Importance Of Palliative Care Nursing Essay

Importance Of Palliative Care Nursing Essay Palliative care improves quality of life of patient and families who face life threatening disease, by provide pain and symptom relief, spiritual, psychosocial support to diagnosis to end of life, In most of world, majority of cancer patient are in advances stages of cancer when first seen by medical professional. For them, only factual treatment option is pain relief and palliative care. Effective approaches to palliative care are available to improve quality of life for cancer patient. Cancer pain release is diffusion of the world health organization global communication program for improve cancer pain control and palliative and supportive care (World Health Organization, 2011). Lung cancer is a disease which consists of uncontrolled cell growth in tissues of the lung. This growth may lead to metastasis, which is the invasion of adjacent tissue and infiltration beyond the lungs. The vast majority of primary lung cancers are carcinomas of the lung, derived from epithelial cells. Lun g cancer, the most common cause of cancer-related death in men and women, is responsible for 1.3 million deaths worldwide annually, as of 2004.The most common symptoms are shortness of breath (WIKIPEDIA,2011). Which nursing problem does lennart have? Pain and Irritation upon draining of tubes. Nausea and diarrhea. Loss of energy. Loss of appetite. Eelevated blood pressure How would you prioritize his problem? Diarrhea Pain and irritation upon draining tube Loss of appetite Nausea Loss of energy Eelevated blood pressure NURSING CARE PLAN Assessment: Objective data: he has an elevated blood pressure and diabetes. Subjective data: diarrhea. Nausea, pain. Take medical history. Patient complained of abdominal pain, bowel movement cramping. Increased frequency of stool, increased frequency of bowel sounds loose, liquid stools, diarrhea. Assess onset and patterns of diarrhea Assess and identify individual stress factors and coping behaviors. Assist thorough diagnosis including neurologic and psycho logic Assess patients attitude toward pain. .Discuss with patient, family and other medical team the treatment and medical Diagnosis: diarrhea, pain, nausea related to lung cancer. Intervention: Observe and record frequency, characteristic, amount, time of day, and precipitating factors related to occurrence of diarrhea Observe pain associated with episodes Observe nausea and vomiting. Every day make blood test for diabetes and give medication and give diabetes food. Give treatment to hypertension and cheek blood pressure and give low salt food advice patient make exercises every day. Auscultate abdomen for presence, location, and characteristic of bowel sounds observe for associated factors such as fever / chills, abdominal pain / cramping .Determine diet and nutritional status. Review drug intake. Determine recent exposure to different / foreign environment, change in drinking water, food intake and illness of other. Note concurrent illnesses, treatment, food and drug allergic, lactose intravenous and therapy side effects. Eliminate: relaxation techniques to decrease stress / anxiety. Provide for changes in dietary intake to avoid diarrhea. Limit caffeine and high fiber foods, avoid milk and dairy products. Recommended change in drug therapy as appropriate (eg. Antacid) Assess baseline hydration, note postural hypotension, tachycardia, skin cracks, and condition of mucous membranes. Review laboratory work. Administer drugs as indicated to decrease gastrointestinal motility and minimize fluid losses. Administer IVF as indicated. Maintain skin integrity (ointment skin as needed) .Promote returns to normal bowel functioning: Increase oral fluid intake and return to normal diet with assist from his family members. Give medication as ordered, for example to decrease motility and to absorb water and explain that to the patient and to his family. Patient maintains normal bowel function with good hydration. Understanding of causative factors and rationale for treatment regimen .Demonstrates appropriate behavior to assist with resolution of causative factors like proper food preparation or avoidance of irritating. Verbalization of pain upon draining of tube Distraction behavior (moaning, crying, pacing, seeking out other people or activities, restlessness .Autonomic responses like diaphoresis , blood pressure and pulse changes . Papillary dilatation increased or decreased respiratory rate. Pain, Alleviate patient from pain, Provide comfort while draining of tube Explain procedure to the patient and family and when it hurt to reduce concern of the unknown .Nursing priority: assess etiology / precipitating and c ontributory factor. Determine possible pathophiysiologic / psycho logic causes of pain eg( inflammation , thrombosis ,grief ,fear and anxiety ) Nursing priority: evaluate patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s response to pain. Observe patients walk, how patient holds body, sits ,facial expression ,cool finger tips / toes , which can mean constricted useless . Determine pain characteristics; dull, throbbing, constant , sharp ,intermittent Assess for referred pain. Monitor vital signs as usually it increase in acute pain, Review patients previous experience with pain. Nursing priority assist patient to explore methods for alleviation and control of pain: Instruct patient to report pain as soon as it begins ,encourage verbalization of feelings about the pain ,provide quiet environment , calm , activities . provide comfort measures ( eg. Back rub , change of position , use of heat or cold if indicated ) and encourage his family to do it .encourage relaxation exercise with the use of individualized tapes ( eg. Music and instructional ) .encourage to use diversirnal activities ( eg, TV ,radio and socialization ) ,assist in treatment of the cause of pain and evaluate effectiveness .encourage rest to prevent fatigue ,identify ways of avoiding or minimizing pain ,review ways to lessen pain ,discuss with significant others ways in which they can assist patient and can reduce precipitating factors that may cause or increase pain . Evaluation: Patient reports that he is relieved from pain. He follows prescribed pharmacologic regimen. Verbalizes methods that provide relief . Demonstrate use of relaxation skills and dimensional activities. Conclusion: Cancer patient has severe pain the nurse should be observer this pain and give medicine and attention to case of spiritual psychical through palliative care. Cancer patient need to support from teamwork and family is the source of light and hope of the patient, I think support depend on family. Teamwork is foundation palliative care and everywhere cooperative teamwork will outcome become high for palliative care. Communication is contact the most powerful factor in palliative care causes it is a point of communication between teamwork and family and between patient, teamwork, good communication is the secret success palliative care.

Transaction, Operating Accounting Exposures

Transaction, Operating, & Accounting (Translation) Exposures Foreign Exchange Exposure – measures the potential for a firm’s profitability, net cash flow, and market value to alter because of a change in exchange rates. Q: What are the three main foreign exchange exposures? A: 1) Transaction Exposure 2) Operating Exposure 3) Accounting Exposure Transaction Exposure – measures changes in the value of outstanding financial obligations incurred prior to a change in exchange rates.Operating Exposure (Economic Exposure, Competitive Exposure, Strategic Exposure) – measures a change in the present value of a firm resulting from any change in future expected operating cash flows caused by unexpected changes in exchange rates. Accounting Exposure (Translation Exposure) – measures accounting-derived changes in owner’s equity as a result of translating foreign currency financial statements into a single reporting currency. Exhibit 8. 1 [pic] Note: In th e fourth quarter of 2001 Amazon. om reported a net income of $5 million, due in part to a one-time foreign currency gain of $16 million. Hedging – To take a position that will rise (or fall) in value to offset a change in value of an existing position. |Benefits of Hedging |Costs of Hedging | |Improved the planning capability of the firm. |Risk-averse strategy that benefits management more than | |Reduced the likelihood of financial distress. i. e. the risk that cash|shareholders. (i. e. shareholders can diversify currency risk on an| |flows will fall below what is required for debt payments and continued|â€Å"as needed† basis) | |operations) |Consumes the firm’s resources