used then is ‘Lets lock and load.’ Many people have commented on the reasons behind the inaccuracies portrayed by the filmmakers. The inclusion of names and places that did not exist then makes the movie somewhat intriguing hence captures the viewers’ attention. In addition, they appear in order to meet the movie’s objectives. For instance, Frederick’s history had to be modified for the purpose of ‘narrative expediency’. On the other hand, mistaking the words as they were really used is a sign of carelessness of the filmmak ers. Lessons from the Specific Period The viewer learns a lot about a specific time in history. Firstly, the picture of the World War II becomes clear. The war stands as a real life experience, rather than a mere fiction. The viewer learns a good deal of the entire period of 1939-1945. It is a period when people went through severely hard time, following the many fights that saw the death of their beloved parents, brothers, sisters, relatives, and friends as well as enemies. This period stands as one when peace was the cry of all, but the deed of few. It is a period when all people, men and women, young and old participated in the fight. Just as the viewer is driven to tears by the events in the movie, it is a lesson that, 1944 was no more than a year dominated by tears. It depicts the price of the peace that people enjoy nowadays. Freedom is not the yearning of the liberals, but of the captives, just like the biblical story of the children of Israel. It comes through a lot of pains , sacrifices and sufferings. Therefore, it suffices to infer that, today’s freedom is a result of yesterday’s painful experiences such as those of 1944. A Propaganda Film Critics declare the film a complete propaganda where the director wants to sway people to a particular way of thinking. For instance,† A prime example of American Propaganda occurs after a group of Germans kill one American soldier near what looks to be a communications area with a huge satellite.Advertising We will write a custom essay sample on The 19th or 20th Century specifically for you for only $16.05 $11/page Learn More One German soldier remains alive, and in a plea to no be killed he says, ‘I love America’† (Hurst 4). Therefore, it suffices to infer that the movie glorifies the role of America in the War and not any other country, hence propaganda. Steven, in a technical way, uses it to convince a nation, stricken by war, that sacrificing to fight back can help restore peace. This does not regard whether one dies, or is injured in the process. Symbolically, he gives powerful countries like America, a mandate to give orders to other countries. For instance, the movie talks about saving Private Ryan. This can be interpreted in a variety of ways, both negative and positive. Firstly, one can conclude that Steven refers to America’s power to choose which or who to or who not to assist. Secondly, one can deduce that Steven wants to show the role that powerful people or countries, like America, ought to play in times of crises: to save rather than to kill, as it was during World War II. In addition, the movie passes for propaganda because, Steven can be mistaken for speaking in favour of wars, a case that can in turn induce the predicted third world war. Stereotyping The issue of stereotyping comes in handy in the film. For instance, it is a fact that the boats were steered by a British navy, but what the movie pict ures is a Jerseyan stereotype that arises since a Jerseyan pilot seems quite entertaining compared to the British. Steven seems to favour the issue of stereotypes. This stands in the way he strategically locates his characters. For instance, Tom Sizemore, acts as the deft sergeant, Edward Burns is the quick-tempered Private Raiben, among others. The employed stereotypes are not damaging. It is worth noting that the use of stereotypes in the movie has contributed to its evident strength and the excellent performance. When Steven employs these stereotypical characters, his message to the viewers stands better conveyed compared to the situation with non-stereotypical actors. Parallels/Conclusion In conclusion, building on the day-to-day happenings, there stands out events parallel to what Steven depicts in his work. For instance, just as America stands powerful, with a significant role to play in the film, so is the case today. It is a super power nation, whose role and significance ou tweighs that of the rest. In addition, whenever any war strikes any country, America has to be involved in ‘saving’ or rather bringing the situation to normal. The Israel-Afghanistan conflicts serve as the best illustration of this. America comes out as the dominant peacemaker. In addition, the exclusion of the troops of other countries in any peace-building process stands today. If the American forces are incorporated, it is of less significance to involve others. All, these, among others, are in accord with what Steven brings out in his masterpiece.Advertising Looking for essay on history? Let's see if we can help you! Get your first paper with 15% OFF Learn More Works Cited Custin, Davis. Saving Private Ryan: Historical Accuracy. London: Word Press, 2004. P. 22. Print. Finnigan, Charles. Saving Private Ryan, 2010. Web. Hurst, Lynda. Saving Private Ryan: Propaganda. Oxford: Oxford Publishers, 2002. This essay on The 19th or 20th Century was written and submitted by user Addison Randolph to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.