The Modern World Human Exposure - 869 Words

From the beginning of time and creation, human being was surrounded by nature. In the earlier times humans had more exposure to nature in their daily life activities such as the members of hunting and gathering societies mostly survived by hunting animals, fishing, and gathering plants and members of pastoral societies and horticultural societies lived on open lands, relied on their animals, plants, fruits, vegetables and planted crops for survival. Early human societies completely depended upon their immediate environment. However, in the modern world human exposure to nature has drastically reduced. Industrialization and urbanization has brought changes in almost every aspect of society. For example accelerated development over the last century, and particularly the post-war decades, natural environments and the wildlife have come under increased pressure. â€Å"Now, much of world’s natural forest, wetlands, rivers, lakes and coastal environments have been destroyed or se riously degraded as a consequence of development and pollution†. Human activity has altered the dynamics and functioning of the Earth systems and broken harmony with nature to a degree never seen before. (https://en.wikipedia.org/wiki/Harmony_with_nature). However, there is now a very important shift happening in the modern world especially of architecture and design. Humans are awakening to the reality that we are part of the larger ecosystem of the earth and that our creations can both injure and heal theShow MoreRelated Effects of Microwave Radiation On The Human Body Essay1554 Words   |  7 Pages Effects of Microwave Radiation On The Human Body I am going to research the effects of microwave radiation on the human body mainly from mobile phones. I am going to collect a wide range of information from a number of reliable and different sources. To research the effects of microwave radiation on the human body I am going to look at five different sources. Firstly I am going to look at the Internet to find two sources of information one from a scientific organisationRead MoreThe Walking Dead1495 Words   |  6 Pagesspecial effects and its subtle commentary on hope and the human condition. Watching the hour-long gorefest in which infected men, woman and even children are repeatedly shown receiving violent and bloody blows to the head, one cannot help but wonder, is â€Å"The Walking Dead’s† portrayal of violence harmful in its appeal to debased human interests or does it ultimately provide a hopeful look at the human spirit trying to survive in a bleak world? One look at primetime’s lineup of this or that network’sRead MoreSociological Concepts Of Identity And Globalization1083 Words   |  5 PagesSuggested by Van Kreiken, sociology helps researchers ‘understand the world around them, especially how it is changing. (Kreiken 2011, p2) thus it is only natural that sociologists are intrigued at how relationships operate and their evolution over the past century. This essay will endeavor to critically examine the sociological concepts of identity and globalization, and the manner in which they have swayed the aspect of human relationships in Australian society, over the course of history. My JapaneseRead MoreAdvantages and Disadvantages of Modern Communications751 Words   |  4 PagesFrom day to day, our world has been changed gradually form one condition to another. The revolution of new ideas always comes up to the minds of every person, especially the idea to improve technology which people need to make the living better. As the result, modern technology has been bringing people certain advantages such as ways for fast communication, the improvement of traveling, and good health care medical treatment. However, loneliness, world destruction weapons, pollution, and samenessRead MoreAn Essay on Cause and Effect972 Words   |  4 Pagesï » ¿Cause and Effect essay: A change in the way you deal with other people Introduction The human civilization, from the beginning of the times, has been dictated by constant cultural and social changes. These cultural and social changes did not only have a significant on the lifestyles of human beings around the world, but it also effected on how people deal with one and other. It must be noted that human civilization across the globe has remained in the constant process of evolution and no matterRead MoreThe Hidden Truth Behind Violence in Modern Society781 Words   |  4 Pagesviolent behavior or attitudes toward another, is spreading throughout the globe like a disease, corrupting our modern society. The drastic increase in violent and aggressive behavior in modern society can be attributed directly to the prevalence of drug and alcohol abuse, easy availability of deadly weapons and the limitless exposure to mass media that celebrates these behaviors. Within modern society, one of the primary causes of violence and aggression is the proliferate abuse of drugs and alcoholRead MoreCause And Effect Of Pollution721 Words   |  3 PagesEvery day, millions of humans, plants, and animals are affected by pollution. Cancer, disease, and kidney failure are