Congestive Heart Failure: Complications and Affects

Congestive Heart Failure: Complications and Affects Congestive heart failure is a cardiac disease that causes many complications and affects many individuals in multiple ways. Aspects of ones life that are impacted by CHF are: activities of daily living, including social, family, and spiritual involvement. It can be very difficult for someone with heart failure to manage the disease and deal with the complications both physically and emotionally. However, there are some preventative measures that can be taken to avoid such extremes. Nurses play a huge roll when caring for a patient suffering from heart failure. It is important that they understand how this disease is affecting their patient beyond the cardiovascular system, and to be aware of interventions that will improve the outcome of their patients health. A patient presents to the clinic complaining of dyspnea, fatigue, weakness, swelling in his feet so bad that he is unable to put his shoes and he has a persistent cough. The nurse quickly assesses the patient and expresses her concerns of the probability of heart failure to the physician. The physician further assesses the patient and begins to get a history of the patients onset of symptoms. It is discovered that the patient has gained about five pounds in the last three days despite not being able to eat very much food. As the doctor auscultates heart sounds, he notes that his patients heart rate is very rapid. After careful consideration the physician diagnoses the patient with heart failure. Now what? The nurse must anticipate the level of care her patient is going to require while considering the many effects the diagnosis of heart failure is going to have on the patient. We would like to take this opportunity to now explain exactly what heart failure is, the details of its dive rse effects, and describe the care expected. Heart failure is a clinical syndrome that results from the progressive process of remodeling, in which mechanical and biochemical forces alter the size, shape, and function of the ventricles ability to fill and pump enough oxygenated blood to meet the metabolic demands of the body. Seventy five percent of heart failure cases are caused by systemic hypertension (Grandinetti, 1974/à ¢Ã¢â€š ¬Ã¢â‚¬ ¹2010). A third of patients experiencing a heart attack will also develop heart failure; another common cause is structural heart changes such as: valvular dysfunction especially pulmonic or aortic stenosis which leads to pressure or volume overload on the heart. (Grandinetti, 1974/à ¢Ã¢â€š ¬Ã¢â‚¬ ¹2010). However, those are not the only risk factors. Other serious risk factors that nurses should be aware of are: coronary artery disease, irregular heartbeats, diabetes, medications used to treat diabetes such as Avandia or Actos, sleep apnea, congenital heart defects, viruses, alcohol, certain kidney conditions, and of course, genetics (Mayo Clinic, 2010). As you can see, CHF is a very intricate disease process that involves more than just the heart muscle itself. Complications from chronic heart failure take a serious toll on a patients ability to perform ADLs without becoming short of breath or easily exhausted. The patient may have activity limitations demonstrated by the avoidance of walking long distances, walking up stairs, or exerting themselves because they become dyspenic very easily. The nurse must assess the patients ability to perform minor tasks such as putting on shoes. Since heart failure can lead to severe swelling especially in the feet and ankles, the patient may not be able to put his or her shoes on without assistance or in some cases a specially designed shoe may be necessary. It is also important that the nurse inquire the patient about the ability to perform simultaneous arm and leg work, such as carrying groceries. This type of activity may place an intolerable demand on the failing heart (Ignatavicius, 1991/à ¢Ã¢â€š ¬Ã¢â‚¬ ¹2010). Congestive heart failure does not solely affect the patients ability to perform activities of daily living, yet it affects other portion of life such as their family, social, and spiritual lives. Patients with advanced CHF often require help with daily tasks (i.e. making food, getting dressed, running errands, housekeeping); and family members often help out by doing these tasks for their loved ones. If the patient lives with a family member, that person may also be responsible for further management of cares in the home. This requires the family to be willing to learn about the disease process, and when it is necessary to call the health care provider or bring the patient into the hospital. This can cause a great amount of stress on the family member due to the responsibility of managing care. The fact that the patient may not be able to perform tasks on their own may lead to frustration which can further lead to self isolation due to the fact that they dont want to be bothersome no r embarrassed by their deficits. This is damaging to their social life and may cause depression. While the patient may be struggling with managing their social lives and trying to remain as independent from family members as possible the patient may turn to their religion. They may turn to their faith and pray more in hopes that it will benefit them and