and expected cash flows to the firm | |Management has a comparative advantage over shareholders. (i. e. |are not increased. (i. e. gency theory, NPV of hedging is zero, | |understanding the currency risk of the firm and take advantage of a |and FX losses appear on the I/S while hedging are b uried in | |disequilibrium through selective hedging) |operating and interest expenses) | Transaction Exposure Transaction Exposure – measures changes in the value of outstanding financial obligations incurred prior to a change in exchange rates. Transaction exposure can arise from the following activities: ? Purchasing or selling foreign goods and services on credit. Borrowing or lending in another currency. ? Foreign exchange contracts. Exhibit 8. 3 The Life Span of Transaction Exposure [pic] Example Expect to collect ? 1,000,000 in three months on a sale, minimum acceptable value $1,700,000. Q: What type of transaction exposure has occurred? A: Billing Exposure S0 = $1. 7640/? ES90= $1. 76/? F90= $1. 7540/? iU. K. = 10% per year (2. 5% per quarter) kU. K. = 8% per year (2% per quarter) iU. S. = 8% per year (2% per quarter) kU. S. = 6% per year (1. 5% per quarter) P90ATM = $1. 75 (1. 5% premium) P90OTM = $1. 71 (1% premium)Note: ES90 is the estimated spot rate in three mont hs, â€Å"i† is the borrowing interest rate, and â€Å"k† is the investment interest rate, P90ATM is an at-the-money three-month put option, and P90OTM is an out-of-the-money three month put option. Q: Is the pound expected to appreciate or depreciate? A: Depreciate Q: What is the forward premium/discount on the pound? A: [pic] Q: What are the four alternatives to hedge a transaction exposure? A:1) Remain unhedged 2) Hedge in the forward market 3) Hedge in the money market 4) Hedge in the options market 1) Remain unhedged, collect ? 1,000,000 in three months at the new spot rate. pic] 2) Hedge in the forward market, collect ? 1,000,000 in three months at $1. 7540/?. [pic] 3) Hedge in the money market, borrow ? 975,610 today, and exchange for dollars at the current spot rate ($1. 7640/? ). Invest the $1,720,976 for 90 days, and in 90 days pay back the loan + interest with the ? 1,000,000. Q: To construct a money market hedge, how much should the investor borrow today if the annual interest rate is 10% and the company expects to receive ? 1,000,000 in 90 days? A: [pic] Q: At what investment rate is the money market hedge superior to the forward contract? A: [pic] pic] Note: Either the forward contract or the money market hedge is better than an uncovered position if the spot rate at time 2 is less than the forward rate. But, if the funds can be invested at anything above 7. 68% (or 1. 92% for 90 days) then the money market hedge is a better option than the forward contract. If the spot rate at time 2 is greater than what can be earned by investing the funds in the company (in this case the funds are invested in the company yielding the company’s WACC of 12% or $1,772,605) then the uncovered hedge would be superior. 4) Hedge in the options market.An at-the-money[1] (ATM) put option is selling for a 1. 5% premium. The cost of the option is (size of the option) x (premium) x (spot rate) = cost, in this case ? 1,000,000 x 0. 015 x $1. 7640 = $26 ,460. This is the maximum loss, while the maximum gain is the spot price – the cost of the option. [pic] To compare the alternatives, first estimate what you expect spot rates to be, then estimate a range of possible prices, and consider your ability to accept the downside. Then select the best strategy. Some Examples: [pic] Q: Transaction exposure arises from what? A: Sales and expenses that are already contracted for.Operating Exposure Operating Exposure (Economic Exposure, Competitive Exposure, Strategic Exposure) – measures a change in the present value of a firm resulting from any change in future expected operating cash flows caused by unexpected changes in exchange rates. Q: Operating Exposure depends on whether an unexpected change in exchange rates causes unanticipated changes in what? A: Sales volume, sales prices, or operating costs Figure 9. 