Postoperative pain management Essay Example | Topics and Well Written Essays - 3000 words

Postoperative pain management - Essay Example Management of pain following a surgery employs oral or rectal analgesics, intramuscular opioid injections, systemic opioid analgesia, continuous subcutaneous infusion of analgesics, and patient-controlled analgesia (PCA).Management of pain following a surgical procedure is one of the major challenges and source of concern for health care providers (Berge et al, 2004). However, surveys have revealed that hospital postoperative pain management, such as opioid intramuscular injections are frequently inefficient, resulting in unrelieved pain in approximately 50% of patients (Steinberg et al, 2002). Various studies have shown that postoperative pain has significant influence on the recovery of the patient, length of stay in the hospital, mobility, cost of hospitalization and also postoperative morbidity like cognitive dysfunction and pulmonary complications (Pain Management Guideline Panel., 1992). According to Sommer et al (2008), moderate to severe pain occurs in more than 50 percent of patients who undergo abdominal surgery It is crucial to control postoperative pain and currently in every hospital in the western world, control of post operative pain is given utmost importance. An understanding of pain management in the postoperative period can be enhanced through reflection. Reflection is evaluation and examination of thoughts and actions of oneself. For health practitioners, reflection means focusing on the interaction of oneself with colleagues and environment in a particular situation so that they are able to evaluate their own behavior. â€Å"Reflection gives scope for better understanding of oneself so that existing strengths can be used to build-up for future actions "(Somerville and Keeling, 2004). In order to be an effective practitioner, one must be able to identify one's strengths in approaching a problem, assess one's level of competency and improve on what one thinks are the weaknesses so that when the same problems arise in the future, the right ap proach can be adapted. Reflection is also an opportunity for professional growth and development to increase competence in the nursing practice (Alexander, Fawcett and Runciman, 2006). Reflective practice is very essential for nursing clinical practice because it helps the nurse to understand, assess and learn through the experiences during clinical practice (Burns and Grove, 2005). In the following assignment, I shall discuss about management of a patient with postoperative pain based on Gibbs (1988) Reflective Cycle. This is because, Gibbs Reflective Cycle is a straight forward and recognized framework for reflection wherein it enables clear description of the situation of the patient, the analysis of feelings, evaluation of the experience, analysis to make sense of the experience, conclusion where other points are considered and reflection upon experience to examine what you would do if situation arose again. Case description Mr. X was a 67 years old male patient, who I looked af ter in a Surgical High Dependency Unit (SHDU). He was transferred from theatre following Whipples, where a total pancreatectomy was performed along with the removal of Gall Bladder and Duodenum.  Past medical history included hypertension and chemotherapy 2 years ago following the diagnosis of pancreatic cancer. He was also underweight. The patient was transferred to SHDU in a stable condition. On the 1st day post op, the Epidural Analgesia’s catheter was dislodged by accident and according to the protocol (NHS 2009), it could not be used anymore. Although, the patient had prescribed oral pain reliefs as required, Mr. X showed discomfort and pain, once resting and moving in bed. Because of the risk of post operative complications including pressure sores and chest infection, the issue was highlighted to Pain Management Nurse, who prescribed Patient Controlled Analgesia (PCA). The Pain Management Nurse provided short educational session for Mr. X, as he never used PCA before and appeared to be anxious about

Letter of Transmittal Essay Example for Free

Letter of Transmittal Essay As per the request you made, I am writing this report to point out problem areas that Pinkberry will have to carefully consider as it attempts to expand its presence internationally, and particularly into the Kuwaiti market. For five years now, Pinkberry has established a solid reputation as the finest purveyor of frozen yogurts in the US, rising to gain the market leadership position in this category. This has largely been made possible through our unique product offering, which makes use of the highest quality, real, non-fat milk. With our success in the US market, time is ripe for the company to expand internationally and capture the global market by leveraging on this strength, which is also the source of the company’s competitive advantage. One of the prime investment destinations that we have identified is Kuwait. With a real GDP growth rate of 8. 5% in 2008, a relatively open economy, high rates of growth in the services sector driven by a boon in oil prices in recent times, opportunities for growth in this market abound for Pinkberry. Additionally, US products enjoy very favorable attitudes in the country, with the two countries having pre-existing trade relationships where the US is Kuwait’s largest import partner accounting for about 13% % of all its imports. Notwithstanding these factors, Pinkberry’s entry and subsequent success in the Kuwaiti market is likely to be tempered with various challenges. These include cultural differences between the Kuwaiti and US markets, political-legal forces, and the unavailability of local sources of raw materials. By going through this report, I believe that you will get an exhaustive appreciation of these factors, which will enable us come up with strategies that will help us effectively conquer the Kuwaiti market. I remain greatly thankful for the opportunity to prepare this report and will remain freely available for any clarifications arising. Yours faithfully, Business Development Manager, Pinkberry.

