Theoretical Framework in Nursing Process Essay Example for Free

Theoretical Framework in Nursing Process Essay Think back to the last time someone close to you became sick. Using Myra Estrin Levine’s conservation model: what would have been the focus of your assessment? How did the illness affect you and the rest of your family? Levine’s Conservation Model  is focused in promoting adaptation and maintaining wholeness using the principles of conservation. The model guides the nurse to focus on the influences and responses at the organismic level. The nurse accomplishes the goals of the model through the conservation of energy, structure, and personal and social integrity (Levine, 1967). Although conservation is fundamental to the outcomes expected when the model is used, Levine also discussed two other important concepts critical to the use of her model – adaptation and wholeness. (http://nursingtheories. blogspot. com, retrieved April 16, 2012) Now recalling the recent hospitalization of patient RG (my girlfriend) due to vaso-vagal syncope, I unknowingly applied all of the four conservation principles, as well as the major concepts that revolve around the model. A few days prior to admission, patient RG reported to began having episodes of constipation. Two hours prior to admission, she stated that she woke up due to severe abdominal pain and directly went to the bathroom. A few moments later she was found by her mom on the floor, just regaining her consciousness and with a deep, moderately bleeding, 2-cm laceration on the right cheek bone area. She was rushed to the emergency room and was eventually brought to the OR for repair of facial laceration by a plastic surgeon. I happened to be on duty at that time and, as expected, was the one to attend to her during her stay in the ER. Standard ER protocols would lead me to primarily assess for changes her level of consciousness (should the origin would be neurological in nature), followed by a brief review of systems – any variation from the normal vital signs would deem significant for a patient who’s chief complaint is loss of consciousness (should the origin would be cardiac in nature). Immediately, the theory of conservation would imply that the patient should temporarily be placed on bed rest while we still determine the possible cause of the problem (conservation of energy). Simultaneously, measures were done to revent infection from and further bleeding of the laceration (conservation of structural integrity). When the bleeding has been controlled and tests and other basic interventions have already been done, I tried on keeping her mind as far away as possible from worrying about the probable effects of the cheek injury and the development of a facial scar with her self-image perception (cons ervation of personal integrity). Lastly, as I was already on the outgoing shift, I made sure that I stayed with her even after my duty for additional support until she was brought up to the OR (conservation of social integrity). Once she was out of the OR, it was advised that she still be confined for the next 24 hours for observation and to make sure that the episode of loss of consciousness would not recur again. After being discharged, she was advised by her attending physician to rest for a additional week prior to going back to work. Apparently the facial damage has also exposed her facial nerves which also had to be repaired. In addition, her parotid gland has also been injured, causing facial swelling whenever she eats. For the next week she had to adapt with the condition and I was there for her helping her adjust with the challenges and though out the whole ordeal. To make matters worse, the injury on her facial nerves caused weakness on her facial muscles leaving her central incisors to become unstable, resulting into even more pain and discomfort when eating and chewing. This caused strain in our relationship as she was highly irritable most of the time. It was as hard for me and for the rest of her family as it was for her as we are all clearly affected by her disability/limitations. Still, that did not deter us from being all there to support her. In two weeks, the swelling improved and the pain went away. She started eating normally again and the scar on her face became barely noticeable. Without realizing it, I have put into good use Myra Levine’s conservation theory. B. Using Roy’s model of adaptation, what were her adaptive needs in the following modes: physiologic, interdependence, role function, and self-concept In the physiologic mode, adaptation is concerned about the preservation of physical integrity (Fawcett, 1984). Basic human needs such as oxygenation, nutrition, elimination, activity and rest, protection, and temperature regulation are identified with this mode. In addition, the body’s complex processes in the form of fluid, electrolyte, and acid-base balances as well as the neurologic and endocrine functions are also taken into consideration (Manriquez, 2009). In the interdependence mode, emphasis is on the need for social integrity. Interdependence entails maintaining balance between dependence and independence of an individual’s relationship with others. Dependent behaviors can be observed as affection-seeking, help-seeking, and  attention-seeking. Independent behaviors include mastery of obstacles and initiative taking. Manriquez (2009) describes this as â€Å"the need is to achieve relational integrity using the process of affectional adequacy†, i. e. the giving and receiving of love, respect and value through effective relations and communication. In the role function mode, the need for social integrity is also emphasized. When human beings adapt to various role changes that occur throughout a lifetime, they are adapting in this mode. Knowing who one is, in relation to others, so one can act is the primary essence of this mode. â€Å"Role set† is the complex of positions that an individual holds which involve role development, instrumental and expressive behaviors as well as the role-taking process (Manriquez, 2009). In a group setup such as a family, the role can be assessed by observing the communication patterns. The need is role clarity, understanding and committing to fulfill expected tasks so the group can achieve common goals. For example, when a couple adjusts their lifestyle appropriately following retirement from full-time employment, they are adapting in this mode (Wikipedia retrieved April 24, 2012). In self-concept mode, the need for maintenance of psychic and spiritual integrity is its main function. Perceptions of one’s physical and personal self are included in this mode. (Wikipedia retrieved April 24, 2012). The goal is to exist with a sense of unity, meaning, and purposefulness in the universe (Manriquez, 2009).