just some of the rapidly increasing effects. Pollution is a growing concern that is gradually changing the way the environment and ecosystem function. With thousands of foreign and natural contaminants being pumped into the environment every day, serious action will need to be taken to reverse the life-threatening effects of pollution. Although, some could argue that pollution isRead MoreRhetorical Analysis Of The Clock Shadows And Dark And Gritty 1583 Words   |  7 Pagessociety is an imitation of our reality. If so, then our contemporary entertainment era overstocked in brooding, morally ambiguous anti-heroes bearing five o’clock shadows and â€Å"dark and gritty† narratives are a reflection of the flawed and unrelenting modern-day reality that we inhabit. This age of morally gray storytelling is a stark contrast to the idealistic depictions of American society and â€Å"traditional family values† found throughout various 1950s television (Museum of Broadcast Communications)Read MoreRadioactive Material And Its Effects On Society1659 Words   |  7 PagesRadioactive Caves Over exposure to radioactive material is known for causing slow and painful deaths. Many equate it with decaying life, however people still willingly subject them selves to its exposure. Since radon’s discovery, there have been many different viewpoints about its power and potency. Some proclaim its amazing power to heal, while others fear its strength and destructive nature. The paradox of these very differing views about what radon really is has caused controversy and many conflictsRead MoreOccupational Exposure To Diisocyanates In Polyurethane Foam Factory Workers788 Words   |  4 Pages Everyday, millions of works around the world are exposed to dangerous chemicals in the manufacturing of the modern world. Today, more then ever, the use of toxics materials and chemicals are used in many every day products. In order to protect workers from these hazards, safety professional must use a wide range of test and monitoring instruments. â€Å"Occupational Exposure to Diisocyan ates in Polyurethane Foam Factory Workers† was research conducted in Poland by Dominka Ã…Å¡wierczynska-Machura, Slawomir

Analysis of the Wine Industry - 3427 Words

PESTLE ANALYSIS OF INDIAN WINE INDUSTRY FOR MANUFACTURING AND LAUNCHING AUSTRALIAN WINE JACOB’S CREEK IN INDIA -Joohi Kamath Table of Contents Serial Number Topic Page Number 1 Abstract 2 Abstract The below mentioned report is a PESTLE analysis on the wine industry in India, which is a potential market for Australian Wine Jacob’s Creek owned and produced by Orlando Wines; currently a part of Pernod Ricard Pacific, a wholly owned subsidiary of Pernod Ricard to launch a base in India and expand their business. Pernod Ricard – The Distributor Pernod Ricard is a French company that produces distilled beverages. It was founded in 1975. It s the largest MNC in the wine and†¦show more content†¦India‘s federal, state and local policies have been controlling the Indian market, a factor that both encourages the growth of the Indian wine market and domestic industry while at the same time increasing the difficulty of foreign brands and their ability to penetrate into the marketplace. But there are risks and rewards inherent with this emerging market. The import duty on bulk wine was zero from 2001 till 2003/04. In the year 2004/05 the duty for wine imported in bulk was raised to the same level as that of imported bottled wine. Simultaneously, the state excise duty on bulk wine which was Rs7 per litre was raised to Rs200 per litre, and later to 200% of CIF value. Hence the concept of bulk wine being imported then bottled in India is no longer feasible. The Central Government levies import duty, in addition to which each State Government further impose their own taxes on imported wine. The taxes levied vary from state to state. They are complex and keep changing on a fairly regular basis. Because of the complex tax structure and permit regulations it is very hard for a distributor in one state to sell the product to buyers in another state. Each state has different levels of taxation as well as varying labelling requirements, Types of labels, fees for registering labels, etc which need to be adhered to. Wine exporting countries, through their High Commissions and Embassies in India, been making representationsShow MoreRelatedWine Industry Analysis2724 Words   |  11 PagesUS winery industry had a growth rate of 4.7% between 2006 and 2011, and is expected to grow by a rate of 4.9% over the next five years [ (IBISWorld) ]. In California alone an average of 175 wineries have opened every year since 2000 [ (Richard Green) ]. The states of New York and Virginia have been major players in the US wine industry. The data shows that the demand for wine has been increasing at an exponential rate over the past 5 years. Average annual revenue for the wine industry is expectedRead MorePESTLE analysis on wine industry1112 Words   |  5 PagesPESTLE analysis on wine industry Constellation Brands, EJ Gallo Winery, and Wine Group are amongst the three top producers of Wine in the United States. The success of the three