make it easier for them to deal with losing their independence. Spiritual well-being is an important, modifiable coping resource for depression, but little is known about the role of spiritual well-being in patients with heart failure (Bakelman, 2010). However, hope is a major indicator of ones wellbeing. This is especially true for patients with heart failure. Those who are hopeful tend to feel better and are more socially involved (Ignatavicius, 1991/à ¢Ã¢â€š ¬Ã¢â‚¬ ¹2010). Another factor that plays a major role in how patients with heart failure manage their care is the cultural background which they are from. For instance, those in minority communities may require more direct contact and consistent encouragement to follow the recommendations for treating their disease. A 2006 study concluded that: Nurse management can improve functioning and modestly lower hospitalizations in ethnically diverse ambulatory care patients who have heart failure with systolic dysfunction. Sustaining improved functioning may require continuing nurse contact (Sisk, 2006). It is not well understood why this is, but it may be likely that those patients who reside in minority communities do not have access to the types of health promotion and prevention programs as those who reside in a more socioeconomically stable community. Moving on now to the psychological effects that disease casts upon its victims; many patients with heart failure are at risk for anxiety and frustration. They may experience symptoms such as dyspnea, which further complicates their anxiety level. Those who are dealing with an advanced disease are certainly at high risk for depression. It is not certain whether the function impairment contributes to the depression or the depression affects functional ability. It is thought that those who are rehospitalized for an acute episode of heart failure are more likely to be depressed (Ignatavicius, 1991/à ¢Ã¢â€š ¬Ã¢â‚¬ ¹2010). Nurses may help these patients with alternative coping methods. It is important to keep in mind that nurses have a great amount of responsibility when it comes to prevention and treatment for those suffering from heart failure. Preventative measures that can be taught and reinforced to clients are: to quit smoking, control certain conditions such as hypertension, stay physically active, eat healthy foods, maintain a healthy weight, and tips for reducing and managing stress (Mayo Clinic, 2010). Treatment for these clients is generally directed by the physician, but the nurse reinforces the treatment plan and continues to guide the care throughout its course. Treatment often starts with conservative measurements such as treating the underlying cause, for example, a rapid heart rate or repairing a heart valve (not as conservative). But for most people, treatment involves a balance between the right medications and in some cases devices that help the heart beat and contract properly. Medications often used are: ACE inhibitors, ARBs, Digoxin, beta blockers, diuretics, and aldosterone antagonists. If medications alone are unable to treat the disease, other forms of treatment such as coronary bypass surgery or heart pumps may be used (Mayo Clinic, 2010). Furthermore, nurses must continue to intervene and assess the patients response to prescribed treatments. As mentioned before, nurses can educate their clients on the measures taken to prevent heart failure. Even more so, if the patient already has heart failure, the nurse shall administer medications as prescribed, place the patient on physical and emotional rest, while continuing to monitor for their therapeutic response to the medication and reducing the workload of the heart to increase its reserve. The nurse shall also monitor for complications such as excessive fluid volume, by weighing the patient daily and carefully assessing for lung sounds that would indicate fluid buildup (i.e. crackles in the lung fields) (Grandinetti, 1974/à ¢Ã¢â€š ¬Ã¢â‚¬ ¹2010). Another nursing intervention that may be useful in helping the patient to manage their care at home is to teach them about MAWDS, an acronym that stands for Medications, Activity, Weight, Diet, and Symptoms. This module is an easy way to teach patients about medication usage, recommended activity level, maintaining weight and the boundaries for weight loss and weight gain, a heart healthy diet, which includes low sodium (2-3gms) and fluid restrictions, as well as symptoms that should be noted and reported to the physician immediately (Ignatavicius, 1991/à ¢Ã¢â€š ¬Ã¢â‚¬ ¹2010). This is a very concise and understandable tool that is beneficial to both the nurse providing the education and the patient required to remember and comply with the self-management techniques. It is critical for nurses to understand the care needed to manage the patient with heart failure. They must be able to comprehend all aspects of its affect upon the patient in order to know how to direct them toward the right health choices and to know when to intervene to prevent complications. As we have discussed heart failure affects more than just the patients cardiovascular system, and there are many other factors that are involved in the disease process as well. Lifestyle changes must be made and maintained, those in minority communities may need more frequent contact to manage