Shock

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ShockThe content of this topic paper is "Shock". Shock has several different classifications, and is a progressive widespread reduction in tissue perfusion that results from a decrease in effective circulating blood volume causing a decrease in oxygen delivery and/or exchange in capillary circulation. Each type of shock involves numerous clinical manifestations that may also represent other conditions, making diagnosis difficult. So, let us take a look at the different classifications of shock Anaphylactic, Cardiogenic, Hypovolemic, and Septic. (Silvestri 00) missing comma between Silvestri and 00; period follows references.Anaphylactic shock begins as anaphylaxis, an immune and inflammatory reaction to an allergen. If this reaction is not treated the client goes into anaphylactic shock. Most common symptoms are, but not limited to, hives and swelling of the throat, lips, tongue, and around the eyes with difficulty breathing or swallowing. It only takes one or two minutes for a mild allergic reaction to escalate to anaphylaxis. Death may occur if emergency treatment is not provided. The first nursing consideration is to establish an airway and the administration of vasopressor agents, especially epinephrine and antihistamines. Oxygen should be initiated and I.V. fluids given rapidly, if indicated, along with any other emergency drugs according to facility protocol. Once the client is stable he or she should be instructed on avoiding common allergies, and how to recognize an allergic reaction. (Guyton, 16) see aboveCardiogenic shock results from any cause of heart failure and is notoriously unresponsive to treatment. With in hospital mortality rate ranging from 50% to 80%, these statistics improve with the use of percutaneous angioplasty and thrombolytic/aspirin therapy following an MI. This sentence reads awkwardly. Clinical manifestations include hypotension, urinary output of less than 0ml/hr, cold clammy skin, poor peripheral pulses, tachycardia, pulmonary congestion, tachypnea, disorientation, restlessness and continued chest pain. Nursing considerations are to administer morphine as ordered to decrease pulmonary congestion and relieve pain, administer oxygen, prepare for intubation and mechanical ventilation if necessary, administer nitrates and diuretics as ordered while monitoring B/P constantly. The nurse should also administer vasopressors and inotropics as prescribed to maintain organ perfusion, monitor ABG's and be prepared to treat imbalances, and monitor I&O. Patient should be prepared for possible intraortic balloon pump, PTCA, CABG and insertion of Swan-Ganz catheter to assess heart failure. (Houston, 17) see above about reference punctuation

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Hypovolemic shock is characterized by a decrease in intravascular volume as a result of hemorrhage or dehydration. Clinical manifestations are cool clammy skin, tachycardia, tachypnea, weak thready pulses, hypotension, mental status changes, and a decrease in urine output with the appearance being dark and concentrated. Nursing considerations consists of maintaining client on NPO status, or fluid restrictions until cause is determined. If the cause is from hemorrhage, the bleeding is controlled and possible blood transfusions to replace lost blood volume. Medications should be administered to decrease B/P, such as Dopamine and norepinephrine. If dehydration is the underlying cause, IV fluids are administered to replace electrolytes. (Rice, 11)Septic shock is an abnormal condition that occurs when there is an over whelming infection in the body. Clinical manifestations include fever, chills, lightheadedness, SOB, palpitations, cool pale extremities, elevated temperature, restlessness, agitation, lethargy or confusion. Nursing considerations consist of the administration of oxygen to treat respiratory distress if present, administration of antibiotics, IV fluids to replace lost volume, antipyretics to decrease temperature if present, vasoactive medication to treat decreased B/P, and hemodynamic monitoring for the evaluation of pressure in the heart. (Marieb, 15) In summary, the major classes of shock are anaphylactic, cardiogenic, hypovolemic, and septic. Any of the above states may be combined which would complicate the picture and reduce the possibility of a successful outcome. Shock is a life threatening condition that requires immediate medical treatment. Some degree of shock can accompany any medical emergency, and can get worse very rapidly. The nursing staff should provide additional comfort measures, along with the other implementations listed above in order to help the client regain maximum level of wellness.