organization have been acquired from the recent acquisitions, as well as, their capability of changing with the consumers needs the three major issues which the wine industry is currently being faced with entail upholds the standards of advertising, the corporate buyouts threat as well as, the increasing wine market. IndustryRead MoreWine Industry Analysis of China7515 Words   |  31 PagesChina, India amp; Wine | May 19 2011 | Assessing the global environment and developing solutions for Australian international managers: a WebQuest. (5461 words) | Sheena Bobeechun Troy Credlin Sarah Duff Audrey James. | Table of Contents Executive Summary 3 PESTL Analysis 4 Political amp; Legal Factors (Author - Sarah Duff) 4 Economic Factors (Author - Sheena Bobeechun) 5 Social amp; Cultural Factors (Author - Audrey James) 7 Technological Factors (Author - TroyRead MorePestle Analysis: Brazil Wine Industry2157 Words   |  9 PagesBRAZIL PESTLE ANALYSIS MANAGEMENT 100 – ASSESSMENT 1 1. INTRODUCTION The purpose of this report is to provide Penfolds Winery all the information needed by the company to expand its business interests into Brazilian wine market. The data will be gathered through extensive research of the Brazilian wine market and an internal analysis of Penfolds winery to discover the what the company has and what it needs to have in order for the Brazilian enterprise to be successful. The recommendationRead MoreEssay on Industry Analysis Report the Australian Wine Industry1947 Words   |  8 PagesINDUSTRY ANALYSIS REPORT THE AUSTRALIAN WINE INDUSTRY ‘The Boutique Producer’ by 4 students (anonymous) Executive Summary This report provides an overview of the Australian Wine Industry using Porter’s Five Forces industry analysis framework and seeks to provide recommendations based on the impact of the forces for a start up boutique producer. Through the use of Porters framework and the application of economic theory, the report will provide detailed insight into theRead MoreEssay about PESTEL Analysis of Wine Industry625 Words   |  3 PagesHW#1 A Macro-Environmental Analysis of the Wine Industry in Turkey A factor that influence a companys or products development but that is outside of the companys control is known as macro environment. In this paper, all dimensions that affect that wine industry in Turkey are investigated. It is important to observe the wine industry in terms of political, economic, socio-cultural, technological and natural aspects; it is called as PESTEL analysis. This analysis which provides the deeper lookRead MoreRobert Mondavi and the Wine Industry Case Analysis2143 Words   |  9 PagesExecutive Decision Making Strategic Analysis Robert Mondavi and The Wine Industry, HBS 9-302-102 (Case 1) Post-Class Analysis Individual Assignment Student: à lvaro Toro I. Executive Summary On May 2001, Michael Mondavi took over the position of chairman of Robert Mondavi Company, as well Greg Evans assumed as CEO. They company was founded in 1966, and has became one of the world’s finest and most innovative winemakers, currently having sales for 480 millions, and firm’s marketRead MoreA Report On The Wine Industry, Based On Analysis And Theories For The Current Market3564 Words   |  15 Pagesnot to invest in Tunisian wine industry, based on analysis and theories for the current market. It will point out all the advantages and disadvantages of investing in there and will make a recommendation based on many factors. The first part will talk briefly about Tunisia and will point out all the relevant information that can affect a newly started business in there. It will also go in depth by inserting Michel Porter’s national competitive advantage of industries (Diamond Theory) into theRead MoreRobert Mondavi Corporation: Study Notes760 Words   |  3 PagesQuestion one: the premium U.S domestic wine market and industry The premium U.S domestic wine market and industry had approximately 1500 players or wineries. The concentration of the wine industry had segmentations with the top ten players within the market control more than two thirds of the total production shares. The production of wine was prevalent in all states with the exception of the state of Alaska (Silverman et al, 2001). Selling of wine within the industry was in three tiers (wineries, wholesalersRead MoreSupporting and Promoting Iowa Wines in the Market Place1160 Words   |  5 PagesIntroduction In order to support and promote Iowa wines in the market place, the Iowa Wine Growers Association, assisted by the Midwest Grapes and Wines Industry Institute, has established the Iowa Quality Wine Consortium (IQWC). IQWC will help with consumer awareness and confidence in choosing Iowa quality wines. Identifying an Iowa Quality Wine An Iowa IQ Wine will have the Iowa Quality Wine seal placed on the bottle just above the right corner of main label without covering any information (Illustrated

Graded Unit Free Essays