Prosopagnosias Affect on Daily Life Essay -- Psychology, Mental Healt

In Psychology, there are a wide range of disorders, all of which disrupt a person’s life at varying levels. As a result of this, the Diagnostic Statistical Manual of Mental Disorders is used to diagnose a person with a certain disorder and determine the extent to which the disorder affects their ability to function in society. However, the DSM-IV does not address all of the disorders that people can be troubled with. There are four axes to the DSM-IV: axis I which takes into account clinical disorders, axis II looks at personality disorders, axis III diagnoses acute medical conditions, axis IV is psychosocial and environmental factors and axis V determines a person’s ability to function in society. Agnosia is one of the many disorders that cannot be classified under the any of the axes of the DSM-IV although it is a brain disorder. A specific type of agnosia that has recently been heavily represented in the media is prosopagnosia. Prosopagnosia is a mysterious disorder as the etiology is unknown and there is much variance to the disorder by the individual. As the degree in which this disorder affects the lives of people cannot be determined using typical methods, to what extent does prosopagnosia affect a person’s life? Prosopagnosia is the scientific name for what is commonly known as â€Å"face-blindness.† It is a neurological disorder characterized by a person’s lack of ability to recognize faces (â€Å"Prosopagnosia Information,† 2007). What makes a person having prosopagnosia different than a person who is just â€Å"bad with faces† is that, with prosopagnosia, a deficit in face recognition in the presence of relatively normal object recognition exists (Righart & Gelder, 2007). This means that a person with prosopagnosia cannot recognize... ...Prosopagnosia and PET Study of Normal Subjects [and Discussion]. Philosophical Transactions: Biological Sciences. (pp. 55-62). Vol. 335. Royal Society. Shearer, D., and Peter M. (1996). Effect of Facial Familiarity and Task Requirement on Electrodermal Activity. The American Journal of Psychology (pp. 131-37). Vol. 109. University of Illinois. Simulation of Talking Faces in the Human Brain Improves Auditory Speech Rocognition. (2008) Proceedings of the National Academy of Sciences of the United States of America (pp. 6747-6752). Ed. Dale Purves. Vol. 105. National Academy of Sciences. Song, S. (2006). Do I Know You? Time. Weingarten, G. (2008). Losing Face. The Washington Post. Young, A., and Perrett, D. (1992). â€Å"Face Recognition Impairments [and Discussion].† Philisophical Transactions: Biological Sciences. (pp. 47-54) Vol. 335. Royal Society.