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Dun have 1

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Prince Siddhartha Guatama, who would later be known as Buddha meaing one who has awakened or enlighten one . Buddhism is a religion that is practice by over 400 million people around the world, and is one of the fastest growing religion today. Buddhism is also becoming popular in the western world for a number of reason. One reason is that buddhism has many answers to the problem in modern materialistic societies. It also include a deep understanding of the human mind, which psychologists around the world are now discovering to be very effective and advance.

Buddha was born in Lumbini, Nepal on 56 B.C. Buddha's father was Suddhodana, king of the Sakhyas, and his mother name Maya. At the age of he realize that wealth and luxury did not guaranteed happiness. After six years of study and meditation he finally found the path and was enlightened. After his enlightment Buddha spent the rest of his life teaching the principles of Buddhism, until his death at the age of 80.

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"Buddhism has the characteristics of what would be expected in a cosmic religion for the future,it transcends a personal God, avoids gofmas and theologhy,it covers both the natural and spiritual, as a meaningful unity" Albert Einstein.Buddha was not a God, and didn't claim to be. He was just a man who taught a path to be enlighten from his experience. Buddha is not to be worship, though many do.Buddhists pay respect to the Buddha image not in worship or ask favors. Bowing to the statue is like you are expressing your gratitude for the teaching. Even though Buddhism is a religion, it goes beyond that to more of a philosophywhich mean love of wisdom. Buddhism do not share all belief like Christian, for instance Buddhism teaches that humans are reincaranted. It's a cycle of birth, life, death,and rebirth.One goal of that is to escape that cycle and reach Nirvana, where the mind experiences complete freedom, liberation and non attachment.That all suffering ends. Buddhism is also a belief system which is tolerant of all other beliefs of religion. Buddhism agrees with the moral teaching of other religions but Buddhism goes further by providing a long term purpose within our existence, through wisdom and true understanding. Real Buddhist is very tolerant and not concerned with labels like Christion,muslim,Hindu, or even buddhist.That is why Buddist do not preach to convert people. Buddha is more of a way shower. Buddha basic teaching is the four noble truth and the Eight-Fold path. The first out of four noble truth is life is suffering, life includes pain, getting old, diseases, giving birth, death and many more.Second Noble truth is the cause of suffering is desire and aversion. Third, Suffering can be overcome and happiness can be attained. Buddhist thinksif we give up useless craving and learn to live each day at a time not dwelling in the past or the imagined futurethen we can become happy and free.Finally the forth and last noble truth is that he Noble 8-fold path is the path which leads to the end of suffering

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Orthello

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i want an Othello, brought his own downfall upon him through his flaws, caused the suffering of many people, and he himself loss very much. All of these factors pile up to equal a big tragedy. The biggest things that one notices in the plot, are the great losses incurred by Othello. A key loss of Othello was that of his best companion, his wife, Desdemona. Desdemona was the closest person to him; no one can get closer to a guy than his wife. They were able to share their thoughts with each other and that is very powerful. The unfortunate part to it was that it only took a couple untruthful words from Iago to change Othello's opinion of her. "O, beware, my lord, of jealousy!/ It is the green eyed monster…" (III, iii). From words like this, and just a little more suggestions, Othello killed his wife. Its hard to believe that just a few well-placed words like this started a chain reaction that caused great harm to Othello. Another is how Othello lost his friends, and is faith in them. By the end of the story, Othello has lost probably his best friend he had in Cassio. He lost Cassio because he did not trust him; Othello thought Cassio was his enemy. Othello believed in Iago so much that he forgot about others. And this trust in Iago was wrongly placed; he turned out to be his true enemy. Othello brought this upon himself by blindly following Iago when he had no other reason to do so but Iago's reputation as an honest fellow. "I know, Iago, Thy honesty and love…" (II, iii).When Othello first heard of the possibility of his wife's unfaithfulness, he still had some sanity left in him; but it was the first domino of the many to fall. When he and Iago talk about Desdemona's faith, Othello demands proof of Iago's accusations. "Set on thy wife to observe…" (III, iii). The more of what he heard about Desdemona's supposed affair with Cassio, the more and more Othello started to lose control of himself and the situation. "My lord has fall'n into an epilepsy./ This is his second fit; he had one yesterday." (IV, i). His mind was so manipulated that he was never in control of himself. When he learned the truth that Iago had used him, his last chance of sanity was practically shattered.Othello's flaw was that he took for everything for how it seemed from a distance. He never did research things for himself or ask others for their view on the subject until it was too late. Shakespeare was completely correct in titling the play The Tragedy of Othello, no matter which way one is analyzing the story, literary or by public sense. For every loss that most people would use to consider it, there is flaw that correlates with the literary definition of a tragedy. Whether it was a small loss or a huge loss, it was supported with a mistake or flaw of Othello. Othello created his own downfall. Yes, it was with the aid of Iago, but he still caused it. It just took Iago to bring his flaws to the surface. Iago was a master manipulator, Othello played right into his hands, so Othello was just a victim of Iago.orthello essay please i dont have one