Female Genital Mutilation Essays -- Exploratory Essays Research Papers

  Ã‚  Ã‚  Ã‚  I decided to do this paper in an effort to try and become less ethnocentric and find an appreciation of cultural practices which were not of my own.   I feel I have found a deeper appreciation for many African cultural practices, but my research of African culture has exposed me to many practices that seem inhumane and barbaric. One cultural practice that I just cannot bring myself to agree with is the treatment and oppression of African women by men. Through my studies on Female Genital Mutilation, I had hoped to find a valid explanation for this procedure that is so frequently being done to women and female children.   Instead, I found something deep within myself that wishes this mutilation would come to an end.   Allow me to provide you with the facts.   Ã‚  Ã‚  Ã‚   Female Genital Mutilation, sometimes also referred to as femal circumcision, is a surgical modification of the female genitalia.   Ther are four forms of female genital mutilation.   The first is called Mild Sunna.   It is the removal of the prepuce of the clitoris.   It is comparable to male circumcision when the foreskin is removed from the penis.   Next there is the Modified Sunna which is the partial or total removal of the body of the clitoris.   Then you have the Clitoridectomy or Excision.   This is the removal of all or part of the clitoris as well as all or part of the labia minora.   Lastly, there is Infibulation or Pharaonic circumcision.   This consists of a clitoridectomy and the removal of the labia minora and also the inner layers of the labia majora.   The raw edges of the vulva are then sewn together with catgut or brought together by use of thorns.   A small sliver of wood or straw is often then inserted into the vagina to prevent complete occlusion and to ... ... Nearly one hundred fifty million females have undergone this procedure and it is estimated that each year 2 million individuals are still at risk.   I am hoping that this information will grab at the hearts of others and educate readers on the facts of Female Genital Mutilation.   With that, I devote this to my sisters in Africa in hopes that this violation will one day come to an end. Works Cited 1.   Do They Hear You When You Cry.   Fauziya Kassindja. 1998 2.   Female Genital Mutilation. American College of Obstetrics and Gynecologists Committee Opinion. Number 151. Jan. 2003 3.   Female Genital Mutilation.   Council of Scientific Affairs.   American Medical Association.   JAMA Dec. 2000. Vol.274. No. 21 4.   Infibulation in the Horn of Africa. Guy Pieters M.D. Albert B. Lowentels M.D.   New York State Journal of Medicine. April 2001. Vol. 77. Number 6. pgs.729-731