Congenital Adrenal Hyper Plasia Health And Social Care Essay

To, find the clinical presentation of inborn adrenal hyperplasia and to detect the short term response to intervention. Design: Case series survey.Topographic point AND DURATION OF STUDY:The survey extended over a period of one twelvemonth from July 2007 To July 2008 in Paediatric section Chandka Medical College Larkana.MATERIAL AND METHODS:All kids showing with purging desiccation, daze, failure to boom and equivocal genital organs were examined and investigated exhaustively. The chief stay of the diagnosing was raised degree of serum 17OHP in kid with implicative clinical characteristic.Consequence:A sum of 30 kids were found to hold CAH during the survey period. The major clinical characteristics a presentation were purging 8 ( 26.7 % ) , equivocal genital organs 7 ( 23.3 % ) emesis and failure to boom 1 ( 3.3 % ) . All the patients were followed up after induction of intervention and response was observed.Decision:The survey highlights the importance of common clinical symptoms like, purging being the presenting characteristics of CAH and the effectivity of the replacing therapy in bettering life endangering exigencies due to this status.Cardinal WORDS:Congenitaladrenalhyperphase ( CAH ) ,17 hydroxyprogesterone ( 17 OHP ) , cytochrome P 450 protein ( CYP ) . correspondence to: Dr. Shanti Lal, Assistant Professor Pediatricss *Dr. Abdul Ghani Shaikh Assistant Professor Surgery ** Dr. Amanullah Abassi Assistant Professor Urology Chandka Medical College, Larkana dr.shantilal @ yahoo.comIntroductionCAH is a familial upset characterized by a lack in the endocrine hydrocortisone and aldosterone and an over production of the endocrine androgen, which is present at birth and affects sexual development. The upset is inherited as an autosomal recessive defect in congenital enzyme synthesis. As such there is history of early neonatal decease in the household. The clinical manifestations of the disease relate to the grade of hydrocortisone lack, aldosterone lack, or lack of both and, in some instances, to the accretion of precursor adrenocortical endocrines. These precursors cause abnormalcies such as masculinization or high blood pressure when nowadays in supraphysiologic concentration many of the enzymes involved in hydrocortisone and aldosterone syntheses are cytochrome p450 proteins designated CYP. CYP21 refers to 21-hydroxylase, CYP11B1 refers to 11-beta-hydroxylase, and CYP17 refers to 17-alpha-hydroxylase. Excess adrenal androgen production be gins in early foetal life in authoritative CAH-21 affected babies, and causes unnatural growing of misss ‘ button and masculinisation of the genital-urinary constructions. Badly affected misss may be mistaken for male childs at birth. Affected male childs have no venereal deformities at birth, but continued androgen extra causes remarkably fast organic structure growing. Inappropriately early pubescence leads to premature completion of growing and short concluding grownup height [ 1- 3 ] . Severe signifiers of inborn adrenal hyperplasia are potentially fatal if unrecognised and untreated because of the terrible hydrocortisone and aldosterone lacks that result in salt cachexia, hyponatremia, hyperkalemia, desiccation, and hypotension [ 1,6,7 ] . Females with some signifiers of adrenal hyperplasia ( i.e. , CYP21 lack, CYP11B1, partial 3-beta-hydroxysteroid dehydrogenase lack ) have equivocal genital organs at birth ( authoritative masculinizing adrenal hyperplasia ) or later become virilized in childhood ( simple masculinizing adrenal hyperplasia ) or in adolescence and maturity ( nonclassic masculinizing adrenal hyperplasia ) . Males with CYP21 lack are non by and large identified in the neonatal period because their genital organs are normal. If the defect is terrible, ensuing in salt cachexia, these male babies are seen at 1-4 hebdomads of age because of failure to boom, recurrent emesis, desiccation, and daze. Some babies are ab initio misdiagnosed with stomach flu o r pyloric stricture [ 1,2,6 ] . Hyponatremia and hyperkalemia should raise the possibility of adrenal inadequacy. Two signifiers of adrenal hyperplasia ( i.e. , CYP11B1 lack, CYP17 lack ) consequence in high blood pressure [ 1,2,6,7 ] Congenital adrenal hyperplasia occur among people of all races. Congenital adrenal hyperplasia because all signifiers of inborn adrenal hyperplasia are autosomal recessionary upsets, both sexes are affected with equal frequence [ 1 ] . All kids including neonate who have purging and/or desiccating are diagnosed as acute stomach flu. This consequences in certain congenital mistakes of metamorphosis particularly CAH being overlooked, unsuitably treated and consequences in increasing