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Water

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Water Water is used all around us everyday and is essential in the maintenance of life. Water is a requirement of the human body for the smooth functioning of body systems. Substituting other fluids for water can negatively impact one's health, especially in the case of children. Children who drink juices in the place of water have a tendency to be overweight and are at risk for other problems associated with "normal" growth. For teens and adults, reliance on fluids other than water also has side effects. For example, the sugar in soda contributes to tooth decay in teens, while in adults, the phosphoric acid can ultimately diminish bone density. Water is an odorless, tasteless, and transparent liquid. It may look colorless in small amounts, but in large amounts such as an ocean, it looks slightly blue. Water is the most common liquid on earth. Three-fourths of earth's surface is covered with water. Water is made up of two atoms of hydrogen and one atom of oxygen. Each hydrogen atom is connected to the oxygen atom by a covalent bond. The two H-O bonds form an angle of about 105 degrees. This arrangement results in a polar molecule. A polar molecule is a molecule with a net positive charge at the hydrogen ends and a net negative charge toward the oxygen end. This substance has a great amount of surface tension. Surface tension is a result of the water molecules clinging tightly together. This surface tension is responsible for causing a leaf to float on top of the water. The only liquid with a greater surface tension than water is mercury. Mercury's atoms are so attracted to each other that they tend not to adhere to anything else. Therefore, mercury's surface is able to hold heavier objects up, unlike any other liquid. Vaporization, or evaporation, is the change of a liquid to a gas. Water has a high heat of vaporization. At water's boiling point, it takes 540 calories to change 1 gram of liquid water into vapor. Hydrogen bonding also plays a role in water's high heat of vaporization. Vaporization comes from the rapid moving molecules. These molecules break loose from the surface and enter the air. The hotter the liquid, the faster the molecules move. Therefore, the hotter the liquid gets, the more vaporization occurs. In order for a water molecule to vaporize, it must break from its hydrogen bonds. This process requires taking heat from its surroundings, which, in turn, cools those surrounding elements. This is one way in which animals and plants stabilize their temperatures. Freezing of water occurs when its density increases. The density increases as the temperature drops. The molecules start to move slower and the space decreases between them. At 0 degrees C, the freezing point of water, the water becomes its hardest, or "most stable". Water in solid form takes up a greater amount of volume than water as a liquid. Also, ice is much more dense than liquid, therefore the ice floats in liquid. Water supports many different processes. It is a crucial nutrient in the growth of the human body and is a key element in the stabilization of earth's ecosystems. Water is the most abundant liquid on earth and is also the most important. Please note that this sample paper on water is for your review only. In order to eliminate any of the plagiarism issues, it is highly recommended that you do not use it for you own writing purposes. In case you experience difficulties with writing a well structured and accurately composed paper on water, we are here to assist you. Your cheap research papers on water will be written from scratch, so you do not have to worry about its originality.