their care, and the health care provider must also remain aware of the psychosocial effects such as depression. Once these factors are understood to the best of their knowledge then improvement and management of this dynamic disease can be attained. Even if this means aggressive treatment because the conservative course did not serve its purpose as expected. Sometime drastic measures must be done. Eithe r way nurses shall continue to provide teachings and management strategies to improve the outcome of their patients care. References References Bakelman, D. B. (2010). Spiritual Well-Being and Depression in Patients with Heart Failure. Journal of General Internal Medicine, 22(4), 470-477. Grandinetti, D. (Ed.). (2010). Lippincott Manual of Nursing Practice (9th ed.). Ambler, PA: Wolters Klewer Health, Lippincott Company. (Original work published 1974) Ignatavicius, D. (2010). Medical Surgical Nursing: Patient-Centered Collaborative Care (6th ed.) (L. Henderson, Ed.). St. Louis, MO: Saunders Elsevier. (Original work published 1991) Mayo Clinic. (2009, December 23). In Mayo Foundations for Medical Education Research (Eds.), Heart Failure. Retrieved February 19, 2011, from Mayo Clinic: http://www.mayoclinic.com/health/heart-failure/DS00061 Sisk, J. E. (2006). Effects on Nurse Management on the Quality of Heart Failure Care in Minority Communities. Annals of Internal Medicine, 145(4), 273-283.

Investigation How Business Work Essay

My name is Jasper and I have been asked to choose a company and investigate all about that company. The company I have chosen to investigate about is Safeway Supermarkets. In this task, I will be investigation the business objectives of Safeway’s and why they have those objectives. Safeway’s was first started in 1977 and has grown very large since than. It is in the service business where by they buy stock from manufacturing companies and sell it on to their customers and it’s also a public limited company (Plc). Safeway’s now own about two million high street stores in the U.K. alone and are now looking to opening some of its stores in other parts of Europe. The head office of Safeway’s is at London. All decision must be clarified or accepted by the people at the head office before it goes ahead. Safeway’s makes an income of 50 million pounds a year and are stills looking to improving their income. Safeway’s vision in future is to become (The first choice food retailer for all their customers’ locally.) over the past four years, Safeway have been working hard to achieving its vision and to achieve it, they have set out the following objectives. * To have the best promotional deals on the products which most of there customers regularly buy. * To have the best and most innovative fresh food offers * To have the best product availability, keeping their shelves full every hour of every trading day * And to have the best customer service, in a warm and friendly store environments. Explaining of objectives * The first objective of Safeway’s is to have the best promotional deals. If they do have the best promotion, more and more customers will buy from Safeway’s and the more the customers the more profit they make. * Now a day, people are breaking from the habits of canned food to fresh food and if Safeway’s could do this than a greater number of customers will buy more and more from them meaning they get more profits. Safeway’s sells ready prepare meals for customers who don’t have time to cook. * The third objective by Safeway’s is to keep their shelves always full so that customers don’t go to other stores when Safeway’s don’t have stokes on their shelves. * The fourth objective by safeways is to have the best customer service. If they don’t have good customer service to help customers when they need help, customer will go somewhere else and they will loss money. The functional areas of Safeway’s Lawrence Christensen, CBE, Group Operations Director, Safeway Stores plc, is the Main Board Director with Corporate Social Responsibility, which incorporates Health and Safety and Environment. He chairs the Corporate Social Responsibility Steering Group, which oversees, reviews, monitors and advises on CSR matters particularly where they are of concern to our stakeholders. He also chairs the Corporate Due Diligence Committee, which reviews, monitors and advises on due diligence matters associated with product safety, employment, environment and health and safety. Jack Sinclair, Group Marketing and Trading Director, chairs the Commercial Committee which is responsible for reviewing and making decisions with regard to Trading and Operational performance of the Company, including Promotional and Pricing Strategy, Store and Product Category Performance and Marketing, Seasonal and Range Initiatives. Liz Kynoch, Technical Director, Chairs the Executive Health and Safety Committee and has day-to-day responsibility for health and safety management as well as Product Technical Issues. Jim White, Human Resource Director, employs staff for the company and also makes sure that employees are working in a safe environment. It also dismisses an employee who does not perform his or her job properly. David Wilson, Company Secretary, Chairs the Product Policy Group Committee, which defines and refines company policy. The Board then signs these off. He has