Research Method : Regression Model on the GDP of Sri Lanka

In extension Of the production function, foreign financed capital (l), export (EX) and import (IM) are added into the model to determine their impact on the economic growth. Pawl's (2002) mentioned that the import is considered will affect the economic growth which are divided into intermediate and capital good imports. Flamboyancy's (as cited in Bait, 2013) include FED as the addition input to labor and domestic capital in production function since it's the main source of human capital and new technology for new developing country.As mentioned by Namely (as cited in Bait, 2013), exports are included in the production function as more input of macro are needed. The FED stock was excluded from the Gross Capital Formation as it included both domestic and foreign investment and to avoid double measurement (Bait, 201 3) The production function extended, assuming multiple-linear equation, an Ordinary Least Squared estimate which specified below: Where -? The estimated Gross Domestic Produ ct per capita growth (annual = The Investment in terms of Gross Fixed Capital formation (% of GAP). The Labor force in terms of total (person). The Export of goods and services (% of GAP). = The Import of goods and services (% of GAP). The Gross Capital Formation (% of GAP). = The error term of the regression. In the research done by Bass, Corroboratory and Regale (as cited in Turned, 201 2) studied the long-run and the short-run relationship between the investments with the gross domestic product (GAP). The result of their finding that there are positive long-run relationship between GAP and investment where their finding are consistent with findings obtained from Khan and Khan ND Mathematician (as cited in Turned, 2012).Allah, Zamia, Faro and Jived (as cited in Hussein, 2014) have conducted a research to check whether there is nun-directional or bidirectional causality between the export and economy growth and the result suggested that there is nun-directional causality between th e economic growth and export. In addition, findings by Mishear (201 1) there exist a positive impact on the increasing of real GAP with export in the case study of India which supported by Pharaoh (as cited in Mishear, 201 1) also found that export have positive and significant impact on economic growth.The increasing number of global labor workforce represent the opportunity to drive the economic growth and the increase in the gross domestic product (GAP) but it also represent many challenges (Wristwatch Institute, 2014). With the increase of number of labor in the labor workforce, the productivity level will reach optimum level at a certain point but after that point, the productivity level will decrease as the number keep increasing.As or the case of Sir Lankan, now with the government effort to achieve upper middle income country, the increasing of the labor workforce will bring positive impact to the economic growth of Sir Lankan. According to Pawl's (2002), imported intermedia te goods have a positively and significantly influence the GAP growth in the long run. The main export of Sir Lankan is mainly architecture goods which are mainly depends on the import of fertilizers and agriculture machines. Thus it is acceptable to said that import of intermediate goods will brings positive and significant effect on the economic growth of Sir Lankan.Based on the study by Imprimatur (2013) on effects of the gross capital formation on the GAP growth in India on agriculture sector found that higher level of gross capital formation in the agriculture sector as agriculture is the main backbone of the India economy was able to improve the overall GAP growth rate. This study can be apply to Sir Lankan as Sir Land's main economy are agriculture based economy. Thus, this shows positive relationship between the Gross Capital Formation (GIF) with the Gross Domestic Product (GAP).

Problem Solution Essay

The issue concentrates on the environment and its problems. Nature is fighting back against the abuses we have inflicted on it! Due to human carelessness that damaged the environment, many communities are now suffering from environmental crisis. Food, air and water needed for life’s processes which the environment provides unfortunately contain many harmful substances called pollutants. The presence in the environment—air, water and soil—of waste materials or pollutants which the environment cannot handle, degrade, disperse or diffuse so that it becomes unclean and unhealthy is called pollution. Most pollution is caused by man. Pollutants will increase as population grows, hence, minimizing the production of pollutants and managing its proper disposal must be the goal of every human being. Air pollution that is an undesirable change in the physical and chemical characteristics of air: industrial plants, motor vehicles, indiscriminate throwing and burning of refuse everywhere make the air polluted. Prolonged exposure to air pollution may cause respiratory and other diseases as well as irritation of the eyes, nose and throat. Water pollution that contains more harmful substances such harmful bacteria and poisonous chemicals, are likely to cause gastro-intestinal diseases, cholera, typhoid fever, dysentery, infectious hepatitis, food poisoning and even death. Land pollution is when harmful substances are introduced into the soil making it unable to sustain plant life; toxic residues from the accumulation of chemicals in the land can cause cancer and other diseases. And noise pollution that refers to the presence of too loud, too sudden or very unpleasant sounds that becomes an assault to the body causing mental or physical harm, it affects not only the ears but also directly or indirectly impairs the mind and the whole body. There is a way out of this trap. In a word, it is sacrifice. The fact is that there is no way to both clean up the environment and conserve natural resources without changing the life-style of people in the industrialized nations. The challenge is that of motivating people to make the necessary changes now, before a worldwide disaster forces, much more difficult adjustments upon us.   There is no doubt that our existing resources can be used far more efficiently. It is possible for a large-scale, multiple stage recycling program to be introduced in imitation of natural ecosystems. Just as necessities of life are used by one organism after another in various ecological cycles, so human could reuse many of its essential raw materials over and over. To take a simple example, garbage could be used as fuel to run the mills to make recycled paper, the wastes from which could be burned as fuel. Similarly, it is possible that community water districts will some day become closed systems, meaning that the water would be used again and again, never being discharged into an ocean or river. Some factories already have such closed systems. It is possible to envision larger closed systems designed so that no industrial material would ever be discarded as either waste or pollution. Keeping a clean environment is the responsibility of the government, society and each individual. Today, environmental problems must be given extra attention to protect people from this danger. While it is true that the government has passed laws to make our atmosphere safer, the success of these laws depends largely on the cooperation of the populace. All of us must have knowledge of this environmental menace. Yes, there is still a gleaming hope to save our Mother Earth from total destruction. There is still a chance to regain the lost paradise we unscrupulously abused. We must do our part to make this world a safer place to live in, not just for ourselves and our neighbors but our future generations. People of the industrialized nations learned to accept a more leisurely life-style and a lower standard of living, while encouraging economic growth in the Third World. Works Cited: Barrow, C.J. Environmental Management and Development. Routledge, 2005. Caldwell, Lynton K. Environmental Policy: Transnational Issues and   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   National Trends. Quorum Books, 1997. Kemp, David D. Global Environmental Issues: A Climatological   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Approach. Routledge, 1994.