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Law

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All the directors in OI Ltd have breached their duty of care and diligence. For the breach of fiduciary duty, in accordance with the AWA Ltd v Daniels case , Frances, Harry and Indigo breached their duty of care and diligence because as directors, they owe duty of care to the company and they failed to make enquiries about the motor racing team and OI Ltd's financial position. Besides, they never keep themselves informed about all aspects of the company's business operations when deciding to accept Greg's proposal. Although Harry and Indigo are both managers from different division, however in AWA case, it was established that the degree of care to be exercised is not limited by a director's knowledge or expertise and they must do more than merely represent their particular field of experience. They failed to do so and hence breach the fiduciary duty of care and diligence.

As for James, although he is not involved in business activities and has no particular skills which benefit the operation, in accordance to AWA case, he still is required to familiarize himself with the company's business and its operations and regular attendance at board meetings is required in assisting to monitor the company's business affair. In Vrisakis v ASC , James are still required to attend all meetings also. He would have known about the company facing financial difficulties if he had went for the meeting and familiarize himself with the company's business.

Greg breached the fiduciary duty of care and diligence which was established in AWA case that directors owe a duty of care to their company. Instead of informing OI Ltd about their financial status, he proposed to the directors about the loan and induced them by mentioning to them about the benefit from the publicity they will gain. Although he is a non-executive director, but in AWA case, the court state that a non-executive director should not be entitled to rely on information and have a lower standard of care compared to executive directors.

Frances, Harry and Indigo has breached s180 (1) , because a person who is also a managing director and executive director would not have been so ignorance about checking the company's financial status before approving the proposal by Greg and also a reasonable person would have checked the financial status in the motor racing team as well as the person managing it. Here, Frances breached the statutory duty of care, s180 (1), as a reasonable managing director would have taken more steps to make more enquiries and find more information.

As for Harry and Indigo, they breached s180 (1), statutory duty of care as well. In ASIC v Adler case, they still have to make inquiries about the company's affairs. All the directors who have breached the duty of care and diligence do not have any defences as in section 180() because they did not satisfy all the business judgment rules .

Harry, manager of the motor vehicle insurance division. The duty to avoid conflicts of interests is breached where directors fail to disclose their material personal interests in transactions with the company . According to the case Furs Ltd. v Tomkies and Queensland Mines Ltd. v Hudson , a disclosure of interest to the general meeting of members or board of directors can avoid a breach of their fiduciary duty. Since Harry did not disclose his interest to OI Ltd, hence he breached his duty to avoid conflict of interest.

Directors breach their fiduciary duty if they enter into a contract where their interest is direct or indirect. This is because directors should obtain the best deal for the company and not be seen to put themselves in a position where they may further their own interest . To prove the breach of fiduciary duty of deriving personal profits by Harry, two proves are determined in Regal (Hastings) Ltd v Gulliver . First, Harry utilized his position as the manager of motor vehicle insurance division and special knowledge held by him as a director of OI Ltd to enter into contract with ITO which presumably will result in personal profit. In accordance with South Australia v Clark , Harry breached his fiduciary duty because he, as the director of OI Ltd (first company), must not exercise his power for the benefit or gain of his second company (Shifty Insurance Pty Ltd) without clearly disclosing his second company's interest to the first and obtaining OI Ltd's consent.

Under statutory law, Section 18 will be breached if officers and employees make improper use of their position to gain advantage for others . Harry's intention can be shown by him incorporating Shifty Insurance Pty Ltd and entered in the contract with ITO. Hence, according to Chew v R case, he has breached s18

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Memories

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gThank you all for all the prayers. It is good to hear . . . (If you are) wondering why I havent been injured yet . . . (its because) you all got angels and Jesus and God surrounding. . . . I pray for you all every day, too. 1th September 16It was a letter she received from her son nearly two weeks ago. Her little precious one. She looked at it and started praying again and again. She prays for him every day since he left her alone. It was a war that separated them. She was waiting. Thought of her son came back any time soon. She believed he is surrounded by angels and that kept her going. She thought about him all day believing that her son was doing what he needed to do to rid this world of terrorists. Every time she launched a different phase of the war. She was wondering how he was doing. She remembered how he was so excited when he joined the Armyc She looked at the railway located front of her. This was the place when she saw him last. She was crying over at him, begging him not to leave her alone. After all there was a phase he told her it was his job to bring peace into this place.