responsibility for assisting the Board to ensure compliance with all its legal obligations and to ensure that in regard to corporate governance the Board takes account of, and reflects, wherever appropriate, the standards required by the combined code appended to the UKLA listing rules. His role is to ensure that the Board follows its procedures fully and that in the management of the business, it has regard, at all times, for its duty to act in the best interests of the company (present and future shareholders), and to have regard to the interest of other stakeholders. These stakeholders are employees, customers, suppliers and any others who may be affected by its operations. He is vice chairman of the Corporate Due Diligence Committee and a Member of the CSR Steering Group. Nicola Ellen, Strategy Manager – CSR, reporting to Lawrence Christensen, is responsible for day-to-day CSR management. Which is the report sent to stakeholders of how the company is doing in teams of income and the company environment. Dr. Kevin Hawkins, Director of Communications reports to the chairman (David Webster) about the press release and public affaires. He also chairs the Charity Committee, which manages the corporate charity budget. David Webster, director of Finance chairs the finance departments. His job is to give financial advice to the company and to also calculate the profits and loss of the company. He also keeps financial records of the company. Department job roles In every functional area, there are different job roles. A job role tells determines the jobs and tasks of employee that they are being expected to do. Below are some of the job roles in the functional areas. Human Resource * Employ and dismiss employee on reasons. * Motivate * See that all employees are treated the same due on their work. Marketing and trading * To promote products * Perform researches * Good communication skills Technical * Make sure that all employees are working in safe environments. * Get safely equipments for employees * Test employees knowledge of safety incase of emergency Communications * Have good communication skills * Be very persuasive * Make sure that the press don’t release bad stuff about company Strategy * Be able to know what company need to survive * Be able to create reports (CSR) * To be able to set out company’s aims and objectives Laws, which protect Employee rights. The governments has set up laws just is to protect the employees rights. These laws are to be followed by employers or they could be put out of business. The laws are has follows. o Employments Rights Acts1996 o The Sex discrimination Acts 1975 o Race relation Acts 1976 o Disability discrimination Acts o Equal opportunity legislation The Employments Rights Acts This rights covers mostly all the other rights of the employees i.e. * The employer must give the new employee, a written statements or a contract no more than 8 weeks after the employee has started working for the company. * All employees must be given an entitlements pay slip, which shows the gross and net pay etc. * An employee asked to work on Sunday can â€Å"opt-out† by serving notice. * All females can take maternal leave and can return to work on the same terms and conditions has they were. * An employee can act has a trade union official or health and safety official and cannot be dismissed. * All employees who have been dismissed through redundancy have the rights to receive redundancy payments if they have been working fro the firm for more than two years. * Employee have the rights to take a time of on the grounds for jury service and antenatal care * Any employees that this dismissed from working on medical terms have the rights to receive payments for up to 26 weeks. The Sex discrimination Acts 1975 This act makes it illegal fro any employer to discriminate upon anyone on the grounds of gender either directly or indirectly. This act applies to the following recruitment and selection for jobs and promotion, training, the way you are treated in a job, dismissal and redundancy. The Race Relation Acts This act makes it illegal fro any employer to discriminate against on the grounds of the persons colour, race nationally, or ethnic origins whether directly or indirectly. The Disability Discrimination Act This act is concerned with the discrimination against people with disabilities in employments, when obtaining goods and service or buying/renting land or property. The disability can be physical, sensory or metal but must be relatively long tern (for more than 12 months). An employer must not treat a disabled person more favorably than able body person whether in recruitments, training, promoting or dismissal unless it can be justified. Employers must also be ready to make reasonable adjustments to the work place to enable a disabled person to do their jobs. Disabled person who suffers any discrimination can report their complains to the employments tribunals. Discrimination in this case is not divided into direct or indirect but less favorable treatments can be justified. Equal opportunities in Safeway’s Safeway’s makes sure that it follows these acts. In order not to violate any of these Acts, it states at the bottom of its application forms about the above acts. An example of safe ways employments from has been attached to this work.