Free Essays on Death Pen

The Debate over the merits of capital punishment has endured for years, and continues to be an extremely indecisive and complicated issue. Adversaries of capital punishment point to the Marshalls and the Millgards, while proponents point to the Dahmers and Gacys. Society must be kept safe from the monstrous barbaric acts of these individuals and other killers, by taking away their lives to function and perform in our society. At the same time, we must insure that innocent people such as Marshall and Millgard are never convicted or sentenced to death for a crime that they did not commit. Many contend that the use of capital punishment as a form of deterrence does not work, as there are no fewer murders on a per- capita basis in countries or states that do have it, then those that do not. In order for capital punishment to work as a deterrence, certain events must be present in the criminal's mind prior to committing the offence. The criminal must be aware that others have been punishe d in the past for the offence that he or she is planning, and that what happened to another individual who committed this offence, can also happen to me. But individuals who commit any types of crime ranging from auto theft to 1st-Degree Murder, never take into account the consequences of their actions. Deterrence to crime, is rooted in the individuals themselves. Every human has a personal set of conduct. How much they will and will not tolerate. How far they will and will not go. This personal set of conduct can be made or be broken by friends, influences, family, home, life, etc. An individual who is never taught some sort of restraint as a child, will probably never understand any limit as to what they can do, until they have learned it themselves. Therefore, capital punishment will never truly work as a deterrent, because of human nature to ignore practised advice and to self learn. There are those who claim that capital punishment is in itself a form o... Free Essays on Death Pen Free Essays on Death Pen The Debate over the merits of capital punishment has endured for years, and continues to be an extremely indecisive and complicated issue. Adversaries of capital punishment point to the Marshalls and the Millgards, while proponents point to the Dahmers and Gacys. Society must be kept safe from the monstrous barbaric acts of these individuals and other killers, by taking away their lives to function and perform in our society. At the same time, we must insure that innocent people such as Marshall and Millgard are never convicted or sentenced to death for a crime that they did not commit. Many contend that the use of capital punishment as a form of deterrence does not work, as there are no fewer murders on a per- capita basis in countries or states that do have it, then those that do not. In order for capital punishment to work as a deterrence, certain events must be present in the criminal's mind prior to committing the offence. The criminal must be aware that others have been punishe d in the past for the offence that he or she is planning, and that what happened to another individual who committed this offence, can also happen to me. But individuals who commit any types of crime ranging from auto theft to 1st-Degree Murder, never take into account the consequences of their actions. Deterrence to crime, is rooted in the individuals themselves. Every human has a personal set of conduct. How much they will and will not tolerate. How far they will and will not go. This personal set of conduct can be made or be broken by friends, influences, family, home, life, etc. An individual who is never taught some sort of restraint as a child, will probably never understand any limit as to what they can do, until they have learned it themselves. Therefore, capital punishment will never truly work as a deterrent, because of human nature to ignore practised advice and to self learn. There are those who claim that capital punishment is in itself a form o...