preventable mortality earlier in life. The intent of survey is to depict our experience of placing CAH in footings of their presentation and short term intervention.Patients AND METHODSThis crossectional survey was carried out in paediatric section of Chandka Medical College Larkana from July 2007 to July 20 08. The chief purpose of the survey was to happen out the chief manners of presentation of CAH and to see the response of intervention on short term footing. A successful response to replacement therapy observed within a period of two to four was surcease of emesis, need for endovenous fluid therapy and failure to boom. All patients suspected to hold CAH i.e. with clinical characteristics and raised serum degrees of 170HP were included in the survey. A elaborate history ( purging, failure to boom, sibling decease ) followed by thorough physical scrutiny ( blood force per unit area, hydration, misss for equivocal genital organs and male childs for precocious pubescence ) was carried out. Probes done included complete blood count, blood sugar, serum carbamide and electrolytes ( Na 130 – 150 mmol/l ; potassium 3.5 – 4.0 mmol/l ) , karyotyping and serum17OHP degrees ( Normal & A ; lt ; 100 ng/dl ) . Classical salt blowing assortment have 17 OHP degrees & A ; gt ; 2000 mg/dl ; Classical virilizing & A ; gt ; 1000 ng/dl and nonclassical = 100 – 200 ng/dl. Karyotyping was done in patients with equivocal genital organs to set up the diagnosing of CAH in our survey. Classically they had to be female karyotype who was virilized [ 4 ] . Patients that had other grounds for equivocal genital organs and failure to boom like nephritic cannular defects etc were excluded from the survey. All probes were carried out in Patholo gy Department Chandka Medical College Larkana except 17 OHP and Karyotyping from Agha Khan University Laboratory. All patients were treated with replacing therapy including cortisol 50 mg/M2 stat followed by 1000 milligram / M2/ twenty-four hours 6 hourly, tapered to 20 milligrams / M2 /day. In salt losing assortment ab initio normal saline 20 milliliter / kilogram was repeated if necessary followed by florinated steroid ( fludrocortisone – 0.15 milligram / M2 ) was given. The response to the criterion paediatric pattern was studied.ConsequenceSum of 30 patients were diagnosed to hold CAH. The age scope of kids was from 4 to 180 yearss with a average age at the clip of presentation was 39.67 yearss. ( table-1 -fig-1 ) the sex distribution was about equal ( table-2-fig-2 ) . The chief clinical characteristics included emesis, equivocal genital organ, desiccation and failure to boom ( table-3 ) . Probes of all the patients showed raised degrees of 17OHP. Karyotyping was done in patients with equivocal genital organs. All instances diagnosed to hold CAH were put on replacing therapy. Short term response was observed after a period of 4 hebdomads. All instances showed positive response shortly after the induction of therapy. The patients who presented with failure to boom started deriving weight. As emesis was the major symptom at presentation, it responded good to intervention. Children showing with equivocal genital organs were put on replacing therapy and subsequently referred for surgical intervention i.e. clitoroplasty.DiscussionCAH is chiefly disease of early babyhood as the average age of presentation in our survey is 39 yearss. It is widely present all over the universe with equal male to female ratio [ 1,2 ] . The present survey besides shows the same consequence with average age of presentation being 39.67 yearss. However there is little male preponderance in our survey ( 56.7 % ) . Clinical characteristics observed in this survey are in conformance with other surveies.The frequent manners of presentation include purging, equivocal genital organ ( Fig-1 ) , daze and failure to boom [ 1,2 ] . Some patients presented merely one symptom and other with two or three marks and symptoms togetherTable- 1: Outstanding characteristics of the 30 instances studied.Average age of presentation ( yearss ) 39.67 Male: female ratio 1.5:1 Major symptom/sign ( purging n equivocal genital organs 10 ( 33.3 % ) Positive Family history/Neonatal decease 10 ( 33 % )Figure: 1Equivocal Genitalia Ambiguous GenitaliaTable-2: Gender distribution.No of PatientsPercentagesFemale 13 43.3 % Male 17 56.7 %Table-3: Presenting characteristics of the instances.No of PatientsPercentagesVomiting 8 26.7 % Equivocal genital organs 7 2.3 % Vomiting and equivocal genital organs 10 33.3 % Failure to boom 1 3.3 % Daze 4 13.3 %Figure: 2Equivocal Genitalia Ambiguous GenitaliaTable-4: Treatment.No of PatientsPercentagesHydrocortisone 7 23.3 % Hydrocortisone and fluodrocortisone 23 76.7 % Most of the kids in our survey