1 Financial and Operating Cash Flows Between Parent and Subsidiary [pic] Q: What are four proactive ways to manage op erating exposure?A: 1) Matching currency cash flows 2) Risk-sharing agreements 3) Back-to-back or parallel loans 4) Currency swaps Note: Planning for operating exposure depends on the interaction of strategies in finance, marketing, purchasing, and production. Accounting (Translation) Exposure Accounting Exposure (Translation Exposure) – measures accounting-derived changes in owner’s equity as a result of translating foreign currency financial statements into a single reporting currency. Q: What are the financial goals of the multinational enterprise? A:1) To maximize consolidated after-tax income ) To minimize the firm’s effective global tax burden 3) To correct the positioning of the firm’s income, cash flows, and available funds. Note: These goals are frequently seen as inconsistent. Functional currency – the dominate currency used by the foreign subsidiary in its day-to-day operations. Q: What are the two basic methods for the translation of fo reign subsidiary financial statements? A: 1) The current rate method 2) The temporal method Current rate method – a method of translating the financial statements of foreign affiliates into the parent’s reporting currency.All assets and liabilities are translated at the current exchange rate. Temporal method – assumes that a number of individual line item assets such as inventory and net plant and equipment are restated regularly to reflect market value. Q: Which method is the most common worldwide? A: The current rate method Q: What are the advantages of the current rate method? A: 1) The variability of reported earnings due to translation gains or losses is eliminated, because the gain or loss on translation goes directly to a reserve account (rather than passing through the income statement). ) Does not distort balance sheet ratios such as the current ratio or debt-to-equity ratio (because the relative proportions of the individual balance sheet accounts rema in the same. Q: What is the disadvantage of the current rate method? A: 1) It violates the accounting principle of carrying balance sheet accounts at historical costs. Q: What is the advantage of the temporal method? A: 1) Foreign nonmonetary assets are carried at their original cost in the parent’s consolidated statement. Homework Problems Chapter 8 1.Imagine one of the companies from your final project is expecting an $80million payment in one year. The company also expects $20million in expenses in one year. Use real figures or the following: Current spot rate 3. 4x/$ (trend shows 3. 8x/$ two months ago) Interest rates are 14% in your country and 4% in the U. S. Forward contracts are too expensive Based on the current spot rate and relative interest rates, please advise your company on its currency exposure. Chapter 9 2. Imagine one of your companies will soon be exporting to China.Use the following (replace the $ equivalent with your currency at the current spot price): C urrent sales of 1,000,000 units per year at a price equivalent to $24 each. Current spot price Rmb8. 2/$, but the H. K. advisory will drop the value next week to Rmb10/$. Direct costs are 75% of the U. S. dollar sales price. Accepting this forecast, advise the company on two options: 1) Maintain the same renminbi price (i. e. no change in price) 2) Raise the price to offset the devaluation and experience a 10% drop in unit volume. A) What would be the short-run (one year) impact of each strategy?B) Which do you recommend? Optional Assignment: (0. 5 participation points) Prepare a write-up on the country you are doing for your final project. (Include GDP, inflation, major exports/imports, major stock exchange, currency, exchange rate, and anything else you find interesting and relevant)†¦ use sources like countryreports. org, cia. gov, etc. And remember to compare your country to something (i. e. the U. S. or another country in the region)†¦ Try to make everything you turn in look â€Å"professional,† imagine you're getting paid for your work.Please cite your sources throughout the report, and if you could e-mail it to me before next Monday, that's even better. Final Project These are two great sites to look at for your final project: globaledge. msu. edu www. world-exchanges. org ———————– [1] An at-the-money put, means that the strike price is equal to the current spot price†¦ Meaning an investor is indifferent between exercising the option or going to the market. In this case the forward rate is $1. 7540/? , and the option is $1. 75/? plus 1. 5% premium.