Free Essays on Teens And Alcohol

Teens and Alcohol Did you know that in America we have a growing underage drinking epidemic? Will according to a research investigation we do. The research conducted by Columbia’s National Center on Addiction and Substance Abuse (CASA), underage drinking has become an epidemic in America and alcohol is the number one drug used by teens. It has shown that teens begin drinking as early as middle school and by high school graduation 80% of teens have tried alcohol. Also according to the National Institute on Alcohol Abuse and Alcoholism, teens who start drinking by the age of 15 are four more times likely to develop alcohol dependency. They have shown that over 3 million teenagers are out right alcoholics and that several million more have a serious drinking problem. Both research groups agree that alcohol causes health problems and it is also a contributing factor in the top three causes of death among teens: accidents, homicide and suicide. In order to stop this epidemic, as a society we need to teach teens what alcohol is and what alcohol does to them. They need to know what harm alcohol does to them physically and mentally. They need to know that, not only does alcohol cause harm to themselves, but when they are drinking they can cause harm to others as well. That alcohol is a dangerous and can lead them into trouble. Alcohol is a drug made when fruits, grains and vegetables are fermented. This is when a process using bacteria and yeast causes the sugars in the original food to change chemically into alcohol. Fermenting is an everyday useful process that enables us to make medicines, cheeses, vitamins and citric acids. These things help us get better when sick and gives us some of the foods we eat. Alcohol is also used in everyday life as an antiseptic, sedative and even as a cleaning product, but when consumed it can be dangerous to our health. Alcohol is an addicting drug that impairs one’s ability signif... Free Essays on Teens And Alcohol Free Essays on Teens And Alcohol Teens and Alcohol Somewhere a mother waits up for her sixteen-year-old daughter who went to a â€Å"birthday† party with her new boyfriend. The girl’s curfew was ten o’clock and it is now twelve-thirty. There comes a knocking on the door, the mother opens it to find a police officer, hat in hand, trying to find the right words to break the news gently to the worried mother. The â€Å"birthday† party was really a beer bash and at ten o’clock when the girl finally made it clear that she had to go home, the young man who had already had far too much to drink, decided to drive her home, and passed out while driving, on the train track. The locomotive was traveling about 80mph carrying the car about two miles down the tracks. The girl never had a chance to get out of the car before the train hit. The girl died on impact and the boy was pronounced DOA at the local hospital. There is a worried mother pacing the floor†¦. How many mothers have to have their families shattered by the unexpected death of their children? It is hard enough for teenagers today to grow-up. The pressures of being young are, in some cases, overwhelming. However these pressures are doubled when these young people go out and get drunk every night. Teens who consume alcohol run the risk of not growing up mentally, damaging their internal organs, and they even risk their very life. Teenagers are dying way too young due to the consumption of alcoholic beverages. Young minds must be protected whether they want to be or not the legal age for the purchase and consumption of alcoholic beverages should be raised to twenty-five. Alcohol clouds the mind and numbs the brain. Heavy drinking causes the reflexes to be sluggish. When minors get drunk, their mental processes get messed up. Some teenagers think he/she really needs a drink in order to deal with school and homework. The scribbles they call penmanship would make a newborn baby’s scribbles... Free Essays on Teens And Alcohol Teens and Alcohol Did you know that in America we have a growing underage drinking epidemic? Will according to a research investigation we do. The research conducted by Columbia’s National Center on Addiction and Substance Abuse (CASA), underage drinking has become an epidemic in America and alcohol is the number one drug used by teens. It has shown that teens begin drinking as early as middle school and by high school graduation 80% of teens have tried alcohol. Also according to the National Institute on Alcohol Abuse and Alcoholism, teens who start drinking by the age of 15 are four more times likely to develop alcohol dependency. They have shown that over 3 million teenagers are out right alcoholics and that several million more have a serious drinking problem. Both research groups agree that alcohol causes health problems and it is also a contributing factor in the top three causes of death among teens: accidents, homicide and suicide. In order to stop this epidemic, as a society we need to teach teens what alcohol is and what alcohol does to them. They need to know what harm alcohol does to them physically and mentally. They need to know that, not only does alcohol cause harm to themselves, but when they are drinking they can cause harm to others as well. That alcohol is a dangerous and can lead them into trouble. Alcohol is a drug made when fruits, grains and vegetables are fermented. This is when a process using bacteria and yeast causes the sugars in the original food to change chemically into alcohol. Fermenting is an everyday useful process that enables us to make medicines, cheeses, vitamins and citric acids. These things help us get better when sick and gives us some of the foods we eat. Alcohol is also used in everyday life as an antiseptic, sedative and even as a cleaning product, but when consumed it can be dangerous to our health. Alcohol is an addicting drug that impairs one’s ability signif...