What Has to be Done About Medical Assistant Scholarship Essay Samples Before You Miss Your Chance

What Has to be Done About Medical Assistant Scholarship Essay Samples Before You Miss Your Chance Medical Assistant Scholarship Essay Samples - the Conspiracy Don't forget to begin your essay strongit should have the capability to spark the interests of your readers. It is believed to be the absolute most significant part your application, since the scholarship committee will use this to assess who you are as an individual, in addition to your outlook in life. This letter might be simple but it can give a lot of difference with regards the decision on whether someone is going to be qualified for a scholarship grant or not. Considering all the knowledge areas and tips that you're already mindful of in writing a scholarship letter, it is possible to easily put together all of the information that you must make sure you and your scholarship letter will stick out. Therefore, you've decided you wish to visit nursing school, but realize you might require some financial guidance. Moreover, even as little as a diploma doesn't guarantee truly valuable professional abilities and knowledge. If you get this scholarship, you're expected to perform 100 hours of community service each year. As this scholarship could possibly pay for a complete year of school, it's worth your time and energy to apply. The Pain of Medical Assistant Scholarship Essay Samples To win, you need to write a brief essay about the Seventh Amendment and the way it influences your life. The access to scholarship funds varies wildly based on where you are. If it is time to set the draft together, your ideas and main points will be prepared to go. To assist you get off to a great start, we've. The Medical Assistant Scholarship Essay Samples Stories You should compose a 1,000 word paper that's professionally formatted and referenced. Being invited for a scholarship application is a remarkable experience that's why you ought to make the absolute most out of it. If you believe that a spe cific word is appropriate for your essayuse it without doubt! Show your enthusiasm, and how interested you're in truly being a component of their program. Without knowing suitable essay making, your likelihood of going into a fantastic college are slim. If you're asking for a scholarship, odds are you're likely to should compose an essay. Though a last-minute essay writing procedure can be done when creating a scholarship essay, it is going to be best in case you will allot time when putting together all the information which you'd like to include within this document. You don't need to possess the ideal writing skills so as to be creative and compose an effective essay. You will also get to take a look at a couple of essay examples, in addition to a list of do's and don'ts that is likely to make the writing process even simpler for you. Discover how brainstorming and planning will be able to help you write your very best college essays. Let's explore some ideas about what your essay headline may be. After all, you're going to compose a mere essay. A superb essay is one which leaves a long-lasting impression. Starting an essay is frequently the hardest portion of the procedure, so you may find it simpler to start in the center. A Secret Weapon for Medical Assistant Scholarship Essay Samples The samples on this list gives you a very clear image of what you ought to be making. Make certain your font size is able to make your discussion effortless to read. Don't make the size of your font too large nor too tiny. The total format of your essay, for example, font size and margins, will solely be based on the instructions provided to you. Proofreading is a significant part of writing a scholarship essay, particularly if you're asking for a foreign program. How to compose the Application Essay. Applicants will be requested to submit a concise essay. Remember that all scholarship applications are different, and that means you might have to design your essay to fulfill those particular requirements. Scholarship essays have turned into an effective tool within this search. They are a serious matter. Especially since scholarships are not simple to get, and judges are extremely harsh. Many scholarships are provided to very specific groups or kinds of students, so make certain that you fit inside that group. Some scholarships will just request a statement of financial need. Unless you're fortunate enough to happen across an extremely obscure and unusual scholarship with no more than one or two qualified applicants, you will have to handle some competition to be given a scholarship award. As a prospective student, it's absolutely in your very best interest to look for and apply to a range of relevant scholarships. If you don't withdraw from your program, you don't ever have to repay the money you get through a scholarship. You should make an application for scholarships online. Being part of an excellent educational institution can be rather costly.