| | |This project contains information about activity of exercise which I will do with a service user at my placement. It will base on | |sociological and psychological knowledge and also current policies and legislations. | | | |I am student in a local authority day centre. We will write a custom essay sample on Graded Unit or any similar topic only for you Order Now My placement supports adults with physical and sensual impairment. The day centre | |provides range of different groups designed for disabled people. I have chosen an exercise group to my project to describe an | |individual service user. | |The organisation is registered service and regulated by the Care Inspectorate which was established by Regulation of Care ( Scotland| |) Act 2001. Trained and qualified staff works with the Scottish Social Services Council (SSSC) requirements. All service users | |within the placement are treated accordingly with the criteria delineated by the National Care Standards – Support Services. |Each service user in the organisation has his key worker, who creates an individual care plan based on assessments and taking into | |account the needs and expectations of the individual. | |As a student in the placement I comply with all regulations listed above. In the centre I provide appropriate level of care and help| |in taking part in all available activities. Treat all service users with dignity, privacy, give to all service users choice, provide| |safety, allow realising potential and take account of equality and diversity to each individual. |I chose an individual who I named Mr X to the provisions of the Data Protection Act 1998 to mention that personal information have | |to be used in fully anonymous as awareness of confidentiality and one of a main principal of National Care Standards and SSSC – to | |respect a privacy of service user. | | | |Mr X is disabled since 2009 after when he had cerebrovascular accident (CVA) and resulting in his left sided weakness. Despite his | |disability he still lives in his own home and has a support worker. He is keen to remain as independent as possible but is | |frustrated by his poor mobility. He uses wheelchair fulltime and suffers from epilepsy and diabetes. | |Mr X grew up in nuclear family. He had both parents and sibling – brother and four sisters. His siblings and his mother still live | |and they all are in very good relation to each other. | |Mr X grew up in very familiar environment during his primary socialisation and values gained through this time transferred on his | |later life. He also had a lot of friends. Mr X was very attached to his family and treats closest people as the most important. As | |Bowlby’s theory of attachment says that through attachment to mother Mr X’s basic physiological needs had been satisfied in primary | |socialization. | |(Malim. T, Birch. A. ,1998) | | | |According to one of functionalists George Murdock theory that family performs four main functions. One of the functions is | |reproductive function relate to rising children and take responsibility for them. | |(I. Marsh, M. Keating, S. Punch, J. Harden; 2009) | |Firstly Mr X was attached to his mother as she was his primary caregiver while in his adulthood he directed his attention to his | |wife. She took care of him after the loss of his mobility. | | | |Eli Zaretsky, one of Marxists says that view of ideal family, detached from economic world is only illusion. He means that families | |are a source of cheap labour. In according to Mr X’s life I can say that he and his wife were also parts of the ‘family economy’. He| |worked with Scottish Water and his wife was a cleaner in local school and also as nursing auxiliary. They had spent mostly time at | |their work places which caused lack of time to spend with children. | |(Zaretsky. E; 1976) | |Now his source of socialisation is only his family, mainly his sons who he sees regularly. | | | |Mr X experienced feeling of loss. Firstly he lost his health through CVA and his wife which passed away two years after he became | |disabled. |Based on Elizabeth Kubler – Ross On Death and Dying research in which she presented five stages model by which I going to describe | |Mr X’s feelings: | |Denial and isolation – Mr X after lost his health and wife felt that what had happened was very unfair and hard to accept by him. | |Anger – Mr X felt that God does not exist because in other way the tragic situation would never have happened. | |Bargaining – Is a form of truce, begging and promising himself and God, trying to make a deal with the God. |Depression – Mr X gave up and became resigned and lack of motivation to continue living. | |Acceptance – Mr X accepts the present life with the supports of hisfamily. Also classes in the Day Centre give a new meaning to his | |life. | |(E. Kubler – Ross; 2003 ) | | | |To analyse a personal needs and development of Mr X I use PIES model of needs and Maslow’s Hierarchy of Human Motivation. |There are four categories: physical need to improve Mr X’s mobility, intellectual need to through communication and reflects on the | |choice of appropriate equipment to perform an exercises, emotional to rise Mr X’ self esteem and strengthen his self – confidence, | |and also social need as interaction with other service users. | | | |Maslow’s hierarchy of human motivation believes that to achieved the higher-order