Dangers of Online Predators

The Dangers of Online Predators and What Can be done to Protect Our Youth Marcos Williams CM 107: College Composition 1 Unit 9: Final Abstract This paper is to educate parents and children about the dangers of online predators. Predators are going to great links to prey on children and they are going to great links to hide their identity. Predators are hiding in cyberspace and they are lying in wait for children to go online so they can make their move on unsuspecting children. Law enforcement agencies and parents have to do whatever it takes to protect children and they should make sure that the necessary steps are taken.Law enforcement agencies are using the media and they are hiding online to help capture these offenders. Parents should make sure that their home computers have the proper software, know who kids are friends with online, gain access to all emails kids use, make sure computers are visible at all times, and never turn a blind eye and think that this will never happen to their children. Kid’s safety is always a priority and they should be guarded at all times. I have chosen a degree in Criminal Justice with an emphasis in Cyber-crimes to protect kids against online predators.Educating parents and children about the dangers of online predators and discussing how law enforcement agencies and parents can protect our children is the first step. This paper will discuss what kids don’t know about online predators, how these online predators are hiding their identities from law enforcement, how law enforcement is cracking down on online predators, and most importantly, how parents can protect their kids against online predators. Kids do not realize that predators look for kids with a lack of self-esteem, kids that are vulnerable, and kids that are having problems at home.These offenders meet children in public chat rooms geared towards teens and teens engaging in sexual subjects (Wolak, 2004). They will soon lure kids into private chat roo ms or instant messaging. Some offenders lie about age and or sex to gain trust of children. Once trust is built, the predator introduces the child to pornography. This lowers the child’s inhibitions and desensitizes the child to nudity, and validates adult-child sexual relations (Berson, 2003). After all these things occurs, a face to face meet between the child and predator often follows, and the child is usually sexually abused or worse (killed).Some offenders create child-like avatars, go online and pose as teenagers. Predators use free Wi-Fi at public access points or connect to unsecure wireless routers installed in private residents rather than using their own personal accounts. They hide IP addresses by using proxy servers. Predators use â€Å"throw- away,† free e-mail accounts such as hush mails (private emails that children set up and hide from their parents) and counter surveillance methods. Offenders use pre-paid credit cards to hide any online transactions. They also steal IP addresses of business to avoid detection.These measures that offenders are taking, is making it hard for law enforcement to track them down (NSCEPI, 2010). Law enforcement officers are posing as minors online and assuming different gender to catch online predators (Mitchell, 2005). There is also the media, like the television show â€Å"To Catch a Predator,† to catch and arrest some of these predators. Cyber Tip-lines have been formed so that if parents see anything that is inappropriate they can report it to law enforcement. The FBI, Homeland Security, and other agencies have put together different types of operations to protect kids from online predators (NSCEPI, 2010).Law enforcement officers are collecting and preserving all evidence of grooming, such as pornography, Web cameras, and other electronic equipment to bring down these predators (Brown, 2001). Law enforcement agencies across the nation are taking the necessary steps so that evidence can be g iven to the prosecutor and use at trial to show the perpetrator’s motivation (Brown, 2001). Parents should talk to their kids about the dangers of online predators. They should become computer literate and learn the lingo that children use online, PLS (parents looking over my shoulder), FTF (lets meet face to face), and other abbreviations.Parents should put parental software on computer to monitor sites and keep kids off unsafe sites (Dombrowski, 2007). Home computers should be kept in a family room or kitchen so that parents can monitor and see exactly what sites the children are on. Parents should also discourage their kids from going into chat rooms, especially, private chat rooms with strangers. They should always make sure they know who all of their children’s friends are on the internet (Dombrowski, 2007). When a parent notices inappropriate material on their computer they should notify law enforcement immediately.Parents should use all these measures plus becom e familiar with the internet and the language their kids use on the computer to protect them from online predators. I have chosen to get my Bachelor’s degree in Criminal Justice with an emphasis in Cyber-crimes to protect kids from online predators. In the Cyber-crime field I will be able to protect kids from online predators and educate parents and kids of the online dangers that