The Theme in How It Feels to Be Colored Me - Free Essay Example

Sample details Pages: 3 Words: 935 Downloads: 1 Date added: 2019/08/15 Category Literature Essay Level High school Topics: How It Feels To Be Colored Me Essay Did you like this example? Maya Angelou said: â€Å"we all should know that diversity makes for a rich tapestry, and we must understand that all the threads of the tapestry are equal in value no matter what their color.† In How It Feels to Be Colored Me Zora Neale Hurston toys with the idea that one may be able to channel an inner awareness acknowledging that one may embody two selves, two spiritual beings. Throughout the years, African Americans have faced injustice and unfortunately still do present day. Some carry the anger of slavery that their ancestors faced; some hide behind that anger and project their emotions differently. Don’t waste time! Our writers will create an original "The Theme in How It Feels to Be Colored Me" essay for you Create order Some are able to project a double consciousness of who they are and some find the strength and self-confidence to embrace individuality in their African American heritage. Hurston does just that, but identifies herself with the human race, rather than solely the race associated with the color of her skin. She states that she â€Å"has no separate feeling about being an American citizen and color† (Hurston 3). Illuminating the fact than despite events and beliefs that surround her, she is confident and finds comfort in who she is: â€Å"I am merely a fragment of the Great Souls that surges within the boundaries† (Hurston 3). In How It Feels to Be Colored Me, Zora Neale Hurston presents the capacity of harboring strength and utilizing it for control in claiming who you are despite outer influences from those surrounding you.   In her essay How It Feels to Be Colored Me, Hurston speaks of her memory as a thirteen years old growing up in Eatonville, Florida. Very subtlety she highlights events, memories from the â€Å"very day [she] became colored†(Hurston 1). Living in an exclusively colored town she noted that the only time white people would pass by was on their travels to and from Orlando. She describes the interactions between the whites passing by and the town’s people of Eatonville, highlighting the difference between the Southerners and Northerners. She notes that interaction with them seldom occurred, â€Å"they were peered at cautiously from behind curtains by the timid. The more venturesome would come out on the porch to watch them go past† (Hurston 1). A formal connection never made between the two, except for the ones that Hurston initiated. She did not see any differences between her and the white people passing through town, in fact she even spoke to them. But, â€Å"if one of [her] family happened to come to the front in to see [her], of course negotiations would be rudely broken off†(Hurston 1). She acknowledges the differences between her family and herself partaking in social exchanges with whites, but never gives off any ideas or hints that she is ashamed of whom she is or the community that she and her loved ones embody.   Zora Neale Hurston has worked on ethnographic texts that have given authors and researchers a more in depth perception on African Americans and all Americans living amongst one another (Lori Jirousek). Hurston states in her essay that she is â€Å"not tragically colored. There is no great sorrow dammed up in my soul, nor lurking behind my eyes. I do not mind at all† (Hurston 2). Using ethnographic context from Hurston, analyzers have been able to conclude that through How It Feels to Be Colored Me Hurston, â€Å"attempts to transcend race and avoid victim status†, â€Å"has an individualistic standpoint that not only emphasizes her own self-determination and self-definition, but also promotes those same qualities in others† and d evelops â€Å"a new definition of community that challenges [†¦] boundedness of such categories as race and nation† (Jirousek). Hurston illuminates the mere fact that what others may think or say about ones skin color cannot make one feel less than or inferior or unless he or she lets it. She does not let the mere fact that she is black belittle her in any shape or form. She grabs racism by the horns when stating â€Å"At certain times, I have no race, I am me† (Hurston 3). Her ability to channel self-confidence is what allows her to transcend race and its rubbish tendencies, develop and urgency towards self-definition and breaks the barriers between stereotypical sense of belonging between race and nations. Stating that she does â€Å"feel discriminated against, but it does not make [her] angry. It merely astonishes [her]† (Hurston 3). She continues to capitalize and assert her confidence in one sentence: â€Å"How can any deny themselves the pleasure of my company? It’s beyond me† (Hurston 3). Hurston worked on the establishment of â€Å"national coherence and solidarity† (Jirousek) by providing the shared relationship between an individual and their nation, something she broke through in her essay How It Feels to Be Colored Me.   United States in the 1920’s was an era of injustice. Filled with many wrong doings on certain groups of people. Hurston alludes that she does not view herself any differently than her neighbor, â€Å"[she] has no separate feeling about being American and colored† (Hurston 3) as stated previously. She decided to not let outer influences have a say in the image she wants to create for herself and share with the world. She dives into her ancestry stating: â€Å"Someone is always at my elbow reminding me that I am the granddaughter of slaves. It fails to register depression with me. Slavery is sixty years in the past. The operation was successful and the patient is doing well, thank you (Hurston 2). The strength and resilience she embodies is what gives her the strength to look past that and recognize that she is equal to her fellow Americans no matter her the color of her skin or her ancestry.