needs must first meet the basic needs. |During Mr X’s healthy life he was happy and fully satisfi ed. He had love each other family – wife and two sons so he felt | |belongingness and been attached, he was working so was independent and also received respect from colleagues. He had also very | |active social life. Mr X used to enjoy playing golf and football during his healthy life so he was very active person. He has seen | |himself as very sociable individual enjoying a beer with friends. He was leading successful life until became disable. The | |disability made him unable to do things from previous days. His motivation decreased and he became very frustrated. | |(R. Gross; 2005) | | | |I started my preparation to an activity with a consultation with a manager. I chose as activity exercise group and gained permission| |from the manager to perform the activity. Then I discussed my chose with Mr X’s key worker and also gained from the key worker a | |care plan of the service user and other significant information regarding Mr X’s background, family, health condition and general | |risk assessment. | | | |An important factor for me was a conversation with Mr X and eventually gained permission from him. I explained clearly to the | |service user how the activity will be proceeded. Through the conversation and observation of Mr X’s I learnt what he expects from | |the activity. Also I assured him of his right to choose a course of the activity whether to amend decision. I am going to abide by | |the rules such as National Care Standards by giving to Mr X choice and treat him with dignity and communicate with him in | |appropriate and open way. | |Thanks exercises he hopes to regain the mobility in legs. In the exercise group he feels is given him a purpose to get up of bed and| |the opportunity to interact with his peers in a supported environment. | |I spoke with the leader of exercise class about the course and the main objectives of group. Also the leader informed me that the | |exercise group will take place in main hall of the placement and showed me the room in which it is held needed equipment. | | | |In my placement is using personal – centred planning model of care. The idea of the model was created by O’Brien and Lovett. This | |model is targeted for people who want to change something in their life. The model also focuses on make individuals as independence | |as possible. Mr X has significant left sided weakness and he requires a high level of assistance with all tasks and activities. He | |would like to attend a local gym to work more on building strength on his left side. He also discussed with his support worker a | |possibility of using community venues out with the Day Centre that may have activities running that would keep him busy and involve. | | | | | |For my project as I mentioned I chose exercise group. Main purpose of activities is to keep Mr X as fit as possible, encourage him | |to exercise and more motivated to make progress in becoming back to his mobility. It will make him a lot of satisfaction and | |increase their confidence and belief in his own abilities. Classes also will allow him to be among peers to avoid allowing it to | |feeling of isolation. During the activity I will communicate with Mr X in openly and clearly as awareness of SSSC Codes of Practice | |and Human Rights Act 1998. | |To my activity I intend to use the appropriate music played from a CD and exercise equipment stored in a designated lockable room. |The first step will bring a stroller with the equipment and the preparation of music Initially, it will be simple exercises in the | |warm-up then we will use selected by Mr X weights, stretching equipment and balls. To carry out a risk assessment I will carefully | |check environment if there are any type of hazards such as spillages on a floor or other obst acles around Mr X and others service | |users, remove these threats. Also all equipment to be checked if there are any damaged equipment and remove them. I have to make | |sure that the individual took appropriate medication due to his epilepsy and diabetes. |I planned my activity on 19 of March 2013. The activity will take about 70 minutes with 10 minute break for tea, coffee or something| |cooling to drink in terms of the diabetes of Mr X which excludes sweetened beverages. | |During my activity I will use personal – centred planning model of care because the model let me focus on the individual | |expectations and also let me be fully involved into the activity as Mr X as well. As a method I would be most likely to use | |Essential Lifestyle Plan of Method of Intervention. During this method is taken into account a health condition, communication. | |Health and safety of the individual is a priority as maintaining Health and Safety at Work Act 1974. | |In case of Mr X is very suitable to him the Essential Lifestyle Plan to achieve the objectives which is to give satisfaction to Mr | |X, being able to do exercises that will increase their confidence and belief in their own abilities I am going to be patient and | |empathic, also treat with respect Mr X’s choice in the