Care, rationale and outcome in Coronary Care Unit

Care, rationale and outcome in Coronary Care Unit Nurses are required to continue education and upgrading of skills to ensure their patients receive the best possible nursing care. Cardiac nursing is a dedicated nursing practice that gives focused and precise nursing interventions, that are governed by the best practice nursing standards using latest research based facts. Nurses need to have good technique and skill when performing health history and physical assessments to enable them to look after the person as a whole. When nursing patients, nurses need to understand the care they give and reasoning of why they deliver the cares in a certain way. A sound knowledge of assessment and observations help nurses plan, initiate and deliver health care. Without knowledge and rationales the nurse may not deliver cares in the correct manner or have the ability to know when to initiate them. Myocardial infarction is a common cause for admission into the Coronary Care Unit and this case study follows cares, rationales and outcomes in this s etting. Mr Smith (synonym for confidentiality) is a retired 58 year old man that was admitted to a Coronary Care Unit (CCU) via the Emergency Department (ED) of the Atherton Hospital. His admission diagnosis was an Anterior ST Elevated Myocardial Infarction (STEMI), which had already been treated with thrombolytic therapy. On the morning of his admission, he drove himself to the ED with chest pain. He presented with left sided chest pain that radiated to his left jaw and left arm which he scored 10/10 and described as â€Å"crushing†. He was diaphoretic and hypertensive with nausea and vomiting. An ECG showed sinus bradycardia, rate of 60 bpm with hyperacute T waves in V2-V4, that progressed to ST Elevation. Thrombolytic therapy was administered 1 hour of his presenting to ED and within 2 hours of the initial chest pain that commenced at home. His ST segment was elevated approximately 8mm and continued to increase until 70 minutes post thrombolytic when he had 50% resolution of the ST elevation. When he presented to the ED he was given oxygen, morphine, anginine, aspirin, clopidigrel and enoxaparin as first line pharmaceutical treatments. He was transferred that afternoon to Townsville. Mr Smith was not managed in Atherton due to the lack of cardiac catheter services and was transferred for a Percutaneous Coronary Intervention (PCI) the next day where he had a stent placed in his proximal area of his Left Anterior Descending Coronary Artery (LAD). Anterior MI’s affect a large surface of the heart, thrombolytic therapy and PCI are the most effective way to treat them (Evans-Murray, 2008 ). His medical history includes a previous STEMI and PCI in 1997, hypercholesterolemia, depression, a ruptured bowel and neck injury from a Motor Vehicle Accident in 1977. Upon further questioning Mr Smith admitted to recently becoming â€Å"very short of breath† whilst mowing the lawn. His risk factors include ex-smoker ceasing in 1993, hypercholesteremia, and stress of brother dying 3 weeks previous. His current medications were aspirin 100mg daily, atorvastatin 20 mg daily and zoloft 200mg daily. Upon arrival to a Townsville Coronary Care Unit (CCU), Mr Smith was pain free. He was connected to continuous cardiac monitoring and admission workup was attended, this includes admission paperwork, ECG, vital signs, mobile Chest x-ray and pathology tests. He was ordered and given stat doses of aspirin, clopidigrel and IV lasix. Mr Smith had an IVT running in his Left hand and an IVC in his Right hand.

Compare the NIMBYism Between China Three Gorges Dam and India Delhi Essay

Compare the NIMBYism Between China Three Gorges Dam and India Delhi Dam. (Research Project) - Essay Example While the authoritarian government in China hardly allows people to give own opinions, people in India have the power to complain and provide personal opinions. Due to this difference, transnational movements have great influence over the Indian people than the Chinese people. India enjoys these privileges because the country endures a democratic regime. The other key factor discussed in the paper that also creates the difference is the history of each dam project. The Indian project is much older and has resulted to more damages as compared to the Chinese dam project. People in India would more likely to perceive future disasters than the Chinese people making their case more complicated. This implies that political structure is the most important as analyzed in the paper. Dr. Yat-Sen first proposed Chinese Three Gorges dam project with the main objective being to control the flooding of Yangtze River and generation of electricity. However, according to a public opinion survey by Chetham, the local population felt that the extra energy generated by the project would not benefit them as the project was aimed at producing energy not intended to the local consumers. The dam spans River Yangtze by the Sandouping town. The dam is the largest power station in the world with respect to its installation capacity of 22,500 MW. The Three Gorges Dam became fully functional in early July 2012, but the dam itself was completed in the year 2006. At this time, the main turbines within the underground plant started production of hydroelectric power. Every main turbine is known to yield a power capacity of up to 700MW. In total, the project has 32 main turbines, which together with other smaller generators, 22,500MW of electric power is generated. On the other hand, the Delhi Dam project started with an embankment dam specifically on River Maquoketa. It was situated about two and half

Shahrukh Khan and Representation of Islam in His Movies Essay

Shahrukh Khan and Representation of Islam in His Movies - Essay Example Shahrukh khan and his movies†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦....................................................9 7. Shahrukh khan and impact of Islam in his movies†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦10 7.1 Veer Zaara and underlying mechanism†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦....10 7.2 Shahrukh’s contribution†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦............................................................13 7.3 Message of the film†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦...................................................................13 7.4 Criticisms faced and public response†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦......................................14 8. My Name Is Khan and Islam†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.....................................................14 8.1 Biased fee lings †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦........................................................................16 8.2 Message of the film†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..................................................................17 8.3 Shahrukh khan and My Name Is Khan†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦....................................18 9. ... Firstly the paper focuses on the crux of Islamic fundamentalism and their principles. Then the focus is entailed on the significant role of media and their policies to change the angle of representation of readers and viewers about societal facts and information. In this part the dominant role of media in representing Islam is also concentrated. Moving on to the next section limelight is given on the role of Bollywood and the influence of Islam in them. Then the core discussion is about Shahrukh khan’s movies and the impact of Islam in them. Three outstanding movies of Shahrukh have been adopted for this purpose as for example Veer Zaara, My Name is Khan and Hey Ram. In Veer Zaara, a marvelous cross cultural love story ahead of its times and the impact of religion and the message of communal harmony has been beautifully spun. Public responses are also shown. Then a plethora of in detailed explanation of the representation of Islam and Shahrukh khan’s most acclaimed film ,’My Name Is Khan’ has been provided. Finally ending a short discussion is also given about the movie Hey Ram where Shahrukh khan played a small role of Muslim archaeologist where also Islam has a vivid significance. 1. Introduction Shahrukh Khan, recognized as the king of Bollywood with a huge fan base, is the world’s one of the most popular movie persona in the modern times. From a new comer in the film industry with no god father behind and with tremendous passion and complex understanding for movies have made him reach the summit of success. He reigns over the hearts of millions as a romantic hero for which he is initially recognized with his super hit films