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There was a time when they were full of happiness. The time when his dad was still alive. His dad was a brave war warrior, who also fought for the country. She married him after he's return from the war then there was born of her little precious one. They lived just front of beautiful lake near the mountains. They didn't like to live in the city, where someone ruled over them. They only wanted freedom. When he was young he used to play war games with his dad. It wasn't ones of those silly one but you make little mad ball and threw them at each other. She was thinking how a long time can be seen as so short after while. She was scared thinking now its coming back to him as a cold metal bullet. Through his soft body lead him into cold death. All sort of thought went through her brain.

How much she loved him. She was and always. The love that they shared always seemed so true. Their time may be passed, but she will always cherish, all of the memories. Our words could not perish. As she stand alone she remembered his dreams. It all seemed so real, but nothings as it seems. Maybe time is an illusion. All of the good times, he and she shared together. Shell never forget him. Hell remain in her heart. Together forever.She was dreaming a nightmare... How many days have passed by after the day when he left? Am I still arriving? At last there was another letter. It was a report of her precious one's death. She panicked. After long pause she was walked towards where she always prayed for him. She sat there not talking, not thinking anything. She was tired, tired from her life. After one night people found her lying down on the street, as cold as ice. It was a story of how the war brings such a thing.This day September 17 year after she passed away, I pray for her. After her death there was no one to wait for his return. There was no need for it anymore. If I could talk to him now, I would tell him that she loves him and are proud of him even though they are no longer standing on the earthc

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Stress Management

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There is a strong tendency to resist the idea that we might need help. It may surprise you

to know that many more people seek help than you might think. In fact, it is likely that within

your circle of friends or colleagues, at least one person (and probably more) have gone for some

form of counseling or support. People just dont talk about it much. This leaves the impression

that counseling is for ?weak? people, or somehow means that people who seek it out are

?abnormal? in some way. It is the opposite. People who ask for help when they need it show a

maturity and awareness of themselves that others may not. Those who choose to suffer in silence

pay a price that may not be necessary. It is important to realize that if you go for counseling, it

doesnt mean that you are crazy, or abnormal. It just means that you recognize that life is crazy

enough to cause problems for the best of us.

People seek help for a number of problems. We can consider three types addictions,

personal problems, and workplace problems. Addictions to substances such as alcohol or drugs

(including prescription drugs) can be lethal. Substance dependencies can destroy careers and families and need to be addressed. Personal problems can include family difficulties such as a shaky marriage, trouble with teenagers, or the loss of a loved one. Sometimes, anxiety and depression may stem from events that occurred some time ago (e.g.. abuse). These kinds of problems can also be devastating, and cause a vicious circle. If they are not dealt with, they may increase distress. Workplace problems relate to the stress of work, difficult interpersonal relationships with colleagues, or with the boss, or the effects of drastic change in our jobs. Regardless of the types of issues you may be dealing with, counseling helps you cope more effectively with the problem. Counseling cant remove all the stresses, or fix everything but it can help you be better able to cope with what is happening.

Most governments have Educational Assistance Programs available to employees. These

programs will provide counseling or refer you to other resources that may be more appropriate. If you have a sympathetic family doctor, that may be a good place to start. There are also services offered by psychologists, psychiatrists and other agencies in the community if you prefer to go that route. Costs vary, depending on whether fees are covered by medical insurance plans (psychiatrists or other medical doctors are usually covered). It is important to realize that counselors are only human...there are good ones and bad ones. You need to find someone that you can trust, and that fits your own style.

Far more people than you would think take advantage of counseling to help them through rough periods. It is important to be alert to the possibility that your burden can be best carried by sharing the load with someone else, and sometimes friends, or family are not enough. There is help available, and seeking it out indicates that you are mature enough to recognize that you need it.

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