type of exercises to underpinning Equality Act 2010, National Care Standards | |and SSSC. |To maintain Safe Practice during performance of activity I make sure that I provide the safest environment for Mr X and other | |service users, myself and leading worker. During this I comply with Health and Safety at Work Act 1974. | | | |As a contingency plan I will go with Mr X to a local museum because the service user is sympathetic to the history of the town. | | | |In the above project I contained my plan for an activity focusing on needs and development of Mr X. Information above includes | |method and model of care to be used, sociological and psychological concepts which helped me better understand and feelings and | |needs of the service user in terms of regulations and polices underpin antidiscrimination practice and principles essential in | |social care. | |REFERENCES | |Alangul. S, Meggitt. C; Further Studies for Social Care; 2002 | |Bingham. E; HNC in Social Care; 2009 | |Gross. R; The Science of Mind and Behaviour; 2005 | |Kubler – Ross. E; On Death and Dying; 2003 | |Maclean. S, Shiner. M; Social Care and the Law in Scotland; 2011 | |Malim. T, Birch. A. , Introductory Psychology ; 1998 | |Marsh. I, Keating M, Punch. S, Harden. J; Sociology – Making Sense of Society; 2009 | |Miller. J, Gibb. S, Baker. G, Graham. D, Lancaster. E, Hollis. S; Care in practice for Higher Still ; 2005 | |O’Donnell. M; Introduction to Sociology; 1997 | |Zaretsky. E; Capitalism, the Family and Personal Life; 1976 | | | | | |http://www. learning-theories. com/maslows-hierarchy-of-needs. html | |http://www. simplypsychology. org/Erik-Erikson. tml | | | |Codes of Practice for Social Service Workers and Employers | |General Risk Assessment of Mr X | |National Care Standards – Support Services | |Personal Care Plan of Individual and additional information gained from manager and individual’s key worker | Word Count |1 868 | How to cite Graded Unit, Papers

Clinical Remediation Activities

Questions: 1. What do you consider to be the main priorities of care for Mr. Teng in the first 24 hours post-op? 2. Describe the assessments that you would undertake in the post-operative period to enable early detection of potential post-op complications? 3. Day 1 post-op. At 1000hrs you assess Mr. Tengs vital signs to be? 4. Identify the immediate nursing priorities of care, with associated rationales, for James on admission to the Emergency Department? 5. Explain why rest and reassurance are an important aspect of James ongoing care? 6. James asks you if he is having a heart attack. What would your response be? 7. How do pre-existing medical conditions predispose Bill to post-operative complications? 8. What are the most likely post-operative complications to develop for Bill? 9. What pre and post-operative nursing interventions will be essential while taking care of this patient? 10. What are the priority nursing interventions on admission to the ward? 11. What are Mrs Johnsons risk factors for peripheral arterial disease? 12. Outline the primary nursing responsibilities when caring for Mrs Johnson? Answers: 1. The key priority of Mr. Teng in first 24 hours post-op include the pain management, control of patients breathing after anaesthesia and proper wound care. 2. The assessments that would be undertaken in post-operative period include: A-E assessment Pain score measurement Consciousness of patients 3. The assessment of data is suggesting a fluid imbalance of Mr. Teng, as a post-operative complication. Other data that helped in clarifying findings are a lower BP, 98/65 and 100 ml urination since 12 midnight. The student nurse will inform the registered nurse, who is patients in-charge and administration of fluid retention medication. 4. James would be admitted to the emergency department immediately and then he would be assessed through cardiac MRI and ECG (Doenges, Moorhouse Murr, 2016). Based on diagnosis, nitroglycerin would be administered, as it helps in widening blood vessel and more blood flow to heart muscle with relieving pain. 5. Sometimes, in case of angina pecortis, chest pain lasts for longer period, in other cases, like exercise-induced chest pain last for less time, however, it becomes difficult to distinguish the cause of chest pain, thus, rest and reassurance of the cause of chest pain is important to be considered for getting proper ECG result. 6. The immediate response to Jamess query would be not sure, prior having the ECG and CT scan reports, which would confirm whether he had an angina or heart attack. 7. Bill has previous history of type 2 diabetes mellitus, smoking history and hypertension and on auscultation, respiratory tract disease. Thus, these medical conditions can pre-dispose to poor immunity, tendency of delayed recovery and breathing problem. Answer 2 8. Bill can have several post-operative complications like delayed wound recovery, blood loss during surgery and risk of revive after anaesthesia. 9. Pre and post operative assessments are required to ensure healthy condition of patient. A-E assessment, fluid balance and consciousness should be assessed during both pre and post operative period. 