lurk in cyberspace. Online predators are trying to manipulate and prey on children that are going through something in their home life.Predators are getting smarter and wiser when it comes to lurking and preying on children through the internet. They are taking many precautionary measures to protect their identity from our kids and law enforcement. The FBI, Homeland Security, and other agencies have put together task forces to stop online predators. Law enforcement have partnered with the television show â€Å"To Catch a Predator† to stop online predators. Most of the predators that are arres ted on this show are men between the ages of 20 to 55 years of age. Law enforcement and prosecutors are doing everything they can to put these criminals behind bars.Parents should take the necessary steps to protect their children from these types of predators. Parents need not turn a blind eye and think that their child will not become prey to predators while online. They need to get computer literate and learn the lingo that their children are using while they are on the internet. Parents need to educate their kids about online dangers and keep their computers in areas where traffic is heavy flowing. They also need to get the proper software on their computers to cut down the risk of predators getting to their children.In summary, parents and law enforcement officials need to work together to educate themselves and kids about the dangers of online predators because online predators are doing whatever it takes to manipulate and prey on children. They are also doing whatever it take s to protect them from being identified and prosecuted. References Berson, I. (2003). Grooming Cyber victims: â€Å"The Psychological Effects of Online Exploitation for Youth† Journal of School Violence 2, no. 1(2003): 9-18 retrieved from: http://www. cs. auckland. ac. nzl~john/NetSafe/IBerson. df Brown, Duncan. â€Å"Developing Strategies for Collecting and Presenting Grooming Evidence in a High Tech World† Update (National Center for Prosecution of Child Abuse), 2001, 1. http://www. ndaa. org/publications/newsletters/update_volume_14_number11_2001html Dombrowski, S. C. , Gischlar, K. L. , and Durst, T. â€Å"Safeguarding Young People from Cyber Pornography and Cyber Sexual Predation: A Major Dilemma of the Internet† Child Abuse Review 16, no. 3 (2007): 153-70 https://www. ncjrs. gov/App/Publications/abstract. aspx? ID=240947 Mitchell, K. J. , Wolak, J. , and Finkelhor, D. Police Posing as Juveniles Online to Catch Sex Offenders: Is It Working? † Sexual A buse: A Journal Research and Treatment 17, no. 3 (July 2005): 241-67 retrieved from: http://www. unh. edu/ccrc/pdf/CV82. pdf. National Strategy for Child Exploitation Prevention and Interdiction: A Report to Congress August 2010 http://www. justice. gov/psc/docs/natstrategyreport. pdf Wolak, J. , Finkelhor, D. , and Mitchell, K. J. â€Å"Internet-Initiate Sex Crimes against Minors: Implications for Prevention Based on Findings from a National Study. † Journal of Adolescent Health 35, no. 5 (2004):11-20

The US Criminal Justice System Racial Profiling Free Essay Example, 1500 words

This study showed that the Hispanic and Black individuals were more at the risk of being violently treated. More black Americans admitted to being guilty of crimes they did not commit. From this information, it is crystal clear that racial profiling is very prevalent at early stages of the criminal judicial system. Moreover, the same is prevalent on the trial process. This is due to the fact that the public prosecutor has the right to deny a case from going to trial and hence end the prosecution process. However, the discretion has been vastly practiced on the basis of racism. The public prosecutors tend to favor the white Americans and in most of the cases, a decision is made on the foundation that the seriousness of the case is wanting and not enough to warrant a trial. This, therefore, stipulates that most of the crimes are committed by the minority groups, the Blacks and Hispanics. The sentencing process is another important aspect that is abused by the criminal justice system b ecause racial discrimination is evident in the process. However, even though the legal procedures established and enforced by the police department to make sure that the punishment is given reflects the offense committed, there exists a substantial amount of leniency applicable to the sentence that is to be given. We will write a custom essay sample on The US Criminal Justice System: Racial Profiling or any topic specifically for you Only $17.96 $11.86/pageorder now The state of New York criminal justice division carried out a study on the verdicts given. It revealed that the Whites were given shorter sentences for similar crimes committed in respect to the crime circumstances. On the other hand, the study portrayed that only one-third of the black minorities received shorter sentences for similar crimes as compared to the whites. Therefore, the study concluded that the black people were sentenced to imprisonment more as compared to the whites who committed similar crimes. The investigation of why the minority races are discriminated against in the criminal justice is significant. This is because there exist social attributes which are believed to be the cause of criminal activities.