presented with relentless purging since birth. This was ab initio thought of, because of enteric obstructor like pyloric stricture or simple regurgitation of milk, which is much more common in immature babies. Vomiting, as the lone presenting characteristic makes the diagnosing small hard but it is frequently associated with equivocal genital organs particularly in females i.e. clitoromegaly. Females are recognized because of equivocal genital organs, but males have normal genital organs and are non diagnosed until subsequently, frequently with a salt losing crisis [ 8 ] . Another of import clinical mark was failure to boom. It was present along with emesis and besides as the lone presenting characteristic. Salt also-rans besides presented in a province of daze. The criterion for diagnosing was raised degrees of 17OHP [ 4,5 ] . As the diagnostic installations are easy available, diagnosing at an early age with induction of intervention is possible. 21 h ydroxylase lacks ( CYP 21 ) is the most common signifier. Approximately 50 % of patients with authoritative inborn adrenal hyperplasia from CYP 21 lack have salt blowing due to inadequate aldosterone synthesis. One tierce of patients in our survey presented with grounds of salt blowing [ 8 ] . Bing an autosomal recessionary upset, there is 25 % opportunity that the status will be found in the siblings of the patient. In our survey there was an increased incidence ( 33 % of the patients ) of upset in siblings of patients in our survey. Incidence in all the patients could non be found as some of the patients were the first issues of the parents. Even in those, in whom the upset was suspected, merely clinical diagnosing was thought of on the footing of early neonatal decease. However attempts should be made in set uping antenatal diagnosing possible as intrauterine Decadron during the first trimester helps in cut downing opportunities of equivocal genital organ. This is done via chorio nic villus trying in first trimester at 8 hebdomads gestation [ 1-3 ] . Amniocentesis at 12 hebdomads can besides be done. As a antenatal direction step, Dexamethasone ( 10 – 20 ug /kg / twenty-four hours ) at diagnosing of gestation is started. Stop the intervention in male childs and unaffected misss. Affected misss in whom Decadron should be continued, maternal urinary estriol ( mark & A ; lt ; 375 ng/ deciliter ) are followed up [ 8,9 ] .DecisionFollowing points are drawn from our survey:  · CAH is fundamentally a disease of early babyhood  · The usual presenting ailments are really common like purging, desiccation and failure to boom.  · Prompt intervention with replacing therapy can efficaciously abort a life endangering province.

Epic Hero In Beowulf - 1134 Words

What is a hero? The technical, dictionary definition of a hero according to the EOD (English Oxford Dictionary) is â€Å"a person who is admired for their courage, outstanding achievements, and noble qualities† (â€Å"Hero†). While this seems like a fairly reasonable definition, do all heroes possess all of these qualities? During the medieval times, stories were told of knights and of fierce warriors who all became heroes for defeating beasts, going on grand adventures, and fighting for love. But were they really heroes according to the definition? Figures such as knights, kings, and warriors often were courageous and made great accomplishments. However, in many cases they lacked what even many modern-day heroes do: nobility. â€Å"Beowulf†, an epic†¦show more content†¦While these men aren’t your typical â€Å"everyday heroes† they still have some heroic qualities like courage and persistence. However, like Beowulf, they are still lacking some as well. The knight himself (the one who is telling the story of the cousins) was described in the general prologue as â€Å"a worthy man... [who] loved chivalry, truth, honour, freedom, and all courtesy† and was â€Å"a truly perfect, gentle knight† (2-3). Along with possessing these noble qualities, he had also fough t many battles. The description Chaucer made for the knight was that of a true hero. However, the knight’s characters were not quite as noble as he was. Arcita and Palamon, sworn brothers who almost died together in battle, were not given very good descriptions, but based on their actions and interactions with each other, neither had very much honor. When they both fell in love with Emily, the Duke’s (Theseus’) sister-in-law, they argued over who would have her. However, neither man was in the position to be hers anyways because they were both jailed for life. But when Arcita was released yet banished, he couldn’t help but disguise himself and return to Athens so he could continue watching her. However, Palamon too was dishonorable by escaping