10. During admission, taking the incident report, medical history and reason for admission should be noted. 11. Risk factors of developing peripheral arterial disease by Mrs. Johnson are her medical history of hypertension, myocardial infarction, smoking history and type 1 diabetes. 12. The key responsibilities of the caring nurse towards Mrs. Johnson include proper wound management, surgical site infection prevention, control of blood pressure and blood sugar level (Gulanick Myers, 2013). Bedside check AM Shift Patient/time 0700 0800 0900 1000 1100 1200 1300 1400 1500 Mr. Campbel Atenolol due Mr. Nash Oral antibiotic due Physiotherapy appointment, dressings are stained and peeling Panadol due Oral antibiotic due Mr. Bates Usual meds Appointment with hand physiotherapist Panadol due Discharge Mrs. Brason Sinemet tablet due Regular meds due Sinemet tablet due Regular meds due Sinemet tablet due Regular meds due Triggers Patient Triggers Bed 1 What are the complications related to abdominal polyps? Why doctors ordered to cease IV fluids immediately? What is the cause behind patients infrequent urination? What is the role of atenolol at this time? Bed 2 Why the team doctors of the patient suggested ceasing PCA and starting Oxycotin BD with Endone PRN? What are the post knee surgery complications? What others information a nurse should know to ensure proper wound management? Bed 3 What complications may the patient experience, while travelling by train after 1 day of left hand surgery? What complications he can experience during post surgery period? What is the information, which should be conveyed to patient regarding recovery and follow ups? Bed 4 What are patients input and output data? What are the risk factors associated with her symptoms like poor skin turgor and dry mucous membrane? What is the role of Sinemet tablets in her care plan? What should be key priorities of a nurse dealing with a patient experiencing parkinsons disease along with additional complications? Nursing priorities Patient Triggers Bed 1 To ensure ending the IV fluid after receiving the order of doctor Assessment of abdominal discomfort and documenting the assessment findings Conveying the findings to doctors and work according to the doctors orders Taking observations of the patients vital signs after every 4 hours Proper administration of scheduled medications (Kalisch et al., 2011) Completing all the documentation prior patients discharge Communication with the patient and family regarding follow up and further threatments Bed 2 Post-surgical wound management and infection control through maintaining hygiene measures Dressing to be reviewed and dressed accordingly - ensure wound chart in place (Urden, Stacy Lough, 2014) Ensure patient has been charted for regular Oxycontin BD and Endone PRN regime after PCA has been taken down Pain score assessment after scheduled interval Keep patient adhered to the physiotherapy sessions at scheduled time Bed 3 To ensure proper wound dressing and management To ensure proper infection control and hygiene measures while dealing with the surgical wound Documentation of pain score Communication with the patient regarding complications he may have, while travelling by train at this condition Administering due medicines at the scheduled time ordered by doctor(Kalisch et al., 2011) Assisting the patient in the physiotherapy session Communicating with patient regarding the follow up sessions Bed 4 To assist the patient in her ADLs To assist the patient with emotional and moral support To ensure the patient is consuming required amount of water needed To document proper input and output data of the patient To assess the patients skin integrity and inform the doctor regarding this To ensure proper dressing of wound and infection control (Urden, Stacy Lough, 2014) To ensure proper administration of patients regular medication at scheduled time To document patients vital signs at scheduled time interval Progress Notes Bed 1 Patient name: Mr. Campbell Sex: Male Age: 40 yrs Date and time Notes 0400 hrs Temp- 37.2 degree Celsius, HR- 80 bpm, BP- 150/75 mmHg and RR- 14 rpm. 0800 Patient reported mild abdominal discomfort BP has been lowered to 120/70 mmHg and there was no complain regarding abdominal discomfort prior discharge Passed urine 3 times with a bladder scan result of 40 mls 1400 hrs Patients wife will pick him up upon discharge Bed 2 Patient name: Mr. Nash Sex: Male Age: No information Date and time Notes 0600 hrs Temp- 36.5 degree Celsius, HR-65bpm, BP-110/65mmHg and RR-12rpm, patient appeared to be drowsy but conscious, he was able to communicate 0800 hrs After PCA has been taken down, he had been administered with Oxycontin and Endone 0900 hrs Patient visited physiotherapy session and mobilisation would be reviewed in the afternoon Dressing was done after physiotherapy session. It was observed that the surgical site is oozing. Gauze and Mepilex border has been used for dressing. Dressing need not to be changed regularly, it should be changed only when needed Bed 3 Patient name: Mr. Bates Sex: Male Age: No information Date and time Notes 0800 hrs His regular medicine has been administered 1000 hrs Patient had a physiotherapy appointment. Patient is able to elevate his arm as much as possible and recommended to use arm sling, if needed 1200 hrs Panadol has been administered 1400 hrs Patient will be discharged after review at hand clinic Analgesia script ready for patient Discharge forms and instruction provided to the patient Bed 4 Patient name: Mrs. Branson Sex: Female Age: 90 yrs Date and time Notes 0700 Sinement administered to the patient 0800 Patients regular medicine has been administered 1100 Sinement administered to the patient 1200 Patients regular medicine has been administered 1300 Sinement administered to the patient 1400 Patients regular medicine has been administered Oral intake of the patient has been increased after consulting with speech pathologist and geriatric consult The patient appears to be confused and facing difficult in communicating with staff The patient needs assistance during shower and incontinence pad applied Mrs Branson has been put on a strict fluid balance chart. With the help of assistance and encouragement, she is drinking fairly well Patient has been categorized to have falls risk, for this, fall assessment form and Waterlow charts updated ISBAR Handover Information What do you like to include? I Introduction Parkinson disease is the key concern of Mrs. Bransons case. In addition, she has undergone a fall. Information about patient other medical history are needed to be included S Situation Experiencing a fall, Mrs. Branson has been admitted to the hospital since 5 days. She has a poor appetite and appeared confused, she has hearing difficulty also. She is mobile, but she is not willing to drink water. However, no input and output data for the patient has been found. She is being administered with Sinemet tablets at scheduled intervals. No information regarding current vital sign and pain assessment has been provided to evaluate the situation. These information needed to be included B Background Mrs. Branson is 90 years old. Patient has a medical history of Parkinsons disease. She is undergoing a poor appetite and confusion and refusing to intake water. The team doctors recommended increasing her oral intake. She has several complications related to her health status including hearing issue. But she is mobile. No background information about the patient has been provided, her family back ground, family medical history, since when she is experiencing the neurological disorder and other issues has not been included, which are needed to be included. In addition, information regarding her current family members, occupation and social support are also needed to be included A Assessment A- Airway- No information B- Breathing- No information C- Circulation- No information D- Disability- Needs assistance during shower, inconsistency pad application, hearing difficulties, difficulties in communicating with staffs and confused E- Exposure- Poor skin turgor, dry mucous. Dressings on her skin tears were not appropriate. F- Fluids- Refusing to drink water initially, but now she is drinking fairly well, upon assistance and encouragement G- Glucose- No information Neurological- Experiencing Parkinsons disease, Confusion, communication difficulty, hearing difficulty Respiratory- No information Cardiovascular- No information Gastrointestinal- No significant information found Urology- The input and output information are not available. Patient has urine inconsistency problem, for which she needs to wear pad by taking assistance Musculoskeletal- fall injury, categorised to have fall risk and fall assessment form and Waterlow charts updated Integumentary- Poor skin turgor, dry mucous, dehydrated skin No particular information regarding the assessment tools has been provided, which has been used for assessing the patients vital signs. Patients information regarding airway, breathing, circulation, blood glucose level, BP, gastrointestinal and cardiovascular status are needed to be included R Recommendation Proper information regarding patients background and vital signs are needed to include in the progress note A good moral and emotional support should be provided to the patient to encourage her towards her care plan Her family members should be involved in the care process The fall injury should be assessed along with the pain score, after scheduled intervals A proper speech therapy should be undergone along with geriatric consultation She should be effectively communicated for encouraging her to adhere with the fluid balance chart for improving her appetite References Doenges, M. E., Moorhouse, M. F., Murr, A. C. (2016). Nursing diagnosis manual: planning, individualizing, and documenting client care. FA Davis. Gulanick, M., Myers, J. L. (2013). Nursing care plans: nursing diagnosis and intervention. Elsevier Health Sciences. Kalisch, B. J., Tschannen, D., Lee, H., Friese, C. R. (2011). Hospital variation in missed nursing care.American Journal of Medical Quality, 1062860610395929. Urden, L. D., Stacy, K. M., Lough, M. E. (2014).Critical care nursing: diagnosis and management. Elsevier Health Sciences.