from prison. When Palamon revealed himself to Arcita after seeing him in the woods, they stillShow MoreRelatedThe Epic Of Beowulf As An Epic Hero1519 Words   |  7 Pagesaway following a journey, you have most lik ely read an epic. An epic by definition is â€Å"a long poem, typically one derived from ancient oral tradition, narrating the deeds and adventures of heroic or legendary figures or the history of a nation†. Every epic has a main character that undergoes the same archetypal journey as all other heroes, an epic hero. There are specific qualities one must have to be considered an epic hero. Each epic hero possesses superhuman strength, displays a strong sense ofRead MoreThe Epic Of Beowulf As An Epic Hero711 Words   |  3 Pagesthan the writer. These â€Å"epic heros† are protagonists that fulfill their potential of greatness through using their bravery, strength and humility for good. The near ancient tale of Beowulf is a classic example of an epic story that contains an epic hero. In this tale Hrothgar, the king of the Danes, has been terrorized by a beast known as Grendel. This beast has been murdering the king’s people and no one has come close to stopping this killer. A Geat warrior named Beowulf hears of the King’s predicamentRead MoreBeowulf : An Epic Hero930 Words   |  4 Pages The story of Beowulf shows its reader many characteristics of why this Anglo-Saxon poem is an epic. First of all, Beowulf is a warrior of epic renown by the time he formally introduces himself in the poem. Next, Beowulf is the warrior that many strive to be in life. In addition, Beowulf finds himself tackling many quests that involve dangerous beasts, or as he might call them, demons. The next quality shown by Beowulf is his bravery and honor. 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There are two versions of his story which portrays him in a certain way. The video version does not do its best to portray him as an epic hero but instead show that he is a liar, a womanizer, and a coward. TheRead MoreBeowulf : An Epic Hero894 Words   |  4 Pages The character of Beowulf demonstrates several characteristics that make a great epic hero. Throughout his lifetime he displayed several characteristics such as honor, bravery, physical superiority, leadership, and glory. These characteristics all formed how the Anglo-Saxons believed one should live their life. Along with the valorous deeds that Beowulf accomplished he is considered to be a prime example of an epic hero. Beowulf would have even been considered a model human to the Anglo-SaxonsRead MoreBeowulf : An Epic Hero978 Words   |  4 Pages Beowulf is a character that exudes the qualities of an epic hero. Throughout this epic, Beowulf is seen as a hero to many and a major threat to the evils he encounters. The values of the Anglo-Saxons, who would have read and admired this poem, included loyalty, bravery, and honor. Beowulf’s character exemplifies all of these qualities to the highest degree. The values and traditions of the original composers of this story cause Beowulf’s character to be the perfect example of an Anglo-SaxonRead MoreBeowulf: an Epic Hero983 Words   |  4 PagesGauvain British Literature Beowulf Essay 9/22/04 Beowulf: An Epic Hero According to Abrams, the heroic poem is a long verse narrative on a serious subject, told in an elevated style, and centered on a heroic or quasi-divine figure on whose actions depends the fate of a tribe, a nation, or the human race. Beowulf fits Abrams description of an epic, exhibiting all of the characteristics listed throughout the book, thus defining Beowulf as a hero and making the book an epic through its elevatedRead MoreBeowulf, the Epic Hero1431 Words   |  6 PagesBeowulf, the Epic Hero There have been many grand stories about great warriors, and champions; those about epic heroes however, are the truly exceptional tales. One such tale, over a thousand years old, stands out from all the rest: Beowulf, the tale of a great warrior, on his quest to achieve eternal glory, defeating great opponents. Throughout the whole story, Beowulf demonstrates most –if not all- of the qualities that an archetypal hero possesses. He embodies the highest ideals of his cultureRead MoreBeowulf : The Epic Hero960 Words   |  4 PagesPotter, and Beowulf all have in common? They all demonstrate the qualities of epic heroes. Beowulf represents several characteristics of an epic hero and demonstrates the values of the Anglo-Saxons. He is the main character of his story, he has a main goal, he travels and fights with a group of people, and he accomplishes many valorous deeds; the values of the Anglo-Saxons are also shown through the actions of Beowulf, such as courage, loyalty, an d fame. For example, when Beowulf heard a cry